Cognitive Behavioural Therapy in Depression

• Process of CBT

  1. Identification of negative thoughts- 'thought catching' and rational confrontation
  2. Hypothesis testing; patient as 'scientist' data gathering through 'homework', e.g. diary keeping.
  3. Reinforcement of positive thoughts; cognitive restructuring and behaviour activation.
• General rationale of CBT

  Irrational thinking leads to irrational behaviour.

  Cognitive = Behavioural + Emotional

  E.g. Heat = boil + evaporation
• General rationale of CBT

  Respect and appreciation for clients' current situation: when people are sad do not provide them with reasons to 'cheer up'.
• General rationale of CBT

  Helps client to understand the consequences of irrational thinking.
• General rationale of CBT

  Puts the control back in their hands- problem solving.
• General rationale of CBT

  Positive outlook on life- convincing client of their value as a human.
• Irrational thinking

  Defying logic, without proof, doesn't help the person
• Beck's cognitive therapy

  If a therapist is using Beck's cognitive therapy, they will help the patient to identify their negative thoughts in relation to themselves, their world and their future using the triad.
• Ellis's Rational Emotive Behaviour Therapy (REBT)

  Ellis developed his ABC model to include D (dispute) and E (effect/effective). Like Beck, the main idea is to challenge irrational thoughts, however, with Ellis's theory, this is achieved through 'dispute' (argument).
• Step 1 of CBT: Identification of negative thoughts and challenging them

  Logical disputing: Self defeating beliefs are not logical- does thinking this way make sense?

  Empirical disputing: Beliefs may not be constant with reality- where is the proof this is accurate?

  Pragmatic disputing: Emphasise the lack of usefulness of self defeating beliefs- how is this going to help me?
• Step 2 of CBT: Patient as a scientist

  Hypothesis testing and gathering through homework.

  This phase is designed to put new rational beliefs into practice. (E.g. asking people what they think of you)

  The evidence can be used in later sessions/situations (how can you test your own beliefs before it does too far?)
• Step 3 of CBT: Behavioural Activation, reinforcement of positive thoughts, cognitive restructuring


  Client is encouraged to carry out activities that are pleasurable to them.