The cognitive approach to treating depression

• CBT: Beck's cognitive therapy

  Identify and challenge negative triad. Helps patients test reality of their negative beliefs. Therapist sets homework- record when they enjoyed an event (therapist can later use as evidence)
• CBT: Ellis's rational emotive behavioural therapy (REBT)

  Extends to ABCDE- Dispute irrational thoughts and Effect of disputing on attitude to life. Vigorous argument intended to break link between negative life events and depression. Different methods of disputing:

  • empirical argument- disputing whether there is evidence to support irrational belief
  • logical argument- disputing whether negative thoughts follow logically from the facts
• Behavioural activation

  Patient encouraged to be more active and engage in enjoyable activities- provides more evidence for the irrational nature of beliefs
• CBT- evaluation

  It is effective- March et al. (2007) compared the effects of CBT, antidepressant drugs and a combination in 327 depressed adolescents. After 36 weeks- significant improvement in: 81% CBT, 81% antidepressants and 86% combo.

  May not work for most severe cases- can't motivate themselves to engage in cognitive work of CBT or concentrate in session. Commence CBT after antidepressants make them more motivated and alert. Cannot be used as the sole treatment for all cases.
• CBT- evaluation 2

  Success may be due to the therapist-patient relationship- Rosenzweig (1936) suggested that differences in psychotherapy (CBT and SD) are small. The quality of relationship is what determines success.