Cognitive treatments for Depression
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How does cognitive therapy aim to treat depression?
By challenging and removing negative thoughts and changing the negative schema associated with depression
Which two schools of psychology are employed in cognitive treatment?
- Cognitive techniques change thoughts
- Behavioural techniques modify behaviours
Who created cognitive behaviour therapy?
Beck in 1976
What is the aim of CBT?
To challenge the negative cognitive triad of negative thinking by helping people solve practical problems in their lives in a positive way
How many sessions are usually involved with CBT and over how long?
20 sessions over a 10 week period
Describe phase 1 of CBT
- Identification/ recognition of negative thoughts (thought catching)
- Allows the therapist to determine a baseline to monitor improvement
Describe phase 2 of CBT
- A hypothesis is generated to test thoughts
- client: 'I am useless', they are then asked if, in reality, they have been successful at something
Describe phase 3 of CBT
- Scientific testing of negative thoughts
- The therapist may ask the client to do something to demonstrate their ability to succeed
Describe phase 4 of CBT
- Patient as a 'scientist'
- Involves the gathering of data as homework (keeping a diary)
Describe phase 5 of CBT
- Reinforcement of positive thoughts
- Client is rewarded/praised for positive thinking
Describe phase 6 of CBT
- Cognitive restructuring
- Over time, irrational thoughts are replaced by more rational beliefs
Who created Rational emotive behaviour therapy?
Ellis in 1984
What is the task of the therapist in REBT?
To directly challenge/dispute the negative assumptions the client makes due to their automatic negative thoughts (ANTs)
What is rational confrontation?
Vigerous arguments with the client to challenge or dispute their irrational beliefs
How does REBT differ than other forms of therapy
It tends to be more argumentative and confrontational
Give one example of a shame attacking exercise
Taking a banana for a walk
What is the object of shame attacking exercises?
To challenge the client's negative schemas
Describe the Hollon et al study of 2006
- Aim: To compare the effectiveness of cognitive and drug therapy
- Method: P's with moderate to severe depression were either treated with drugs or with 16 weeks of cognitive therapy and followed up for one year.
- Results: Relapse rates for those receiving cognitive therapy was 40% compared to 45% for those receiving drug therapy, a placebo group showed relapse rates of 80%
- Conclusion: Cognitive therapy is at least as effective as drug therapy for treating depression
Describe Robinson's study of 1990
57 studies were meta-analysed and CBT was identified as more effective than drug therapy and psychotherapy with post treatment depression levels remaining significantly reduced
How can CBT be seen as more engaging than other therapies?
The patient takes an active role in their own treatment (patient as a 'scientist' phase 4)
How may CBT result in a more permanent all round benefit than that resulting from other treatment?
The patient gains insight into their thought processes leading to better self management strategies and life enhancement
How is CBT a more substantial method than drug therapy?
It tackles the root cause of the depression (assuming that the root is their negative thoughts) reducing relapse rates
How is motivation an issue?
In order for cognitive therapy to work, the patient must be highly motivated to change. Highly depressed individuals are often lethargic and unmotivated
How may cognitive treatment be unsuccessful on shy patients?
Some people may find this approach too direct and confrontational causing upset and apprehension towards further treatment
What ethical objections can be raised against cognitive therapy?
It is unethical to dictate what someone can and can't think and to say someone's way of thinking is incorrect impugns on their sense of freedom and individuality
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