Cognitive Behavioural Therapy

• CBT aims to identify and change the patient's faulty cognitions. The idea is that the patients learn how to notice negative thoughts when they have them, and then test how accurate they are.
• CBT step 1= The therapist and client identify the clients faulty cognitions (thoughts and beliefs)
• CBT step 2= The therapist tries to help the client see that these cognitions aren't true
• CBT step 3= Together they set goals to think in more positive ways
• CBT step 4= Therapists sometimes encourage clients to keep a diary so they can record and identify situations in which negative thinking occurs so these situations can be tackled
• Challenging irrational thoughts Ellis extended the ABC model to ABCDEF where:
• ellis= D - Disputing irrational thoughts and beliefs
• ellis- E - Effects of disputing and Effective attitude to life
• ellis- F - the new Feelings (emotions) that are produced
• The key idea is that the ‘activating event is not what causes the depression, it is the unhealthy beliefs.
• Therefore REBT focuses on challenging or disputing the irrational beliefs and replacing them with effective rational beliefs.
• Effective disputing changes self-defeating beliefs into more rational beliefs. The client can move on from negatively interpreting everything which in turn helps the client to feel better, and eventually become more self-accepting.
• (-) Individual differences


  CBT appears to be less suitable in situations where high levels of stress in the individual reflect realistic stressors in the person's life that therapy cannot resolve e.g getting evicted. Ellis agreed with this possible lack of success in terms of suitability, and suggested some people simply do not want the direct sort of advice that CBT practitioners tend to dispense. And instead just want a therapist to listen and share their worries without getting involved in the cognitive effort that is associated with recovery.
• (+) CBT suggests that the client is responsible for their disorder


  Which may be beneficial for treatment because it gives the client power to change the way things are rather than them feeling powerless. However, this may lead to the client and therapist overlooking situational factors e.g not considering life events or family problems which may have contributed towards the mental disorder. Therefore, the strength of CBT lies in its focus on the clients mind and recovery, but other (external) aspects of the clients life also need to be considered
• (-) Furthermore, because CBT places responsibility on the client for their problems, in some cases they may begin to feel like he or she is to blame for their problems. This could lead to further negative thought processes and ‘spiralling
• (+/-) Derubeis compared CBT and drug therapy as depression treatments in a placebo-controlled trial.


  Both treatments were more effective than the placebo after 8 weeks. Generally the two therapies were similarly effective, but CBT may have been less effective than drug therapy in cases where therapists lacked experience. He concluded that CBT may only be effective if the therapist is experienced. Patients whose therapists are not may be better off with drug therapy.