COG - TREATING DEPRESSION

• CBT


  This treatment is most used to treat depression but also treats other mental health conditions such as anxiety, phobias, stress etc. The therapist aims to make patients aware of the relationship between thought, feelings, and actions.
• CBT can help people change the ways they think, mostly negatively and change their behaviour in response to these thoughts. 
• CBT involves five to twenty weekly or fortnightly sessions with a therapist lasting for about 30-60 minutes 
• Beck's cognitive therapy


  Like Becks triad of depression, his therapy aims to challenge negative thoughts about a person's self, future, and world view – provides full information about their perception of themself, their future, and the world. 
• Two stages

  1. Assess the severity of the condition 
  2. Establish a baseline, prior to treatment to monitor improvement. 
• Reality testing 


  Challenging thoughts such as ‘I’m useless and I always fail’ and asked whether this is true or not and whether there has been a situation where this is proven to be false. The client is made aware of their negative views and the irrational ideas are replaced with more optimistic and positive beliefs.
• Ellis' REBT therapy


  Irrational thoughts are the main cause of emotional distress and behavioural disorders – make impossible demands on the individual leading to anxiety, failure, and psychological difficulty. 
• REBT is based on the premise that when we become upset it is not the events that upset but the beliefs about the event that cause us to be depressed, anxious and enraged etc. It challenges the client to prove statements they have expressed and replace them with more reasonable ones. 
• ABCDE model

  A – activating event or adversity 

  B – beliefs about event or adversity 

  C – emotional consequences 

  D – disputations to challenge irrational beliefs 

  E – effective new beliefs replace irrational old beliefs 
• MARCH et al

  Found that CBT was as effective as antidepressants, in treating depression. Researchers examined 327 adolescents with a diagnosis of depression and investigated the effectiveness of CBT, antidepressants and a combination of CBT and antidepressants.  

  After 36 weeks, 81% of the antidepressant group and 81% of the CBT group had significantly improved, demonstrating the effectiveness of CBT as a treatment. 

  However, 86% of the CBT plus antidepressants group had significantly improved, suggesting a combination of the two treatments may be more effective. 
• Strengths

  • Client is actively involved in their recovery - learns to help themselves and use skills in new situations 
  • CBT is not physically invasive 
  • CBT works – particularly when combined with drug treatment (KELLER) 
• Weaknesses

  • Clients can become dependent on their therapist or non-cooperative 
  • CBT is not effective for people with rigid attitudes or resistance to change 
  • Or for people who have high stress levels in response to genuinely difficult life circumstances (depressive realism) 
  • CBT is not a quick fix. A therapist is like a personal trainer that advise and encourages but cannot ‘do’ it for the client.