The Cognitive Treatment
Cognitive Behavioral Therapy (CBT)
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This type of therapy is linked with Beck's theory that depression is caused by automatic negative thoughts.
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This therapy aims to change the way patients react to situations and help them to think healthier.
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CBT includes around a 12-20 weekly session including practice sessions.
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The process of CBT
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Step 1: help patients identify and correct faulty perceptions and thoughts ( according to the cognitive triad)
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encourage patients to identify thinking patterns that is assocated with depressive feeling
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Then these thoughts are challenges by reality testing to tell the client that they can correct them
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Step 2: Increase activity and learn alternative problem-solving strategies
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therapist encourage clients to increase activity that can be rewarding
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They teach clients strategies to change their negative thinking
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They encourage the student to practice these strategies.
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Studies on CBT: Elkin et al (1989)
Aim: To see if there was any significant difference in the effectivenss among the three approaches to therapy
Procedure
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Depressed clients were assigned to 4 conditions: (1)- IPT (2) CBT (3) A tricyclic drug (4) placebo ( the medication groups did not receive much support)
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250 patients for 4 month
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Patients must only suffer from depression
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patients come from 3 different treatment center
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Patients with depression were excluded
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28 thearapist ( 8) in CBT, (10)IPT
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All therapist had average 11.4 years of clinical experience
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All treatment 16 weeks
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Assesed symptoms, life functioning and functioning related to particular treatment approaches
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Evaluation was given by another therapist that did not know treatment plan
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The patient’s significant other was an evaluator
Result:
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All treatment worked and did better than placebo
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The drug treatment was faster in reducing depression symptoms
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Out come was influenced by the initial severity of the symptoms— not very effective on severely depressed patient
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IPT was more effective than CBT for the severely depressed patient
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18 month follow up: only 20-30% of patient remained symptom free of depression regardless of treatment
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IPT and CBT reported greater effects of Treatment on ability to edtablish and maintain interpersonal relationships
Limitations
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The conclusion was too generalized and not accurate
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33% of participants of the drug group dropped out
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Other researches have found result that does not match Dobson ( 1989)—found cognitive therapy most effective
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Excluded a lot of participants- the sample is not representative pf the general population
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The goals of treatment different
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Treatment not standardized – therapist and place different
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hard to generalize
Strength:
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Triangulation – therapist, client, clsine’s family and third party
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Internal validity.
Implication: CBT might take a while to be effective but nevertheless does help the patient to recover from depression.
Evaluation
Strength:
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This treatment is based on Beck's theory of depression which has been proven by many studies to be accurate.
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This therapy is effective in treating depression ( Hollon and Beck, 1994)
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This therapy has a lot fewer side effects than taking anti-depressants
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This therapy is more tolerant against relapse
Limitations
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In Beck's theory, the role of the cognitive processes is yet to be determined
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This therapy takes a while to be effective and this can worsen the symptoms
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This type of therapy ignores the link between depression and biology