cognitive treatments for depression

• Cognitive behavioural therapy (CBT)

  Cognitive: The client and therapist work together to review the client's issues.

  Behavioural: Challenges the negative, irrational thoughts by replacing them with effective behaviour
• Cognitive behavioural therapy

  • The most important aspect is identifying any irrational thoughts that have to be overcome
• Beck's cognitive therapy

  The therapy is based around identifying and challenging the irrational thoughts (faulty cognitions about the world, future and self - negative triad)
• Beck's cognitive therapy

  1. Assessment

  2. Formulation and Goals

  3. Homework and monitoring

  4. Treatment completion
• Ellis Rational Emotive Behaviour Therapy (REBT)

  Turns the ABC model to the ABCDE model (A-activating event, B-beliefs, C-consequences, D-dispute, E-effect). The main aim is to challenge irrational thoughts, doing so breaks the cycle of adverse life events leading to depression.
• Challenging irrational beliefs in REBT

  • Occurs through rigorous arguments and is the most important part of the process
• Types of arguments used to challenge irrational beliefs in REBT

  • Empirical argument: Reviewing whether there is actual evidence to support the belief
  • Logical argument: Disputing whether the negative belief is concluded logically from facts
  • Pragmatic argument: Argues against the usefulness of the irrational beliefs
• Behavioural activation

  A separate section of CBT that aims to decrease avoidance and isolation behaviours and increase and reinforce engagement in activities that have been shown to elevate mood
• evidence of effectiveness

  March et al. found CBT and antidepressants each 81% effective, and 86% effective when combined. Thus, the NHS often chooses CBT as the first treatment option.
• suitability for diverse clients

  CBT is not effective for those with severe depression or learning disabilities. Sturmey argued that psychotherapy, including CBT, is unsuitable for these groups due to the learning difficulties and lack of motivation.
• counterpoint

  Lewis and Lewis and Taylor et al. found that CBT can effectively treat severe depression and learning disabilities and may be suitable for a more diverse groups of clients.
• relapse rates

  Ali et al. found high relapse rates in CBT: 42% within 6 months and 53% within a year. This suggests the benefits may not be long-lasting, possibly requiring repeated treatment.
• client preference

  Yrondi et al. found CBT to be the least preferred therapy among clients, as preferences vary based on motivations—some prioritise exploring trauma while others seek quick symptom relief. This suggests a need for more prevalent alternative therapies.