1. Cognitive Behavioural Therapy
Developed by Beck
Aim – Teach ‘clients’ to rethink and challenge their negative perceptions/cognitions
Beck

2. Beck’s Cognitive Therapy
Cognitive Behavioural Therapy
Beck’s Cognitive Therapy
Stage 1
Therapist & client agree
on nature of problem
& goals for therapy
Stage 2
Therapist challenges
the client’s
negative thoughts
Client engages in
behaviour
between sessions
in an attempt
to challenge these
negative thoughts
Aim is for client to realise
thoughts are irrational.
Homework = diary kept
Beck

3. Cognitive Behavioural Therapy
Most common
features of CBT are:
Cognitive Behavioural
Therapy
2. Client recognises
the connection
between cognitions,
affect (mood)
and behaviour
Client monitors
their negative,
automatic thoughts
(cognitions)
3. Client examines
evidence for
and against
their distorted
thoughts
4. Client learns to
substitute biased
cognitions for more
realistic ones
5.Client learns to
identify & alter
their beliefs that
predispose
them to
distort their
experiences

4. Usually a series of 20 sessions over 16 weeks
Cognitive Behavioural
Therapy
Further
developed to
include challenging
behaviour too
Usually a series of 20 sessions over 16 weeks
Homework set
Thought-catching

5. Cognitive Behavioural Therapy
4 basic assumptions
of CBT
Response to life
is based on interpretations
of self & world rather
than what the actual case is
Thoughts, behaviour & feelings are
interrelated & influence
each other – none are
more important than the others
Kendall
Must clarify &
change the way they
think about themselves
& world around them
Need to change
cognitions AND behaviour
Hammen

6. Cognitive Behavioural Therapy
Effectiveness
Compared depressed
patients receiving
a range of therapies
60 pts randomly
allocated
Beck’s CT
IPT
Tricyclics
Placebo - no
treatment
Elkin et al (1989)
All treatments – 16 wks
Assessed before,
during,
at end & follow ups
Assessed:
Symptoms of dep
Overall symptoms &
life functionin
18 mths later = only
20-30% dep free
IPT = most satisfied
with treatment
IPT & CT = able to
recognise sources of dep &
better social rels
Improvement
IPT = 55%
Drugs = 57%
CT = 51%
Placebo = 29%
Drug = fastest to
reduce symptoms
Placebo = better for
mildly dep than severely
IPT = best for social
functioning
CT = best for
dysfunctional attitudes
LT = psychological
better
Relapse higher
for drugs
than CT (47% - 31%)

7. Cognitive Behavioural Therapyde
Effectiveness
Similar to Elkin 58% showed elimination of symptoms if CT or drug treatment
deRubeis et al (2005)
Follow on 12 mths later by Hollon (2005) found difference in relapse rates:
31% for CT
47% for
drug treatment
76% if no
real treatment given
So CT has longer lasting effect & targets underlying problem not just
masking symptoms.
Drug treatment is purely a palliative treatment

8. Cognitive Behavioural Therapy
Effectiveness
Blackburn & Moorhead (2000)
CBT superior to drugs in
particular 1 year +
Rush (1977) –
CBT at
least
as effective
as drugs
Kupfer & Frank (2001)
Most effective treatment is
A combi of
CBT & anti-depressants

9. Cognitive Behavioural Therapy
Appropriateness
Successful & long lasting for many
Deals with root cause not just symptoms
No real side effects or withdrawal symptoms
Allows opportunity to use strategies in range of situations
Gives the patient some control over disorder & the power to change
Appropriate to use with depression as many symptoms are faulty cognitions

10. Cognitive Behavioural Therapy
Appropriateness
Difficult to know how well a client will respond to CBT –
Simons not suitable for people with rigid attitudes
Not a quick fix – can take months to see improvement unlike drugs
Does not focus on why negative beliefs held –
may actually be based on realistic concerns
As relpase may be that negative beliefs etc
are suppressed rather than eliminated
Expensive & time consuming
People do still relapse

11. Take notes from textbook on p 238-9 to expand evaluation & studies
Cognitive Behavioural
Therapy
Take notes from textbook on p to
expand evaluation & studies