Psychological Therapies Cognitive Behavioural Therapy CBT for depression

Aims of CBT To identify and alter negative beliefs and expectations (cognitive) To alter dysfunctional behaviours that are contributing to or maintaining the depression (behaviour)

What to expect About 2o sessions over 16 weeks Active, directive therapy Focuses on hear and now (not like psychoanalysis) Although the initial session may include some background information.

Aspects of the therapy Behavioural activation Homework assignments Thought-catching Cognitive restructuring Problem-solving

Challenging negative thoughts What is the evidence? Is there another way to look at this situation? What is the worst thing that could happen?

Practical skills Conversational skills Improving interactions with people.

EFFECTIVENESS Lots of evidence to suggest CBT is effective in: Reducing symptoms of depression Preventing relapse

Other evidence Inconclusive evidence when comparing with other types of psychotherapy and with anti-depressants. But seems to be as effective as medication in reducing symptoms of depression in its early stage Fava et al (1994) found CBT is superior to drug therapy in treating symptoms after a course of antidepressants.

When used in combination Keller et al (2000) found when drugs and CBT used together effectiveness rose from just over 50% (when either used alone) to 85%

Individual differences appears to be suitable for both Severe and milder depression Not so suitable for clients with high stress levels and are dealing with difficult life circumstances.

APPROPRIATENESS Client is more active than with biological treatments Needs commitment Can motivate them Or put them off.

Appropriateness Not for clients who have rigid attitudes Or are resistant to change. Client cooperation needed. Brief therapy cannot resolve very difficult life situations.

Appropriateness Not a quick process Requires effort and commitment May be easier to identify the faulty thought process than to replace it. Not invasive compared with drugs Gives long-term strategy for dealing with future situations But may become dependent on the therapist.

Appropriateness Not always available on the NHS If it is, there is often a waiting list May take a while to take effect – quicker than psychoanalysis but slower than medication.

Appropriateness Techniques can be used in future May help to prevent relapse