Treatment

• What is Cognitive Behavioural Therapy?

  • Method for treating mental disorders based on both cognitive and behavioural technique
  • Assess the patient and work together to clarify the patient's problems
  • Identify where the negative or irrational thoughts are and put more effective behaviours in place
• What is Beck's Cognitive Therapy?

  • To identify automatic thoughts about the world, the self and the future (negative triad) and once identified these thoughts must be challenged
  • Cognitive therapy aims to help clients test the reality of their negative beliefs
  • They might be told to record when they enjoyed an event then in future sessions if clients say there is no point in going to events the therapist has evidence and can prove that the client’s statements are incorrect
• What is Ellis's Rational Emotive Behavioural Therapy?

  • Extends the ABC model to an ABCDE model – D stands for dispute and E for effect
  • Identify and challenge irrational thoughts to break the link between negative life events and depression
  • A client might talk about how unlucky they have been or how unfair things seem and an REBT therapist would identify this as utopianism and challenge this as an irrational belief and this would involve a vigorous argument
  • Ellis identified different methods of disputing:
  • Logical , empirical and pragmatic
• What is logical disputing?


  Involves disputing whether the negative thought logically follows from the facts
• What is empirical disputing?


  Disputing whether there is actual evidence to support the negative belief
• What is pragmatic disputing?


  Checking if the irrational belief is useful and practical in believing
• What is Behavioural Activation?


  Patients are set tasks that encourage them to be more active and engage in more enjoyable activities
• What is unconditional positive regard?

  • Ellis realises clients need to realise their importance
  • If they felt worthless they were less likely to change their beliefs
  • If the therapist provides respect and appreciation they may be able to change their beliefs
• CBT AO3: Evidence for effectiveness

  • One study 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
  • CBT is usually therapy requiring 6 to 12 sessions so it is also cost-effective.
  • CBT is widely seen as the first choice of treatment in public health care systems such as the NHS
• CBT AO3: Not suitable for everyone

  • Lack of effectiveness for severe cases and for clients with learning disabilities
  • 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
  • The complex rational thinking involved in CBT makes it unsuitable for treating depression in clients with learning disabilities
  • CBT may only be appropriate for a specific range of people with depression
• CBT AO3: Relapse rates

  • CBT is quite effective in tackling the symptoms of depression but there is concerns over how long the benefits last
  • Recent studies suggest that long-term outcomes are not as good as had been assumed
  • In one study depression was assessed 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.
  • CBT may need to be repeated periodically
• CBT AO3: No side effects

  • CBT can be seen to be a good alternative to someone who does not enjoy taking drugs or does not want to have any side effects as a result of drugs
  • There will be no issue with having to find the right dose and other things to do with medication