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Treating Depression - Coggle Diagram
Treating Depression
REBT
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According to ellis 'people are not disturbed by things but rather by their view of things' and so he believed the way people feel is largely influenced by how they think
Ellis identified 11 basic irrational musturbatory beliefs that are emotionally damaging and can lead to psychological problems . These include 'I must be loved by everybody otherwise everyone hates me' and 'I must be excellent in all respects otherwise i am worthless'
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Patients are told to practice positive and optimistic thinking . A central part of the therapy involves using the ABC model as a technique to record irrational beliefs
Challenging negative thoughts and reinterpreting the ABC model in a positive and logical way is called reframing
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Therapists and patients work together to verify reality . If a patient makes a statement 'I'm a poor parent because my children misbehave' , the therapist gets the patient to assess its truth and examine the idea that someones a poor parent because children are sometimes naughty
Patients then become more realistic , more able to distinguish fact from fiction and don't perceive things in extreme terms
After the education phase where patients learn relationships between thoughts , emotions and behaviour , behavioural activation and pleasant event scheduling are introduced , aimed at increasing physiological activity and participation in social and other rewarding activities , eg socialising with others
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Between sessions patients are given goals to boost self esteem . these involve hypothesis testing of negative thoughts through behavioural coping skills , eg testing the belief that they are incapable of being included in conversations by talking to strangers in social situations
Therapists only set tasks they're confident patients can succeed at , failure reinforces the ineptness patients believe in
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Evaluation
CBT is the most effective psychological treatment for moderate and sever depression and one of the most effective treatments where depression is the main problem . It is also very effective in stopping mild depression from developing into severe depression and it has very few side effects
The better trained the therapist , the better the therapeutic outcomes, which illustrates how the use of trained therapists is essential to the treatments effectiveness
The application of CBT occurs over relatively short time period compared to other treatments and is more cost effective than such treatments . CBT also has long term benefits , as the techniques involved are used continuously to stop symptoms recurring
One problem with CBT is whether the theory behind it is correct. Is a depressed persons disordered thinking a cause or an effect of depression ? Many cognitive therapists believe the relationship works both ways
There are ethical concerns with CBT as it can be too therapist centred . Therapists may abuse their power of control over patients , forcing them into certain ways of thinking and patients become too dependent on therapists
CBT is difficult to evaluate . Senra and Polaino (1998) found that the use of different measurement scales to assess CBT produced different measures of improvement amongst patients
For patients with difficulty concentrating , often problematic with depressives , CBT can be unsuitable , leading to feelings of being overwhelmed and disapointed , which strengthens depressive symptoms rather than reducing them
CBT as with all talking therapies isn't suitable for patients who have difficulties talking about their inner feelings , or for those without the verbal ability to do so
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Lincoln (1997) used a questionnaire to identify stroke victims who had developed clinical depression . 19 patients were then given CBT sessions for 4 months , resulting in reduced symptoms , suggesting CBT to be a suitable treatment for specific groups of depressives
Whitfield and Williams (2003) found CBT had the strongest research base for effectiveness , but recognised theres a problem in the national health service being able deliver weekly face to face sessions for patients and suggested this could be addressed by introducing self help versions of the treatment , like the SPIRIT course , which teaches core cognitive behavioural skills using structures self help material
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