COGNITIVE TREATMENTS FOR DEPRESSION

overview of CBT

Behaviour element = change negative and irrational thoughts and put more effective behaviours into place

Cognitive element = CBT begins with an assessment in which the client and the cognitive behavioural therapist work together. a central task is to identify where there might be negative or irrational thoughts that will benefit from challenge

Becks cognitive therapy

helps clients test the reality of their negative beliefs. they might be set HW eg. to record when they enjoyed an event or when people are nice to them.

in future sessions if clients say that no one is nice to, the therapist can then produce this evidence and use it to prove the clients statements wrong.

identify automatic thoughts about the world, the self and the future. once these thoughts are identified they must be challenged

REBT - rational emotive behaviour therapy

central technique of REBT is to identify and dispute irrational thoughts

the intended effect is too change the irrational belief and so break the link between negative life events and depression

this therapy extends the ABC model to ABCDE. D = dispute and E = Effect.

Ellis identified different methods of disputing. empirical argument = disputing whether there is actual evidence to support the negative belief. logical argument = disputing whether the negative thought logically follows from the facts

evidence for effectiveness

81% of the CBT group, 81% of the antidepressant group and 86% combination group were significantly improved

March et al. 2007 - compared CBT to antidepressants and also a combination of the two treatments when treating around 300 depressed adolescents

CBT was just as effective when used on its own

CBT is a fairly brief therapy requiring 6-12 weeks so it is also cost effective

suitability 😢

cases of depression can be so severe that clients cannot motivate themselves to engage with the cognitive work of CBT

the complex rational thinking involved in CBT makes it unsuitable for treating depression in clients with learning disabilities

lack of effectiveness for severe cases for clients with learning or severe depression

CBT may only be appropriate for a specific range of people with depression

relapse rate 😢

in a study, clients were assessed every month for 12 months following a course of CBT.

42% of clients relapsed into depression after 6 moths, and 53% relapsed after a year.

CBT is effective with tackling the symptoms of depression, there are some concerns over how long the the benefits last.

this means that CBT may need to be repeated periodically