cognitive approach to treating depression

• CBT identifies and challenges irrational thoughts, replacing them with more productive behaviours. The therapist and client come up with coping strategies to deal iwith irrational thoughts. The therapist works with depressed individuals to gradually decrease their avoidance and isolation, and increase their engagement in activities that have been shown to improve mood like exercising or going out to dinner
• One strength of CBT is that there is evidence of effectiveness. March et al. compared the effects of CBT with antidepressant drugs and a combination of the 2 in 137 depressed adolescents. After 36 weeks 81% of CBT, 81% of antidepressants group and 86% of CBT and antidepressants group were significantly improved. This means there is a good case for making CBT the first choice of treatment in public healthcare systems like the NHS
• One limitation of CBT is its high relapse rates. Few early studies looked at long term effectiveness and recent studies suggest that relapse is common. Ali et al. assessed depression for 12 months following a course of CBT. 42% relapsed within 6 months of ending treatment and 53% within a year. This means that CBT may need to be repeated periodically
• One limitation is suitability for diverse clients. In severe cases depressed clients may not be able to motivate themselves to engage with the cognitive work of CBT. They may not even be able to pay attention in a session. Sturmey suggests that any form of psychotherapy is not suitable for people with learning difficulties. This means that CBT may only be appropriate for a specific range of clients