cognitive treatments - depression

• main cognitive treatment for depression includes CBT
• CBT stands for cognitive behavioural therapy
• CBT aims to identify irrational and negative thoughts which lead to depression - aims to replace the negative thoughts with positives
• CBT encourages patients to test their beliefs through behavioural experiments and homework
• CBT begins with assessment where patient and cognitive therapist work together to clarify patients problems - jointly identify goals for the therapy and put together plan to achieve them
• CBT involves working to change negative and irrational thoughts and put more effective behaviours in place
• CBT is based on

  • becks cognitive theory
  • ellis's ABC model (REBT)
• becks cognitive therapy

  • used to identify negative thoughts in relation to becks negative triad (self, world, future) - once identified - then challenged
  • patient and therapist identify + work together challenging irrational thoughts - discussing evidence for and against - encouraged to test validity (whether thoughts represent reality) of their negative thoughts
  • set homework - record when they enjoyed event of when someone was nice to them
  • 'patient as scientist'
  • in future sessions - homework helps patients to understand that patients statements are incorrect if they think no one likes them
• ellis's rational emotive behavioural therapy (REBT)

  • REBT extends ABC model to ABCDE
  • Dispute - aim of REBT is to challenges and dispute irrational thoughts
  • Effect
• in ellis's REBT - therapist will dispute patients irrational beliefs with aim to replace irrational beliefs with effective beliefs and attitudes

  • different types of dispute - logical dispute (therapist questions logic of thoughts - does the way you think about situation make any sense) + empirical dispute (seeks evidence for persons thoughts - where is evidence that makes this belief true)
• ellis's REBT as treatment for depression

  • having argument (dispute) between patient and therapist - intended effect is to change irrational belief and break link between negative life events and depression
  • patient may be set homework - will be able to identify own irrational beliefs and then prove self wrong
• evaluation points for cognitive treatments for depression

  • Effective CBT (+)
  • success may be due to patient/therapist relationship (-)
  • overemphasis on cognition (-)
  • CBT requires motivation (-)
• CBT is effective (+) as eval point for treatment for depression

  • strength of CBT is that it is found to be effective through research support
  • example - researcher compared effects of CBT with antidepressants - found after 36 weeks
  • 81% of CBT group
  • 81% of antidepressant group
  • 86% of CBT + antidepressant group had improved
  • shows CBT as effective as medication and helpful alongside meds
  • strength of theory is that its shown to be effective treatment for depression
• success may be due to patient/therapist relationship (-)

  • limitation of CBT is success may not be result of actual therapy but instead the relationship between patient + therapist
  • may be down to quality of relationship that determines success rather than technique used - researcher suggested there isnt much difference between the treatments used for depression
  • comparative reviews find small differences which supports idea of having someone to talk to who listens could matter most
  • therefore treatment may not actually be down to therapy but instead it is relationship that improves patients
• overemphasis on cognition (-)

  • limitation of CBT is that it focuses too much on cognition
  • some psychologists criticised CBT as it suggests persons irrational thinking is primary cause of their depression where CBT doesnt take into account additional factors
  • CBT ignores factors/circumstances that could contribute to depression - e.g. person suffering abuse doesnt need to change their beliefs but instead they need to change their circumstances
  • therefore CBT would be ineffective in treating patients (those with depression due to circumstances) until their circumstances have changed
• CBT requires motivation (-)

  • CBT may not be approrpiate for all individuals
  • some cases of depression can be severe that they cant motivate themselves to engage in hard work of CBT - may not be able to pay attention in session
  • if patients arent motivated there is medication which can be issued (antidepressants) which makes them more alert and motivated
  • however this is limitation as CBT cannot be used as sole treatment for all cases - especially those severely depressed