Psychological therapies to depression

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  • Psychological therapies to depression
    • Cognitive behaviour therapy
      • proposed by Aron Beck
      • emphasises  the role of maladaptive thoughts and beliefs in the origins and maintenance of depression
      • process
        • therapist identifies negative cognitions
        • challenge these thoughts
        • mimic in real world
          • Bryant et al found this was extremely important
      • Emotive behavioural therapy
        • Ellis
        • ABC model
          • Activation
          • Behaviour
          • Consequence
        • Therapist and client identify situations and the negative reactions they produce
        • Therapist helps to rationalise fear
        • Challenging of self-defeating beliefs through intense debate
      • depression can be based on rational thoughts
        • Simons found this was decrease the effectiveness of therapy
      • ignores biological factors
      • limited number of session requires to more cost effective
      • doesn't involve in-depth probing
      • Robinson et al
        • placebo was equally a effective
      • Kuyken et al fond that therapist competence was significant
    • Interpersonal psychotherapy
      • Based on Sullivan's interpersonal therapy model
      • depression can arise from and cause interpersonal relationship difficulties
      • aims to improve interpersonal functioning
        • alleviate symptoms of depression
      • therapy take between 12-16 weeks, has homework and assesses though structured interviews
      • therapy consists of a number of stages
        • first stage
          • identification of the client major problem areas and creation od treatment contract
        • Intermediate stages
          • working through identified problems with the therapist
            • eg grief, role trasnistion or taking on a new one and interpersonal deflects eg poor social skills
        • Termination stages
          • consolidation of what as been learnt and looking at how learn techniques can be learned in the future
      • Elkin et al
        • one of the largest clinical samples of depressed patients in the US
        • IPT was as effective as cognitive therapy and drug treatment in reduction of symptoms
        • However it has not been as extensively researched as cognitive therapy
    • March et al
      • worry that anti-depressants increase risk of suicidal
      • 300 adolescents
      • randomly allocated SSRI's alone or SSRI's and CBT, or CBT alone
      • 12% to, 48% to CBT alone and 78% to commination
    • Barkham
      • CBT and IPT equal effective
      • after 12 months tendencies for symptoms to occur

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