treating depression

Question 1

what are key elements of CBT

Answer 1

• identifying irrational thoughts
• challenging them through direct questioning- disrupting. includes using evidence to contradict them through empirical or logical disputing
• effect of more rational thoughts leading to feeling better
• behavioural activation
• homework

Question 2

what is CBT

Answer 2

• assists patients to identify irrational thoughts and change them by challenging them and replacing them with more effective rational beliefs
• behavioural changing by using coping strategies

Question 3

Ellis on CBT

Answer 3

• extended ABC model to ABCDE
• D= disputing irrational thoughts
• E= effect

Question 4

how are irrational thoughts disputed in CBT

Answer 4

• empirical disputing= therapist challenging irrational thoughts to show they may not be consistent with reality (‘where is the proof that…?) and provide evidence as a counterargument
• logical disputing= therapist challenging irrational thoughts to show they do not logically follow from the information available (‘does it make sense that..)

Question 5

what is the intended effect of disputing in CBT

Answer 5

• change irrational thoughts and so break the link between negative life events and depression
• changing the thoughts leads to healthier emotions and symptoms of depression are alleviated

Question 6

CBT homework

Answer 6

• clients asked to complete homework assignments between sessions
• includes asking someone out on a date, looking for a job, asking friends to tell them what they think of them
• it is vital in testing irrational thoughts against reality and putting new rational beliefs into practice

Question 7

behavioural activation

Answer 7

• specific focus on encouraging depressed clients to become more active and engage in pleasurable activities
• being active leads to rewards that act as an antidote to depression
• activity provides evidence of the irrational nature of the clients thoughts

Question 8

aim of CBT

Answer 8

identifying and challenging irrational thoughts to show the client how irrational their thoughts are, and replacing them with more effective and rational beliefs

Question 9

what is effectiveness of CBT

Answer 9

does the therapy work?

Question 10

what is appropriateness of CBT

Answer 10

should we use the therapy/can it be used by different types of people on different types of phobia?

Question 11

evaluation points for CBT

Answer 11

• supporting evidence for effectiveness from research
• weakness of effectiveness and appropriateness from focusing on present and future
• weakness for effectiveness and appropriateness from living conditions being overlooked
• weakness of appropriateness from client not engaging with hard content

Question 12

supporting evidence of effectiveness of CBT from research

Answer 12

• after 36 weeks, 81% of depressed patients treated with CBT, 81% patients treated with medication, 86% patients treated with combination of 2 had significantly improved
• suggests CBT is effective in the long term by teaching clients new behaviours and thoughts so it should be first choice treatment for NHS
• potentially treating depression should be a combination of both

Question 13

weakness of effectiveness and appropriateness of CBT from focusing on present and future

Answer 13

• some clients are aware of the link between childhood experiences and their depression and want to talk about them
• so they might find present-focus very frustrating
• therefore if depression is due to psychodynamic factors, CBT will not be effective
• so should only be used in some cases

Question 14

weakness of effectiveness and appropriateness of CBT from overlooking living conditions

Answer 14

• therapy emphasises what is happening in the mind so circumstances may be overlooked e.g. living in poverty or abuse
• circumstances need to be changed which is overlooked by the therapy
• therefore CBT will not be effective if circumstances arent changed so shouldnt be used in these cases or should be used in combination with environmental intervention

Question 15

weakness of appropriateness of CBT from client not engaging with content

Answer 15

• severe depression in some cases means the client cant motivate to engage with the hard cognitive work of CBT
• might work to treat them with medication initially, then commence CBT when they are more alert or motivated
• suggests CBT cant be used as a sole treatment for all cases and should be used in combination with others for long term effects