Cognitive approach to depression

• CBT is the most commonly used psychological treatment for depression, as well as other mental health problems
• CBT is used for treating mental disorders based on both behavioural and cognitive techniques
• The therapist aims to make the client aware of the relationship between thought, emotion and actions
• CBT can help people to change how they think (cognitive) and what they do (behavioural). These changes can make a person feel better
• Beck's CBT

  • identify automatic thoughts on the negative triad
  • challenges these thoughts
  • helps clients test the reality of the negative triad- hypothesis testing
  • homework is set
• Process of CBT

  1. "thought catching"- clarify the patient's irrational thoughts
  2. identify goals
  3. identify negative and irrational thoughts needing to be challenged
  4. set homework, patients act "as a scientist"
  5. therapist confronts client with evidence, proving irrational thoughts wrong
• Ellis's REBT

  • extends ABC model
  • D= dispute
  • E= effect
  • identify and dispute irrational thoughts
  • change irrational belief and break line between negative life events and depression
• 2 methods of disputing

  • empirical- is there evidence to support the negative belief
  • Logical- do the negative thoughts follow facts
• the ABCDE model

  • activating event
  • beliefs about the event
  • emotional consequences
  • disputations to challenge irrational beliefs
  • effective new beliefs replace the irrational ones
• Behavioural activation

  • individual avoid difficult situations
  • isolation worsens symptoms
  • decrease avoidance and isolation, increase engagement in activities that improve mood
• LIMITATIONS of cognitive approach to treating depression

  • relapse rates- Ali (2017), 42% of clients relapsed within 6 months, 53% in a year
  • not effective in severe cases- Keller et al (2000) suggested CBT should be used later, drugs first
• STRENGTHS of cognitive approach treating depression

  • focuses on the cause- challenges irrational thoughts which cause depression
  • effectiveness- March et al (2007) found CBT had an 81% improvement after 36 weeks, 81% antidepressants, 86% for both