The Cognitive Approach - TREATING

• what does Beck's CBT and Ellis's REBT aim to do?

  - change negative schemas and challenge irrational thoughts with cognitive restructuring
• patient as a scientist: Beck's CBT


  - 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

  - patient also set homework tasks
• thought catching (Beck's CBT)


  - identifying irrational thoughts coming from the negative triad of schemas (the Self, the World, the Future)
• rational emotive behaviour therapy: Ellis's REBT

  - development of the ABC model, adding D for Dispute and E for Effect
• DISPUTE - Ellis's REBT

  - the therapist confronts the client's irrational beliefs

  - empirical arguments challenge the client to provide evidence for irrational beliefs; logical arguments attempt to show that the beliefs don't make sense
• EFFECT - Ellis's REBT

  - reduction of irrational thoughts (restructured beliefs, B), leading to better consequences (C) in the future
• A03 - March (CBT vs. DT)


  - compared CBT, DT (fluoxetine) or combined treatment

  - at 36 weeks, CBT and DT had an effectiveness of 81%, combined 86%, CBT also had a more significant reduction in suicidal events than DT
• A03 - methodical issues

  - some people with depression are too severely depressed to engage with the demands of CBT;

  - completing homework, challenging irrational thoughts and attending sessions require motivation and commitment