Cognitive approach to treating depression

• Cognitive behaviour therapy - cognitive element

  • Cognitive element: assessment in which client and the therapist work together to clarify the client problems Identify goals and put together a plan to achieve them.
• Cognitive behaviour therapy - behaviour element

  • Involves working to change negative and irrational thoughts and put more effective behaviours into place
• Beck's cognitive therapy

  • identify automatic thoughts about the world, the self and the future so they can be challenged
  • aims to test the reality of their negative beliefs - record instances of positivity
  • The therapist can produce evidence and use is to prove the client's negative thoughts are incorrect
• Ellis's rational emotive behaviour therapy

  ABCDE - identify and dispute

  D - dispute irrational thoughts

  E- effect

  • client talks about how unlucky they are - therapist identifies this as utopianism and challenge irrational beliefs
  • vigorous argument to change belief
  • empirical argument - dispute whether there is actual evidence to support negative belief
  • logical argument - dispute whether the negative thought logically follows from the facts
• Ellis's Emperical argument


  Dispute whether there is actual evidence to support the negative belief
• Ellis's Logical argument


  Dispute whether the negative thought logically follows from the facts
• Behavioural activation

  • work with depressed individuals to gradually decrease their avoidance and isolation
  • increase their engagement in good activities e.g exercising
• AO3 CBT - evidence for effectiveness

  March - compared CBT to antidepressant drug when treating 327 depressed adolescents

  • 36 weeks - 81% CBT, 81% antidepressants, 86% CBT+antidepressants improvement
  • CBT effective on its own and even more with antidepressants
  • 6-12 sessions so it is cost-effective
• AO3 CBT - lack suitability for severe cases and clients with learning disabilities

  • clients can't motivate themselves to engage with the cognitive work of CBT - cant pay attention
  • complex rational thinking involved so clients with learning disabilities may be confused
  • not appropriate for a specific range
• AO3 CBT - high relapse rates

  • concerns over how long the benefits last
  • Ali - assessed depression in 439 clients every month for 12 months
  • 42% relapsed into depression within 6 months
  • 53% relapsed within a year
  • may need to repeated periodically