The cognitive approach to treating depression - CBT

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  • Cognitive behaviour therapy
    • CBT: Beck's cognitive therapy
      • Aims to help patients test the reality of their negative beliefs
      • Idea is to identify automatic thoughts about the world, the self and the future (negative triad)
      • Once identified these thoughts must be challenged (central component of the therapy)
      • Might set homework such as record an event where someone was nice to you
      • Therapist can produce evidence (homework) to prove negative thoughts incorrect
    • CBT: Ellis's rational emotive behaviour therapy (REBT)
      • Extends the ABC model to ABCDE (D-dispute, E-effect)
      • Central technique is to identify and dispute irrational thoughts
      • Could involve a vigorous argument (hallmark)
      • Intended result is to change the irrational belief and to break the link between negative life events and depression
      • Ellis identified different methods of disputing
        • Empirical argument: disputing whether there is evidence to support negative belief
        • Logical argument: disputing whether the negative thought logically follows from the facts
    • Behavioural activation
      • Therapist may also work to encourage a depressed patient to be more active and engage in enjoyable activities
      • This will provide more evidence for the irrational nature of beliefs
    • Most commonly used psychological treatment for depression and a range of mental health problems
    • Begins with an assessment in which the patient and therapist work together to clarify a patient's problems
    • Jointly identify goals for the therapy and put together a plan to achieve them
    • One of the central tasks is to identify where there might be negative or irrational thougts that will benefit from challege
    • Then involves working to change negative or irrational thoughts and put more effective behaviours into place
    • Some CBT therapists do this using techniques purely from Beck's cognitive therapy while some rely of Ellis's REBT. Most draw on both

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