COGNITIVE APPROACH TO TREATING DEPRESSION

• Cognitive behavioural therapy (CBT)

  • Most common psychological treatment e.g for depression

  CBT is an example of the cognitive approach to treatment, though it also includes behavioural aspects. 

  1. Cognitive - challenge negative, irrational thoughts 
  2. Behaviour - change behaviour so it is more effective 

  Client and therapist work together.
• BECK - challenge negative thoughts 


  The aim is to identify negative thoughts about the self, the world and the future - the negative triad. 

  These thoughts must be challenged by the client taking an active role in their treatment. 
• The ‘client as scientists’ 


  Clients are encouraged to test the reality of their irrational beliefs. 

  They might be set homework, e.g to record when they enjoyed an event. This is referred to as the ‘client as scientist’.

  In future sessions if client say that no one is nice to them, the therapist can produce this evidence to prove the client’s beliefs are incorrect. 
• ELLIS’S rational emotive behaviour therapy (REBT) 


  REBT extends the ABC model to an ABCDE model:

  1. D for dispute (challenge) irrational beliefs
  2. E for effect
• Challenging irrational thoughts 


  A client might talk about how unlucky they have been or how unfair life is. An REBT therapist would identify this as utopianism and challenge it as irrational.

  1. Empirical argument - disputing whether there is evidence to support the irrational belief.
  2. Logical argument - disputing whether the negative thought actually follows from the facts.
• Behavioural activation 


  As individuals become depressed, they tend to increasingly avoid difficult situations and become isolated, which maintains or worsen symptoms. 

  The goal of behavioural activation, therefore, is to work with depressed individuals to gradually decrease their engagement in activities that have been shown to improve mood, e.g exercise, going out to dinner, etc.