Treating depression

• Outline the cognitive treatments for depression?

  The most commonly used psychological treatment used to treat depression are Cognitive Behaviour Therapy (CBT) and rational emotive behavioural therapy (REBT). 

  The cognitive elements of CBT therapy aims to identify the irrational thoughts that lead to depression, and replace them with more positive ones. And the behavioural elements of CBT encourages patients to test their beliefs through behavioural experiments and homework.
• what are the two different types of cognitive treatments for depression?

  There are two different strands of CBT, based on Beck’s theory and Ellis’s ABC model.

  All CBT starts with an initial assessment, in which the patient and therapist identify the patient’s problems. Then the patient and therapist agree on a set of goals, and plan of action to achieve these goals. Both forms of CBT (Beck’s and Ellis’s) then aim to identify the negative and irrational thoughts with a therapist and through homework, however their approaches are slightly different.
• outline becks cognitive treatment for depression?

  Beck's cognitive therapy helps the patient to identify negative thoughts in relation to themselves, their world and their future, using Beck’s negative triad. The patient and therapist will then work together to challenge these irrational thoughts, by discussing evidence for and against them.
• outline Ellis’s cognitive treatment to depression?

  Ellis developed his ABC model to include D (dispute) and E (effect). The therapist will dispute (argue) the patient’s irrational beliefs, to replace them with effective beliefs and attitudes. 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). The idea is that the patient identifies their own irrational beliefs and then proves them wrong. As a result, their beliefs begin to change.
• what are the strengths to cognitive treatments of depression?

  One strength of the cognitive treatments to depression is the supporting research from March et al. (2007). They compared CBT, antidepressants, and a combination of both when treating 327 depressed adolescents, they found that after 3 months, 81% of the CBT group, 81% of the antidepressant group and 86% of the combination group were all significantly improved, showing CBT is as effective as antidepressants and even more so when used in combination with them.
• outline the weaknesses of the cognitive treatments for depression?

  high relapse rates

  hard to motivate patients

  too much emphasis on cognitive factors, ignores other possible influences.

  therapist centred - ethical issues.
• elaborate on high relapse rates as a weakness of cognitive treatments for depression?

  However, there is evidence to suggest that although CBT is a quicker treatment, the relapse rate is high which undermines its effectiveness as it is only a short term treatment. 
• elaborate on inaccessibility as a weakness of cognitive treatments for depression?

  Furthermore some clients who suffer with depression, especially those who experience it worse, can find it hard to motivate themselves and commit to the therapy, and those with learning difficulties can find it difficult to communicate or express themselves with the therapist. This means that CBT is not accessible to everyone suffering from depression and cannot be a fully comprehensive treatment.
• outline the ignorance of other factors as a weakness of cognitive treatments for depression?

  it suggests that a person’s irrational thinking is the primary cause of their depression and therefore ignores other factors or circumstances that might contribute to a person’s depression. For example, a patient who is suffering from domestic violence or abuse, does not need to change their negative/irrational beliefs, but in fact needs to change their circumstances. Therefore, CBT would be ineffective in treating these patients until their circumstances have changed. 
• elaborate on ethical issues around therapist centred therapy as a weakness of cognitive treatments for depression?

  Finally, CBT can be therapist centered, which is an ethical concern as it gives the therapist power and the client can become too dependent on the therapist. This is why drug therapies are sometimes preferred as they require less time and effort than therapy. 
• what are the weaknesses of neural explanations of depression?

  However, results from brain imaging studies are inconsistent and haven’t always replicated, for example, Aylward et al observed no difference between the basal ganglias of those with and withou OCD. Furthermore for twin studies to have effective results we must assume they share an environment which is not always the case.