Describe and evaluate the cognitive approach to treating depression
1. Describe and evaluate the cognitive approach to treating depression (12 marks)
Cognitive-behaviour therapy (CBT) is used in the treatment of depression as it works by
challenging irrational thoughts and replacing them with more effective and rational ones.
CBT is a combination of cognitive and behavioural therapy and so focuses on changing
maladaptive thoughts and beliefs which then change behaviour in response to these thoughts
and beliefs. This is done through the extension of Ellis’ ABC model to become ABCDEF in
which D refers to disputing, E refers to effects of disputing, and F refers to feelings. There are
three types of disputing: logical, empirical and pragmatic. For example, in logical disputing a
therapist can challenge a client’s self-defeating thoughts and show them how they do not
follow logically from the information available. Clients are given homework tasks in order to
put new rational beliefs into practice, and CBT often involves a specific focus on
encouraging depressed clients to become more active and engage in pleasurable activities.
Ellis also acknowledged that an unconditional positive regard towards the client helps to
facilitate a change in beliefs and attitudes as it convinces the client of their value as a human
being.
In support of CBT, Ellis claimed a 90% success rate for REBT, taking an average of 27
sessions to complete the treatment. However, he also recognised that the therapy was not
always effective and that this was most likely due to clients not putting their revised beliefs
into action. This highlights the fact that this type of therapy is not quick and requires
considerable effort from the client. It is therefore not a suitable treatment for everyone. CBT
was found to be less suitable for people with high levels of irrational beliefs that are both
rigid and resistant to change (Simons et al., 1995), as well as in situations where high levels
of stress in the individual reflect realistic stressors in the person’s life that therapy cannot
resolve. CBT has been said to be especially effective when used in conjunction with drug
therapy. When these two treatment methods are used alongside each other the client tackles
both the cause and the symptoms of their depression at the same time.
Turner (2014) also suggests that the principles of CBT should be used more often by sports
teams. In particular, the ‘must win’ attitude should be challenged as rational thinking after a
negative event leads to mental healthiness and success. This type of therapy therefore has
benefits beyond the treatment of depression.
