The cognitive approach to treating depression [16 MARKS]
Cogntiive behaviour therapy (CBT) is used in treatment of depression. It works by challenging
irrational thoughts and replacing them with rational ones. CBT is a combination of cognitive and
behavioural therapy as it changes the maladaptive thoughts and then changes the behaviour in
response to these thoughts and beliefs. This is done thought Ellis’s extension of the ABC model to
ABCDEF which he called REBT. This stands for rational emotive behavioural therapy and is a type of
CBT.
D stands for disputing in which the patient and therapist talk about the problem and challenge it.
There are three types of disputing: Logical, Empirical and pragmatic. Logical involves showing the
client that what they think does not actually happen. It also denotes how their way of thinking does
not make any sense. Empirical involves evidence and proof to go against what they believe.
Pragmatic emphasises the lack of usefulness or these beliefs by asking how they will help one in the
future. E stands for effect and this looks at the effects of disputing and F stands for feelings. The
feelings that have now been produced.
Clients are often asked to complete homework assignments during therapy sessions. This may
include asking someone out on a date where they had been previously scared to due to rejection or
looking for a new job. These homework tasks are important as they test the irrational beliefs against
reality and put new rational beliefs into practice.
As an individual becomes more depressed, they tend to increasingly avoid difficult situations and no
longer participate in activities they previously enjoyed. Behavioural action is when therapists try to
work with depressed individuals by gradually decreasing their avoidance and increasing their
engagement in activities that they used to enjoy and that have shown to improve their mood.
Furthermore, Ellis suggested that one main component of therapy was to give unconditional positive
regard to the patient. This would make them feel loved and wanted.
One strength of the cognitive approach treatment is that there is research support. Ellis claimed that
there is a 90% success rate for REBT, taking an average of 27 sessions to complete the treatment.
However, as Ellis is claiming this, it could be likely that his findings are biased as it is his therapy. But,
March et al did find that CBT is just as effective as antidepressants and medication. This suggests
that there is a good case for making CBT the first choice in treatment in public health care systems
like the NHS. In fact, CBT is actually available on the NHS website. This suggests that it is effective nd
Ellis’s findings may not be biased.
One limitation of CBT is that it may not work for the most severe cases of depression. Some cases of
depression are so severe that patients cannot motivate themselves to take on the hard cognitive
work required for CBT and REBT. Where this is the case, it is possible to treat such patients with
antidepressants but you cannot use CBT as they are not alert and motivated. This means that not
only do individual differences play a part but also that CBT cannot be used as the sole treatment of
all cases of depression.
However, many drugs, medications and antidepressants have side effects which could make the
patient feel worse and as a result have to stop taking them. One strength of CBT is that there are no
side effects as the patient is not taking something in. This means that they can continue taking the
course without the fear of having any negative effects and even withdrawal symptoms.
, CBT takes a more holistic approach as it looks at the cognitive and behavioural side. It looks at the
cognitive side by how irrational thoughts can impact us and the behavioural side through
behavioural action. This means that it does not try to break it up into small components and as a
result does not oversimplify the treatment. Furthermore, the idea of unconditional positive regard
comes from the humanistic approach further emphasising how this treatment is not a reductionist.
It is still unknown as to whether depression is a symptom of maladaptive thinking or if irrational
thoughts are caused by having depression. This means that CBT could be targeting a symptom of
depression and not depression as a whole. This would make the treatment ineffective as people
could still have depression but without one symptom of it.
CBT believe that the patient has free will and can change. They do this by allowing the patient to talk
about their problems and by having them be the ones to change it. This can be shown through
behavioural action as the patient still is in control of their behaviour. This means that the treatment
is not deterministic as although the patient is being ordered to do this, they are still in control over
their own disorder.
Cogntiive behaviour therapy (CBT) is used in treatment of depression. It works by challenging
irrational thoughts and replacing them with rational ones. CBT is a combination of cognitive and
behavioural therapy as it changes the maladaptive thoughts and then changes the behaviour in
response to these thoughts and beliefs. This is done thought Ellis’s extension of the ABC model to
ABCDEF which he called REBT. This stands for rational emotive behavioural therapy and is a type of
CBT.
D stands for disputing in which the patient and therapist talk about the problem and challenge it.
There are three types of disputing: Logical, Empirical and pragmatic. Logical involves showing the
client that what they think does not actually happen. It also denotes how their way of thinking does
not make any sense. Empirical involves evidence and proof to go against what they believe.
Pragmatic emphasises the lack of usefulness or these beliefs by asking how they will help one in the
future. E stands for effect and this looks at the effects of disputing and F stands for feelings. The
feelings that have now been produced.
Clients are often asked to complete homework assignments during therapy sessions. This may
include asking someone out on a date where they had been previously scared to due to rejection or
looking for a new job. These homework tasks are important as they test the irrational beliefs against
reality and put new rational beliefs into practice.
As an individual becomes more depressed, they tend to increasingly avoid difficult situations and no
longer participate in activities they previously enjoyed. Behavioural action is when therapists try to
work with depressed individuals by gradually decreasing their avoidance and increasing their
engagement in activities that they used to enjoy and that have shown to improve their mood.
Furthermore, Ellis suggested that one main component of therapy was to give unconditional positive
regard to the patient. This would make them feel loved and wanted.
One strength of the cognitive approach treatment is that there is research support. Ellis claimed that
there is a 90% success rate for REBT, taking an average of 27 sessions to complete the treatment.
However, as Ellis is claiming this, it could be likely that his findings are biased as it is his therapy. But,
March et al did find that CBT is just as effective as antidepressants and medication. This suggests
that there is a good case for making CBT the first choice in treatment in public health care systems
like the NHS. In fact, CBT is actually available on the NHS website. This suggests that it is effective nd
Ellis’s findings may not be biased.
One limitation of CBT is that it may not work for the most severe cases of depression. Some cases of
depression are so severe that patients cannot motivate themselves to take on the hard cognitive
work required for CBT and REBT. Where this is the case, it is possible to treat such patients with
antidepressants but you cannot use CBT as they are not alert and motivated. This means that not
only do individual differences play a part but also that CBT cannot be used as the sole treatment of
all cases of depression.
However, many drugs, medications and antidepressants have side effects which could make the
patient feel worse and as a result have to stop taking them. One strength of CBT is that there are no
side effects as the patient is not taking something in. This means that they can continue taking the
course without the fear of having any negative effects and even withdrawal symptoms.
, CBT takes a more holistic approach as it looks at the cognitive and behavioural side. It looks at the
cognitive side by how irrational thoughts can impact us and the behavioural side through
behavioural action. This means that it does not try to break it up into small components and as a
result does not oversimplify the treatment. Furthermore, the idea of unconditional positive regard
comes from the humanistic approach further emphasising how this treatment is not a reductionist.
It is still unknown as to whether depression is a symptom of maladaptive thinking or if irrational
thoughts are caused by having depression. This means that CBT could be targeting a symptom of
depression and not depression as a whole. This would make the treatment ineffective as people
could still have depression but without one symptom of it.
CBT believe that the patient has free will and can change. They do this by allowing the patient to talk
about their problems and by having them be the ones to change it. This can be shown through
behavioural action as the patient still is in control of their behaviour. This means that the treatment
is not deterministic as although the patient is being ordered to do this, they are still in control over
their own disorder.
