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cognitive approach to treating depression - Coggle Diagram
cognitive approach to treating depression
cognitive behavioural therapy
the assessment
patient and cognitive therapist work together to clarify patients problems
identify goals and put together a plan to achieve them
identify where there might be negative/irrational thoughts that will benefit from being challenged
cognitive element
BECK
aim - to identify negative thoughts within the negative triad
helps patients test the reality of their negative beliefs eg. they may be set homework to record when they enjoyed an event
in future sessions the therapist is able to provide evidence gathered by the patient to prove their negative thoughts are incorrect
this is referred to 'patient as scientist' as patients investigate their own negative beliefs
ELLIS
aim - to identify and challenge irrational beliefs by argument
REBT(rational emotive behaviour therapy) extends the ABC model to ABCDE (D for dispute and E for effect)
therapy often involves vigorous argument with the intention of challenge irrational beliefs and breaking the link between negative life events and depression
disputing
logical - self defeating beliefs do not follow logically from the information available
empirical - self defeating beliefs may not be consistent with reality (involves giving the patient the facts to prove their beliefs down match the evidence)
pragmatic - emphasises the lack of usefulness of self-disputing beliefs - is thinking negatively helping them?
Behavioural activation
therapist encourages their patient to be more active and engage in more enjoyable activities.
depressed patients often lose interest in activities they used to find enjoyable so this behavioural activity will provide more evidence for the irrational nature of their beliefs
evaluation
STRENGTH - there is research to suggest CBT is just as effective as medication for treating depression. March et al compared the effects of CBT with anti-depressant drugs and a combination of the two in 327 adolescent patients. After 36 weeks 81% of the CBT group, 81% of the anti-depressant group and 86% of the combination group significantly improved. this shows that CBT is just as effective and is a good first choice of treatment in the public healthcare system - CA it is most effective to combine them
LIMITATION CBT may be less effective in more severe cases of depression. some patients can't motivate themselves to engage with the hard cognitive work of CBT. it means that CBT cannot be used as the sole treatment for depression
LIMITATION success of CBT may be due to the therapist relationship rather than the therapy itself. Rosenzweig suggested that the differences between methods of psychotherapy might be quite small. all therapies rely on the therapist patient relationship. it means the quality of this relationship determines the success rather than the techniques used
LIMITATION CBT overemphasises the importance of cognitive factors in depression. McCusker said that CBT may minimise the importance of the standards the patient is living in. a patient living in poverty or abuse needs to change their situation and any approach that emphasises the mind over environment can prevent this change. it shows that CBT techniques used inappropriately can demotivate people to change their situation