A03 Cognitive Treatments Of Depression

• It is effective (CBT)

  March et al compared the effects of CBT with antidepressants and combination of 2 in 327 adolescents with main diagnosis of depression
• Findings of March et al study

  After 36 weeks, 81% of CBT groups and Antidepressant groups were significantly improved. CBT emerged just as effective as medication. Makes a good case for making CBT first choice treatment in NHS
• CBT may not work for the most severe cases

  Depression in some patients may be so severe that they cannot motivate themselves to engage with hard cognitive work of CBT. They might not even pay attention to what is happening in a session
• Antidepressants with CBT


  Patients can be treated with antidepressants and commence CBT when they are more alert. CBT can not be the sole treatment for all cases of depressions
• Success may be due to therapist-patient relationships

  Rosenzweig suggested difference between different methods of psychotherapy, such as CBT/systematic desensitisation might be small. It may be the quality of the therapist-patient relationship that determines success.
• Research support for therapist-patient relationships

  Luborsky et al found small difference between CBT/systematic desensitisation in his comparative reviews which supports the view that the opportunity to talk to someone who would listen is what matters
• Some patients really want to explore their past


  CBT focuses on the present and future and not past. Some patients are aware of the link between their childhood experiences and current depression and may want to talk about it. So some people may find CBT frustrating
• Overemphasis on cognition


  McCusker states that CBT may end up minimising the importance of the circumstances in which the patient is living in. CBT can demotivate people to change their situation if used inappropriately. E.g.: person in poverty or suffering abuse