AO3: Cognitive Behavioural Therapy in Depression

• :) Effective

  March compared the improvement rates of 327 adolescents diagnosed with depression in three conditions:

  CBT (81%)- no placebo trial

  Anti-depressant (81%)- placebo trial to test how well it works

  CBT and Anti-depressant (86%)- AD ->CBT is more effective than CBT -> AD because the antidepressants help people to engage in CBT.

  This shows that CBT is equally as effective as drugs so therefore should be used in public health services (like NHS) as it avoids side effects. CBT is not a cure but it provides a cognitive framework to deal with episodes.
• Whitfield and Williams (2003) found that CBT had the strongest research base for effectiveness, but recognised there's a problem in the NHS being able to deliver weekly face-to-face sessions for patients and suggested that this should be addressed by introducing self-help versions of the treatment, like the SPIRIT course, which teaches core cognitive behavioural skills using self-help materials.
• :( Doesn't work in all cases

  Treatment requires a lot of effort from the client which can be especially difficult considering low motivation is associated with depression. Some clients symptoms are so sever that they cannot motivate themselves enough to engage in the treatment. It is easy for the client to quickly become overwhelmed (unethical. However, some of the initial issues can be overcome with antidepressants, therefore cannot be used as a sole treatment. (Link to March).
• :( Overemphasis on cognitions

  CBT minimises the importance of the client's circumstance (poverty, domestic abuse...). CBT could limit the client wanting to change their situation or they could become overly reliant on their therapist.