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The Cognitive Treatment 

Cognitive Behavioral Therapy (CBT) 

  • This type of therapy is linked with Beck's theory that depression is caused by automatic negative thoughts.

  • This therapy aims to change the way patients react to situations and help them to think healthier.

  • CBT includes around a 12-20 weekly session including practice sessions.

  • The process of CBT

    • Step 1: help patients identify and correct faulty perceptions and thoughts ( according to the cognitive triad)

      • encourage patients to identify thinking patterns that is assocated with depressive feeling

      • Then these thoughts are challenges by reality testing to tell the client that they can correct them 

    • Step 2: Increase activity and learn alternative problem-solving strategies 

      • therapist  encourage clients to increase activity that can be rewarding 

      • They teach clients strategies to change their negative thinking

      • They encourage the student to practice these strategies. 

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

  • 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)

  • 250 patients for 4 month

  • Patients must only suffer from depression

  • patients come from 3 different treatment center

  • Patients with depression were excluded

  • 28 thearapist ( 8) in CBT, (10)IPT

  • All therapist had average 11.4 years of clinical experience

  • All treatment 16 weeks

  • Assesed symptoms, life functioning and functioning related to particular treatment approaches

  • Evaluation was  given by another therapist that did not know treatment plan

  • The patient’s significant other was an evaluator

Result:

  • All treatment worked and did better than placebo

  • The drug treatment was faster in reducing depression symptoms

  • Out come was influenced by the initial severity of the symptoms— not very effective on severely depressed patient

  • IPT was more effective than CBT for the severely depressed patient

  • 18 month follow up: only 20-30% of patient remained symptom free of depression regardless of treatment

  • IPT and CBT reported greater effects of Treatment on ability to edtablish and maintain interpersonal relationships

 

Limitations

  • The conclusion was too generalized and not accurate

  • 33% of participants of the drug  group dropped out

  • Other researches have found result that does not match Dobson ( 1989)—found cognitive therapy most effective

  • Excluded a lot of participants- the sample is not representative pf the general population

  • The goals of treatment different

  • Treatment not standardized – therapist and place different

  • hard to generalize

 

Strength:

  • Triangulation – therapist, client, clsine’s family and third party

  • Internal  validity.

 

Implication: CBT might take a while to be effective but nevertheless does help the patient to recover from depression.

Evaluation 

Strength: 

  • This treatment is based on Beck's theory of depression which has been proven by many studies to be accurate. 

  • This therapy is effective in treating depression ( Hollon and Beck, 1994) 

  • This therapy has a lot fewer side effects than taking anti-depressants

  • This therapy is more tolerant against relapse 

 

Limitations

  • In Beck's theory, the role of the cognitive processes is yet to be determined

  • This therapy takes a while to be effective and this can worsen the symptoms 

  • This type of therapy ignores the link between  depression and biology 

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