alternatives to medical model - cognitive

• cognitive explanation

  Believes that faulty cognitive processes can explain mental health - the way in which they perceive and think about situations causes difficulty rather than situations themselves
• cognitive explanation more info

  *Depressed people tend to have irrational cognition and distorted thoughts and judgements which warp their emotions and behaviour, thus causing the depression (cognitive distortion)
• cognitive distortions


  aka irrational thinking

  an individual forms an inaccurate perception of reality that may be highly negative/disturbed. These occur automatically and are not deliberate or controlled
• beck's theory of mental health

  *Cognitive theory of emotional disorders was outlined by Beck & later his student Burns - they recognised that while adverse events happen in everybody's lives, in some individuals specific distortions of thought can lead to negative emotional and behavioural outcomes eg anxiety or depression

  Beck suggested that maladaptive thinking patterns form in childhood as we acquire info about particular aspects of the world - schema development.Different disorders are characterised by different schemas eg depression involves a triad of negative schemas: Early experience forms dysfunctional beliefs which may then be triggered by adverse life incidents (eg death of a loved one), which activate the underlying assumptions. From then on, incoming information is processed with a negative bia, resulting in all the emotional, cognitive and behavioural symptoms of depression. This theory has also been applied to anxiety disorders. *REMEMBER: although difficult early experiences and dysfunctional beliefs may lead to the development of the negative cognitive triad, this doesn't mean the person will develop a mental disorder- a trauma/serious life incident is also required.

  *Beck and other cognitive theorists believed that the nature of schema formation & info processing could be changed via therapeutic techniques
• 4 main cognitive distortions

  over-generalisation, filtering, catastrophisation, dichotomous reasoning
• over-generalisation


  viewing one unfortunate event as part of a never-ending defeat or struggle: 'everything always goes wrong for me
• filtering


  giving greater consideration and focus to negative aspects, while ignoring/downplaying positive ones: 'it doesn't matter that I passed the test because I got that one silly question wrong and let myself down
• catastrophisation


  making a mountain out of a molehill - feeling that a situation/outcome is/will be far worse than is actually is/turns out to be: 'I got the customer's order wrong; I'm bound to get fired now
• dichotomous reasoning


  all-or-nothing thinking, the world is viewed as black or white: 'he's perfect, nothing ever goes wrong in his life - he's so good at everything
• cognitive treatments

  CBT - collaborative behavioural therapy
• CBT

  Now the most commonly used form of psychological therapy.Usually takes place once a week/fortnight for 5-20 sessions. *Involves helping patients identify irrational and unhelpful thoughts and trying to change them.

  *Involves showing patients the links between their thinking, behaviour and emotions eg through drawing diagrams.

  *The rationale for CBT is that our thoughts affect our feelings and behaviour, so by changing our thoughts we can make ourselves feel better.

  *Some forms of CBT focus on directly encouraging changes to behaviour.

  *Aims of CBT in treating depression (according to BABCP)

  1. Re-establish previous levels of activity

  2. Re-establish a social life

  3. Challenge patterns of negative thinking

  4. Learn to spot the early signs of recurring depression

  *Therapy is collaborative - therapist and patient will agree on what the patient wants to change. Therapist may ask patient to express their negative beliefs, then therapist would respond with a vigorous argument to convince patient otherwise. Therapist may also combine behaviour activation with reality testing (encouraging patient to re=engage in activities they would normally enjoy, keeping track of what they enjoyed in a diary) - can be used as evidence to challenge patient when they next say they won't enjoy something.