Cognitive approach to depression

• Ellis (1962) ABC model


  Mental health is determined by the rationality of your thoughts

  A - Activating event (What causes the irrational thoughts)

  B - Beliefs

  C - Consequences (When the activating event causes beliefs there are emotional and behavioural concequences)
• EVALUATION - Negative triad - Strength

  Supporting research

  Cohen et al (2019)

  Tracked the development of 470 adolescents and measured cognitive vulnerability and they found cognitive vulnerability predicted later depression
• EVALUATION - Negative triad - Strength

  Real world application

  • Used to screen for depression to predict later depression
  • Also used in CBT
• EVALUATION - Ellis ABC model - strength

  Real world application

  • Ellis's approach is called rational emotive behavior therapy (REBT)
  • Arguing with the depressed person can change the irrational thoughts
  • David et al (2018) showed evidence it can relieve the symptoms
• EVALUATION - Ellis ABC model - limitation

  It only explains reactive depression and not endogenous depression
• Reactive depression

  Depression in response to a life event
• Endogenous depression

  A type of depression caused by internal stressors and has no links to life events
• Cognitive behaviour therapy

  A type of cognitive and behavioural therapy to combat depression

  1. They work together to identify the clients problems
  2. They then set goals
  3. A task involves where irrational thoughts are
  4. CBT then works to change negative and irrational thoughts by putting more effective behaviours into place
• Becks cognitive therapy


  1. Identify automatic negative thoughts - the negative triad
  2. Challenge the thoughts
  3. Test the reality of their negative beliefs

  Homework might be to make note of the positive things that happened that day e.g when they enjoyed an event
• Ellis's Rational Emotive Behaviour therapy

  • Extends the ABC with a D (dispute) and E (effect)
  • The client would explain negative belief and the therapist would dispute that, turning into an argument
  • The aim is to break the link between negative life events and depression
• Behavioural activation


  When people become depressed they avoid situations and become isolated. Behavioural activation has the goal of getting the individual back out there and lessen the avoidance and isolation
• EVALUATION - CBT - Strength

  Supporting evidence

  March et al (2007)

  • compared CBT to antidepressant drug and a combination of both for 330 depressed people

  After 36 weeks

  81% of CBT group

  81% of antidepressant group

  86% of CBT and Drug group
• EVALUATION - CBT - strength

  Cost effective, usually requires 6-12 sessions and seen as first choice treatment
• EVALUATION - CBT - limitation

  Lack of effectiveness for severe cases and those with learning disabilities due to lack of motivation to engage
• EVALUATION - CBT - Limitation

  Relapse rates are high

  Ali et al (2017)

  Assessed 440 clients every month for 12 months following CBT

  42% relapsed in 6 months

  52% relapsed in a year