The Cognitive Approach to Treating Depression

• CBT aims to identify and challenge irrational thoughts, replacing them with more productive behaviours, and thus treating depression.
• BECK'S CBT:

  1. Identifying the patient's thoughts and challenging them as irrational
  2. Can be led by the cognitive triad, faulty information processing and negative self-schemas
  3. Aims for patient to do reality testing
  4. "Client-as-scientist" where they record events which can be used as counter evidence in therapy sessions, thereby proving the patient's beliefs as irrational
• ELLIS' REBT:

  1. Identify the patient’s thoughts and challenge them as irrational, leading to a vigorous argument
  2. This may be a logical argument (i.e. the belief doesn’t follow on logically from the facts) or an empirical argument (there is no evidence to support the irrational belief).
  3. Aims to change the irrational belief and to break the link between negative life events and depression
  4. Through behavioural activation, patients are encouraged to engage in enjoyable activities, to provide further counter-evidence for their irrational beliefs.
• STRENGTH OF CBT:

  Supporting research evidence

  • March followed a group of 327 adolescents with a main diagnosis of depression.
  • After 36 weeks - 81%, 81% and 86% were the respective improvement rates for each of the three experimental conditions (CBT, antidepressants, CBT+ antidepressants).
• March's research results is compelling evidence for the idea that antidepressants are effective in treating depression and are based on accurate biological explanations of depression.
• WEAKNESS OF CBT:

  Not applicable for all cases

  • March's research showed CBT + antidepressants was most effective
  • Those with severe depression may not be able to attend all CBT sessions and may feel hopeless
• 2. WEAKNESS OF CBT/REBT

  Focuses on the present

  • It's assumed that the patient’s current circumstances are responsible for their depression. But a considerable number of patients may be depressed due to previous events
  • As CBT therapists are unwilling to ‘dwell on the past’, patients may become frustrated that they have such little input or say into how their therapy is brought about.