treating depression

• Cognitive behaviour therapy (CBT) is the most common treatment for depression, blending cognitive and behavioural approaches. Initially, it involves a collaborative assessment between client and therapist to pinpoint problems and set therapy goals. Identifying negative or irrational thoughts is crucial, followed by challenging and replacing them with more constructive thinking patterns.
• Based on Beck's cognitive theory, cognitive therapy targets automatic negative thoughts, aiming to challenge and test their validity. Clients are encouraged to engage in reality-testing exercises, like recording positive experiences, to counteract pessimistic beliefs. Rational emotive behaviour therapy (REBT) expands on this with an ABCDE model, adding dispute and effect elements. REBT therapists vigorously challenge irrational beliefs, employing empirical and logical arguments to alter thought patterns.
• Additionally, behavioural activation addresses depression by combating avoidance and isolation tendencies through gradually increasing engagement in mood-enhancing activities, such as exercise or socialising. Therapists reinforce such behaviours to promote symptom alleviation and improved well-being.
• Point: well-supported effectiveness in treating depression.

  Evidence: March (2007) compared CBT with antidepressants and a combination of both treatments in 327 depressed adolescents after 36 weeks, finding significant improvement in 81% of the CBT group, 81% of the antidepressant group, and 86% of the combination group.

  Explain: These findings indicate that CBT is equally effective alone and even more so when combined with antidepressants. 

  Link: Therefore, this suggests that CBT's effectiveness makes it a primary treatment option for depression in public health care systems like the NHS.
• Point: A limitation of CBT for depression is its ineffectiveness for severe cases and individuals with learning disabilities.

  Evidence: Sturmey (2005) suggests that severe depression can hinder clients' ability to engage with the cognitive aspects of CBT.

  Explain: Similarly, complex rational thinking involved in CBT may not be suitable for those with learning disabilities.

  Link: Thus, CBT's applicability is limited to a specific subset of individuals with depression.
• Point: However, more recent evidence challenges the notion that CBT is ineffective for severe depression and clients with learning disabilities.

  Evidence: Lewis and Lewis (2016) found CBT to be as effective as antidepressants and behavioural therapies for severe depression

  Explain: Other research suggests CBT's effectiveness for individuals with learning disabilities, if used appropriately.

  Link: Therefore, this indicates that CBT may be suitable for a wider range of individuals than previously believed.
• Point: A further limitation of CBT for depression is its high relapse rates.

  Evidence: Shehzad Ali (2017) found that 42% of clients relapsed within six months and 53% within a year following a course of CBT.

  Explain: This raises concerns regarding the long-term effectiveness of CBT in sustaining symptom improvement.

  Link: Consequently, CBT may require periodic repetition to maintain its benefits.