cognitive treatment depression

• CBT evidence from march et al

  One strength of CBT is the large body of evidence supporting its effectiveness for treating depression.

  Many studies show that CBT works. For example, John March et al. (2007) compared CBT to antidepressant drugs and also to a combination of both treatments when treating 327 depressed adolescents. After 36 weeks, 81% of the CBT group, 81% of the antidepressants group and 86% of the CBT plus antidepressants group were significantly improved. So CBT was just as effective when used on its own and more so when used alongside antidepressants. CBT is usually a fairly brief therapy requiring six to 12 sessions so it is also cost-effective. This means that CBT is widely seen as the first choice of treatment in public health care systems such as the National Health Service.
• appropriate for only some

  One limitation of CBT for depression is the lack of effectiveness for severe cases and for clients with learning disabilities.

  In some cases depression can be so severe that clients cannot motivate themselves to engage with the cognitive work of CBT. They may not even be able to pay attention to what is happening in a session. It also seems likely that the complex rational thinking involved in CBT makes it unsuitable for treating depression in clients with learning disabilities. Peter Sturmey (2005) suggests that, in general, any form of psychotherapy (ie. any 'talking' therapy) is not suitable for people with learning disabilities, and this includes CBT.

  This suggests that CBT may only be appropriate for a specific range of people with depression.
• Counter to only appropriate for some

  Although the conventional wisdom has been that CBT is unsuitable for very depressed people and for clients with learning disabilities, there is now some more recent evidence that challenges this. A review by Gemma Lewis and Glyn Lewis (2016) concluded that CBT was as effective as antidepressant drugs and behavioural therapies for severe depression. Another review by John Taylor et al. (2008) concluded that, when used appropriately, CBT is effective for people with learning disabilities.

  This means that CBT may be suitable for a wider range of people than was once thought.
• (deterioration) Relapse rates

  A further limitation of CBT for the treatment of depression is its high relapse rates. Although CBT is quite effective in tackling the symptoms of depression, there are some concerns over how long the benefits last. Relatively few early studies of CBT for depression looked at long-term effectiveness. Some more recent studies suggest that long-term outcomes are not as good as had been assumed. For example in one study, Shehzad Ali et al. (2017) assessed depression in 439 clients every month for 12 months following a course of CBT. 42% of the clients relapsed into depression within six months of ending treatment and 53% relapsed within a year.

  This means that CBT may need to be repeated periodically.