1. Play dough starter

2. Yasmin has just been made redundant
Yasmin has just been made redundant. She takes this very hard and finds herself suffering symptoms of depression. When questioned, Yasmin says that the situation is unfair and that she is ashamed.
How would you put the sequence of events into Ellis’s ABC model?
What kinds of thinking is Yasmin displaying?
Does Yasmin have any symptoms that Ellis’s model would struggle to explain?
Stretch and Challenge - How might you go about challenging these thoughts if you were a cognitive behavioural therapist?

3. Evaluation of cognitive explanation
It only offers a partial explanation so has limitations
Some depression does occur as a result of an activating event (reactive depression). However not all depression arises as a result of an obvious cause
It has practical application in CBT
Like Beck’s explanation, Ellis’ explanation has led to successful therapy. Irrational negative beliefs are challenged and this can help to reduce depressive symptoms suggesting that the irrational beliefs had some role in the depression.
It has good supporting evidence
Much research has supported the proposal that depression is associated with faulty information processing, negative self-schemas and the triad of impairments

4. Cognitive Treatments 4.1.4 Psychopathology
The cognitive approach to treating depression: cognitive behavioural therapy including challenging irrational thoughts

5. Cognitive Behaviour Therapy (CBT)
CBT is the most commonly used psychological treatment for depression, as well as other mental health problems (e.g. anxiety, panic, phobias, stress, bulimia, OCD, Post-Traumatic Stress Disorder, bipolar disorder, etc.)
This is a method for treating mental disorders based on both behavioural and cognitive techniques
The therapist aims to make the client aware of the relationship between thought, emotion and actions
CBT can help people to change how they think (‘cognitive') and what they do (‘behaviour'). These changes can help them to feel better.

6. Each session will last between 30 and 60 minutes.
What does CBT involve?
The Sessions
Meet with a therapist for between 5 and 20, weekly, or fortnightly sessions.
Each session will last between 30 and 60 minutes.
Some CBT therapists work with the techniques influenced by Beck and some work with the techniques influenced by Ellis. Most draw on both
Handout with process
Then worksheet

7. Beck’s CBT
Beck developed a therapy to challenge the negative triad (beliefs) of the client.
First, the client will be assessed to discover the severity of their condition.
The therapist will establish a baseline (or starting point), prior to treatment, to help monitor improvement.

8. Thoughts influence emotions and behaviour.
To feel better you must think positively.
The client is asked to provide information about how they perceive themselves, the future and the world.
The therapist would use a process of reality testing e.g. if the client says, ‘I’m useless, and I always fail’, they will be asked whether in reality, they have been successful at something.
The therapist might ask the client to do something to demonstrate their ability to succeed.

9. The client’s beliefs are directly challenged
Clients are made aware of their negative views.
In this way, irrational ideas can be replaced with more optimistic and rational beliefs.
Through this process, irrational ideas can be replaced with more optimistic and balanced beliefs.

10. Ellis’ REBT Ellis’ Rational Emotive Behaviour Therapy
REBT extends the ABC model to an ABCDE model
D = Dispute (challenge the thoughts)
E = Effect (see a more beneficial effect on thought and behaviour)
Therefore the central technique of REBT is to identify and dispute the patient’s irrational thoughts

11. Common irrational thoughts
Ellis identified what he saw as the most common faulty beliefs experienced by people with mental health problems.
I am worthless unless I am competent at everything I try
I must be approved of and loved by everyone I meet
My unhappiness is always caused by external events; I cannot control my emotional response
It is upsetting when things are not the way I would like them to be
Certain people are thoroughly bad and should be severely blamed or punished for it
Because something once affected my life, it will do so indefinitely
There is always a perfect solution to human problems and it is awful if it is not found
I should depend on others who are stronger than I am
It easier to avoid difficulties and responsibilities than to face them
If something unpleasant happens I should keep dwelling on it

12. Worksheet
Should I opt for CBT?

13. How effective is CBT? CBT is effective
CBT is effective in reducing symptoms of depression and in preventing relapse and there is a large body of evidence to support this (March et al, 2007)
It is the most effective psychological treatment for moderate depression.
It is as effective as antidepressants for many types of depression (Fava et al, 1994).

14. How effective is CBT? CBT may not work for the most severe cases
In some cases depression may be so severe that patients cannot motivate themselves to engage in the therapy
In these cases, it is possible to treat the patient with antidepressants and then CBT can commence at a later date
This is therefore a limitation as it means that CBT cannot be used as the sole treatment in all cases

15. CBT and Drug Treatment Keller et al (2000)
Recovery rates (from depression)
55% drugs alone
52% CBT alone
85% when used together.

16. Strengths
Weaknesses
Clients can become dependant on their therapist, or non-cooperative
CBT is not effective for people with rigid attitudes or resistance to change,
or for people who have high stress levels in response to genuinely difficult life circumstances (depressive realism)
CBT is not a quick fix. A therapist is like a personal trainer that advises and encourages - but cannot 'do' it for the client.
Client is actively involved in their recovery
CBT is not physically invasive
Client learns to help themselves, and can use the skills in new situations.
CBT works (e.g. Mrach, Fava)
Particularly when combined with drug treatment (Keller)

17. CHANGE VIEW: 10 key facts about CBT
Change: your thoughts and actions
View: events from another angle
Homework: practice makes perfect
I can do it: self-help approach
Action : don't just talk, do!
Experience: test out your beliefs
Need: pinpoint the problem
Write it down: to remember progress
Goals: move towards them
Evidence: shows CBT can work

18. "We are what we think. All that we are arises with our thought
"We are what we think. All that we are arises with our thought. With our thoughts, we make our world."
The Buddha