4.3.3 Cognitive Treatments of Depression

• The most commonly used psychological treatment used to treat depression is Cognitive Behaviour Therapy (CBT)
• CBT is a cognitive treatment, although it does have behavioural elements within it: As the name suggests
• Both of the below therapies are forms of CBT

Beck's cognitive therapy 

• Cognitive Therapy is the application of Beck's theory of depression
• As behaviour is affected by thinking, one way to change maladaptive behaviours is to change the irrational thinking which accompanies those behaviours
• CBT assists clients (Beck did not like the word patient as it was felt to take power from the person) to identify their irrational thoughts (from the negative triad)
• The client is encouraged to challenge irrational thoughts directly with help from the therapist
• Clients are often set 'homework' to record positive events, which can be used in the sessions to help them challenge irrational thoughts
• The client may state that, 'Everyone hates me', however, in their homework they recorded a social event they enjoyed thus it is illogical assume that no-one likes them
• The therapist can directly confront the client with evidence to highlight their irrational thoughts or to at least look for other reasons why people may have acted the way they did, for example:
  • A friend ignores you when you see them in town: they probably did not see you or they were distracted
  • You walk into a room and people laugh: those people are probably laughing at what has just been said, they are unlikely to be laughing at you

Ellis's Rational Emotive Behaviour (REBT) 

• REBT extends Ellis's ABC model to ABCDE (D is for Dispute and E is for Effect)
• The main technique for REBT is to identify and challenge irrational thoughts 
• Example:
  • A client talks to their therapist about the fact that everyone hates them
  • REBT would challenge this thought and present a strong argument to dispute this idea
  • The therapist's role is to break the link between negative life effects and depression by changing the clients irrational belief
  • There are different types of arguments identified by Ellis;
    • Empirical arguments: Disputing if there is real evidence to support the irrational belief
    • Logical arguments: Disputing if negative effect follows logically from the facts