CBT

The cognitive appraoch assumes that our thoughts influence our emotions and behaviours. They believe that cognitive disorders stem from faulty or irrational thinking. To cure these disorders we need to change the thinking patterns through CBT.

Internal processes, such as perception, impact our behaviour, so CBT is used to change these perceptions that are causing their illness.

Schemas influence how we respond to the world. Beck said that people have negative schemas of three things, themselves, the world and the future (cognitive triad), resulting in depression. In CBT, people are helped to change these negative schemas, resulting in a change in how they respond to the world.

• Cognitive element: therapist help clients to identify negative thoughts that contribute to their problems
• Behavioural element: therapist enagages in reality testing, such as role play and homework

Dysfuntional thought diary

As homework, clients asked to keep a record of events leading up to unpleasant emotions. To record automatic thoughts and how much they believe in them. Then to write a response to these negative thoughts and rate belief in response. Finally, re-rate belief of automatic thoughts.

Cognitive resturcturing

Work together to identify and change negative thinking patterns, such as challenging dysfuntional thoughts; asking where the evidence is of it.

Pleasant activity scheduling

Ask the client to plan a pleasant activity each day to induce positive emotions and deter from negative ones. Involves keeping a note of experience and how they felt, if not well encouraged to think why it did not and create a solution.

Research support: 

Jarrett el al found CBT was as effective as some antidepressant drugs when treating 108 patients with severe depression over a 10 week trial. However, Hollon et al found no difference in CBT when compared to slightly different antidepressant drug in a sample of 107 patients over a 10 week trial. Suggests CBT not superior.

Therapist competence:

The success of CBT can be on the therapist competence, including ability to structure sessions, plan and review homework, and engage in relations with the client. Kuyken and Tsrivirkos claim 15% of the variance in outcome of CBT due to this.

Individual differences:

CBT appears less suitable for people who have high levels of irrational beliegs that are rigid and resistant to change. Also, for those with high levels of realistic stress (Simons et al)

Empowerment:

Empoweres clients to develop own coping strategies and that people have free will to do this. 

Patient blame:

Assumes that the client is responsible for their disorder. While this is positive in the fact they then are able to change thise, there are also downfalls to this. Important situational factors that the client cannot change must not be overlooked such as family issues. Therefore blaming the patient is not helpful as it may be due to other reasons that must be helped for them to feel better.

What is rational?

The question of who is to judge what irrational thoughts are, to some it may be irrational but to to others they see this as relaistic. Alloy and Abrahamson suggested that depressive realist tend to see things for what they were so were ready for disaster rather than rose coloured thinkers.