cognitive approach to treating depression

• Cognitive approach


  Both Beck's CBT and Ellis's REBT attempt to change negative schemas and challenge irrational thoughts through cognitive restructuring.
• Beck's CBT


  A 'talking therapy' based on the assumption that the way people feel and behave is largely a product of the way they think.
• Beck's CBT - patient as a scientist


  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.
• Beck's CBT - Thought catching


  Identifying irrational thoughts coming from the negative triad of schemas.
• Beck's CBT - Homework tasks


  Include keeping a diary, which is used to record negative thoughts and identify situations that cause negative thinking.
• Beck's CBT - Behavioural activation


  Taking part in activities that the sufferer used to enjoy.
• Ellis's REBT


  Development of the ABC model, adding D for dispute and E for effect.

  Dispute: the therapist confronting the client to provide evidence for their irrational beliefs, while logical arguments attempt to show that the beliefs don't make sense.

  Effect: reduction of irrational thoughts (restructured beliefs B) leading to better consequences (C) in the future.
• Ellis's REBT - Shame attacking exercises


  The client to perform a behaviour they fear doing in front of others. This shows the client they can act against their emotions and cope with an unpleasant experience, and they can survive other people's disapproval. And actually, most people don't notice or care about others.
• Difference between CBT and REBT

  In Beck's CBT therapy, the client is helped to figure out the irrationality of their thoughts themselves by acting as a scientist. In Ellis's REBT, the therapist explains the irrationality of the thoughts directly to the patient through disputation.
• + Supporting evidence for REBT and CBT


  E - Ellis claimed a 90% success rate for REBT, taking an average of 27 sessions to complete the treatment.

  E - This shows that CBT and REBT is extremely effective in treating depression and is reliable, therefore.

  L - However, Ellis recognised that the therapy was not always effective as some clients do not put their revised beliefs into action.
• / Individual differences


  E - CBT may be more suitable for some individuals than others. Eikin et al: CBT appears to be less suitable for people who have high levels of irrational beliefs that are both rigid and resistant to change.

  E - This means that CBT cannot apply to everyone.

  L - Therefore, this reduces the effectiveness of the therapy.
• + Client involvement


  E - The client is actively involved in their recovery. Clients complete homework tasks that generalise learning from CBT sessions into everyday life. It also fosters the independent practice of skills acquired during treatments.

  E - Clients may be more motivated to improve their mental health if they are actively involved.

  L - Therefore, this also improves the economy since mental health is improved.
• / Alternative treatments


  E - Other treatments may be more suitable and may be easier. Antidepressants (SSRIs) and drug therapies require less effort on the part of the client.

  E - Distressed clients may not be able to deal with the demands of CBT. Drug therapies could, therefore, enable them to cope better.

  L - Therefore, it suggests that CBT alone is not an effective treatment for depression and instead should be paired with drug therapies.