Depression - Explaining and Treating

• Beck's Negative Triad


  Beck proposed that depression is characterized by a negative triad of thoughts that includes a pessimistic view of oneself, the world, and the future
• Self-Schemas


  • Negative views about oneself (e.g., feeling worthless or inadequate)
• World Schemas

  • Viewing the world as hostile or unrewarding
• Future Schemas

  • Expecting future failure or hardship
• (Beck) These negative cognitive schemas lead to cognitive distortions such as overgeneralization, where a person might view a single negative event as a never-ending pattern of defeat
• Ellis' ABC Model

  • Activating Event (A): An external event that triggers negative automatic thoughts
  • Beliefs (B): The interpretation of the event, which can be rational or irrational
  • Consequences (C): Emotional and behavioral responses that follow based on the beliefs
• Ellis's ABC:

  Ellis emphasized that irrational beliefs lead to emotional distress and that changing these beliefs through cognitive restructuring can alleviate symptoms of depression
• Cognitive Behavioral Therapy (CBT)


  Patients are taught to identify and challenge their negative thoughts and beliefs. The therapy involves practical self-help strategies and focuses on changing current thoughts and behaviors.
• Rational Emotive Behavior Therapy (REBT)


  Developed by Albert Ellis, REBT helps patients identify irrational beliefs and replace them with more rational ones, thereby reducing emotional distress.
• Differences between CBT and REBT

  REBT is more direct in challenging irrational beliefs and often focuses more on philosophical changes in attitudes towards life's challenges
• Ellis: '"There are three musts that hold us back: I must do well. You must treat me well. And the world must be easy."'
• Mustabatory thinking


  The consequence of not accepting we don't live in a perfect world. The fact that we fail to achieve unrealistic goals, other people don't behave the way we want them to, or an unexpected event happens and ruins our plans leads to disappointment
• (CBT) Patient as a scientist

  The patient generates and tests hypotheses about the validity of their irrational thoughts; when they realise their thoughts don't match reality, this will change their schemas, and the irrational thoughts can be discarded
• CBT Thought catching

  Identifying irrational thoughts coming from the negative triad of schemas
• CBT Homework tasks

  1. Keeping a diary to record negative thoughts and identify situations that cause negative thinking

  2. Behavioural activation: Taking part in activities that the sufferer used to enjoy (e.g. sports, travelling or socialising)
• REBT


  Rational emotive behaviour therapy
• ABC model


  1. A - Activating event

  2. B - Beliefs

  3. C - Consequences
• D


  Dispute - the therapist confronting the client's irrational beliefs
• E


  Effect - reduction of irrational thoughts (restructured beliefs B) leading to better consequences (C) in the future
• Dispute


  1. Empirical arguments challenge the client to provide evidence for their irrational beliefs

  2. Logical arguments attempt to show that the beliefs don't make sense
• (REBT) Shame attacking exercises

  • The client performs a behaviour they fear doing in front of others
  • Shows the client they can act against their emotions and cope with an unpleasant experience
  • Shows the client they can survive other people's disapproval
  • Most people don't notice or care about our actions