Cognitive explanation&treatment for depression

• Cognitive treatments for depression​:

  ​

  Cognitive Behavioural Therapy​

  (Beck)

  Rational Emotive Behaviour Therapy​

  (Ellis)
• Cognitive Behavioural Therapy:

  • CBT is the most commonly used psychological treatment for depression, as well as other mental health problems
  • Based on both behavioural and cognitive techniques​
  • The therapist aims to make the client aware of the relationship between thought, emotion and actions​
• Beck’s CBT (usually lasts 6-8 sessions, each 30-60mins):

  Challenges automatic thoughts ​about the world, the self and the future​ (cognitive triad)
• Homework in Beck’s CBT:

  The patient records positive experiences ​

  to use in therapy to demonstrate reality and CHALLENGE negative thoughts. ​

  • Clients are often asked to complete this between therapy sessions.​
  • ‘Patient as scientist’ - when the patient records when they have enjoyed an event or when people were nice to them. ​
• Unconditional positive regard​:

  • Ellis - it is important in successful therapy to convince the client of their value as a human being. ​
  • The therapist needs to provide respect and appreciation regardless of what the client does and says.
• Ellis’ Rational Emotive Behaviour Therapy (REBT)​:

  A - an activating event 

  ​B - beliefs(rational or irrational, functional or dysfunctional)​

  C - consequences

  D - dispute (challenge the thoughts)​

  E - effect (see a more beneficial effect on thought and behaviour)​

  ​F - feeling (new feelings that are produced)​
• Central technique of REBT is to identify and dispute the patient’s irrational thoughts and to challenges them.
• • Ellis (1962) argues that irrational thoughts are the main cause of all types of emotional distress and behaviour disorders.​
  • Ellis believed that irrational beliefs make impossible demands on the individual, leading to anxiety, failure and psychological difficulty​.
• Implications for the economy:

  • i.e. how knowledge of psychology is of benefit to employers​

  ​

  • Anything to do with treatment of mental disorders and people’s ability to work and contribute as effective members of society would be relevant -  such as, finding an effective treatment (for any disorder) would reduce the number of days people have off work sick so improving productivity 
• AO3:

  • One strength of CBT comes from research evidence which demonstrates its effectiveness in treating depression.​
  • Ellis claimed a 90% success rate taking an average of 27 session to complete the treatment.​
  • However, it was recognised that it is not always effective. May be because clients didn't do their homework and put revised beliefs into action.​
• Some patients really want to explore their past:

  One of the basic principles of CBT is that the focus in therapy is on the

  present and future, not the patient's past. This is in contrast to some

  other forms of psychological therapy. Some patients are aware of the

  link between their childhood experiences and current depression and

  want to talk about their experiences. They can find this 'present-focus'

  very frustrating.
• It is effective

  Has large evidence!

  For example, a study by March et al. (2007) compared the effects of CBT with antidepressant drugs and a combination of the two in 327 adolescents with a main diagnosis of depression. After 36 weeks 81% of the CBT group, 81% of the antidepressants group and 86% of the CBT plus antidepressants group were significantly improved. Thus CBT emerged as just as effective as medication and helpful alongside medication.

  This suggests there is a good case for making CBT the first choice of

  treatment in public health care systems like the National Health Service.