Cognitive Treating Depression

• The cognitive approach to treating depression looks at?

  • CBT

  
  

  2 types of CBT:

  • Beck's Cognitive Therapy
  • Ellis' Rational Emotive Behaviour Therapy (REBT)
• CBT???

  • Cognitive Behavioural Therapy (short - 12 weeks) combines cognitive therapy (a way of changing maladaptive thoughts & beliefs) and behavioural therapy (a way of changing behaviour in response to these thoughts & beliefs). It focuses on the here and now.
  • Drugs can first cover symptoms to engage ppt more in CBT to make it more effective.

  Ellis one of 1st psychologists to develop a FORM of CBT in 1950s called:

  Rational Emotive Behaviour Therapy (REBT)
• Cognitive approach says ___ causes depression?


  • Faulty Thinking
  • Negative Schema
• Ellis???


  • Ellis' Rational Emotive Behaviour Therapy (REBT)

  REBT extends the ABC model to an ABCDE model:

  • D stands for dispute
  • E for Effect
• What happens in REBT:

  Challenges irrational beliefs:

  • A patient may talk about how unlucky they have been or how unfair things seem. An REBT therapist would identify these as examples of utopianism and challenge them as an irrational belief - this would involve a vigorous argument (D: Dispute)
  • The intended effect is to change the irrational beluef and so break the link between the negative life events & depression. This vigorous dispute/argument is the hallmark of REBT.
  • 3 types of dispute
• Ellis identified 3 methods of disputing (D)

  • Empirical Arguments: Type of dispute involves disputing whether is evidence to support irrational belief (checking belief against FACTS of real world) e.g. where is evidence that your beliefs are true?
  • Logical Arguments: Aimed at helping client to see that their reasoning is all wrong and it does make sense to think in this way e.g. explain why u think that's logical?
  • Pragmatic Arguments: Aimed at showing client that the irrational belief they hold is not helpful & it is harming them & those around you e.g. how that thought helpful 4 u?
• Beck's Cognitive Therapy - overview


  • Beck's cognitive therapy aims to replace faulty, irrational thoughts with a more sensible, realistic way of thinking.
  • The idea between CBT is to identify automatic thoughts about the self, world & future. Once identified, these thoughts must be challenged.

  INCLUDES:

  • Patients as scientist
  • Therapeutic Relationships
  • Challenging negative thoughts relating to the negative triad
  • Behavioural Activation
• Therapeutic Relationships - Beck's Cognitive Therapy


  • Beck believed in the importance of therapeutic relationships
  • Beck believed a close personal relationship with patients crucial for them to be treated (trust).
  • Idea of the patient  and therapist working together to clarify the patient's problems.
  • Identify where there might be negative or irrational thoughts that will benefit from change
• Challenging negative thoughts relating to the negative triad - Beck's Cognitive Therapy


  • The aim is to identify negative thoughts about the self, the world & the future - the negative triad
  • These thoughts must be challenged by the patient taking an active role in their treatment
  • Trains patient to be able to manage their own thinking
• Patient as Scientist - Beck's Cognitive Therapy


  • As well as challenging these thoughts directly. CBT aims to help patients test the reality of their negative beliefs. 
  • Patients are encouraged to test the reality of their irrational beliefs 
  • They might set HW e.g. record when they enjoyed event or when people nice to them.
  • In future sessions if patients say no one is nice to them or there is no point going to events, the therapist can then produce this evidence and use it to prove the patient's statements are incorrect. 
  • Trains patient to be able to manage their own thinking
• Behavioural Activation - Beck's Cognitive Therapy


  • Finally BCT may also encourage something called BEHAVIOURAL ACTIVATION - engaging in previously enjoyed activities to raise mood.
• Behavioural Activation -
Beck's Cognitive Therapy


  • Ferster (1973)
  • As individuals become depressed they rend to increasingly avoid difficult situations and become isolated which maintains or worsens symptoms
  • The goal of treatment therefore it to work with depressed individuals to gradually decrease their avoidance and isolation, and increase their engagement in actives that have been shown to improve mood e.g. exercising, going out to dinner etc