Depression - treatments

• CBT


  The 2 techniques of Ellis' REBT and Beck's cognitive therapy intertwined are considered the roots of modern cognitive behavioural therapy (CBT).

  
  

  CBT to treat patients by identifying and challenging patients' negative and irrational thoughts and beliefs, encouraging them to find a more constructive, rational and positive way of thinking.
• Components of CBT

  Cognitive - to identify and challenge negative and irrational thoughts and beliefs

  Behavioural - encourages patients to test beliefs through behavioral experiments and homework - the idea is that the patient identifies their own irrational/negative beliefs and proves them wrong
• CT

  Beck's negative triad -

  Beck's cognitive therapy

  
  

  - patient and therapist together clarify the patients' problems

  - identity negative thoughts about world, self, future (negative triad)

  - these thoughts are challenged, aims to help patients test the validity of their negative beliefs - discussing evidence for and against them.

  - patient will be set homework, to challenge and test their negative beliefs
• REBT

  Ellis' ABCDE model -

  Ellis' rational emotive behavioural therapy

  
  

  Ellis believed that people hold irrational assumptions/beliefs that, if addressed, could alleviate their distressing responses to negative events. Like Beck, the idea is to challenge irrational thoughts, but with Ellis' model, this is achieved through 'disputation'

  
  

  Disputation of beliefs and irrational thoughts

  Effect - healthier beliefs and most positive thinking processes

  
  

  - once identified, the therapist will dispute the patient's irrational beliefs, replacing them with more positive and rational beliefs
• 2 types of dispute - REBT

  1) logical dispute - therapist questions logic of a person's thoughts

  
  

  2) empirical dispute - asks the patient to provide evidence for their beliefs
• A03 - research support (E)


  March et al

  compared effects of CBT, anti-depressants and a combination of both when treating 327 patients with a diagnosis of depression.

  
  

  results =

  after 36 weeks, individually both CBT and anti-depressants had 81% success and combined they had 86% success.
• A03 - research support (E)

  This shows that CBT is as effective and can be offered as a less invasive alternative to medication. It also suggests that a combination of both treatments may be the most effective.
• A03 - research support (L)

  Increases the effectiveness and support for cognitive treatments such as CBT for depression.
• A03 - adv of this study

  large sample size

  can draw more reliable conclusions and make more accurate generalisations

  strengthens the population validity and support for the cognitive approach
• A03 - may not be appropriate for all cases (P)

  One criticism of CBT is that it might not be appropriate for all cases of depression.
• A03 - may not be appropriate for all cases (E)

  Patients with severe depression may fail to motivate themselves to engage with the cognitive work involved - or even attend the sessions.

  
  

  Even if they do attend the sessions, they may be unable to focus attention - inhibits the effectiveness of the treatment.
• A03 - may not be appropriate for all cases (L)

  This weakens the appropriateness of CBT - can't be used as a sole treatment for all cases of depression.
• A03 - overemphasis on the role of cognition (P)


  CBT has been been criticised for its overemphasis on the role of cognition.
• A03 - overemphasis on the role of cognition (E)


  For example, psychologists have criticised CBT for not taking into account other factors such as social circumstances which may contribute to a person's depression.
• A03 - overemphasis on the role of cognition (E)


  Eg: a person suffering from domestic violence and abuse doesn't only need to change their negative / irrational beliefs, but in fact needs to change their circumstances first.