Cognitive Therapies for Depression CBT BECKS COGNITIVE THERAPY
Cognitive Therapies for Depression (CBT) BECK’S COGNITIVE THERAPY & ELLIS’S REBT
Starter Questions Answer in pairs on MWBs 1. What are the general aims of cognitive behavioural therapy? 2. What does the term ‘behavioural activation’ refer to? 3. In Beck’s therapy, identifying automatic negative or irrational thoughts is know as what? 4. What happens once negative thoughts have been identified? 5. What kind of tasks are set for homework? 6. What does the acronym REBT stand for? 7. Which theory is therapy linked to? 8. In Ellis’s therapy, what does the ‘D’ and ‘E’ stand for? 9. What is ‘logical dispute’? 10. What should happen as a result of logical and empirical dispute?
Starter Questions: Answers 1. What are the general aims of cognitive behavioural therapy? 2. What does the term ‘behavioural activation’ refer to? 3. In Beck’s therapy, identifying automatic negative or irrational thoughts is know as what? 4. What happens once negative thoughts have been identified? 5. What kind of tasks are set for homework? 6. What does the acronym REBT stand for? 7. Which theory is therapy linked to? 8. In Ellis’s therapy, what does the ‘D’ and ‘E’ stand for? 9. What is ‘logical dispute’? 10. What should happen as a result of logical and empirical dispute? 1. To help the person identify maladaptive thought and change them 2. Clients are encouraged to be more active and engage in enjoyable activities 3. Thought catching 4. They are challenged 5. Keeping a diary where they record, for example, events they have enjoyed, or where someone was nice to them 6. Rational Emotive Behavioural Therapy 7. The ABC model of depression 8. ‘Dispute’ where the client is encouraged to dispute their beliefs using evidence (empirical dispute) and ‘Effective new beliefs’ which results from dispute 9. Clients are encouraged to consider whether their beliefs are logical, if they make good common sense 10. They re-interpret their beliefs and experience more positive emotions
Cognitive Behavioural Therapy in Action Watch the clip and on MWBs, note down where the aspects of cognitive behavioural therapy that we have discussed are being demonstrated Look out for: • • Identifying automatic negative thoughts about the self/world/future (thought catching) Identifying the activating event and the negative irrational belief that has resulted from it Effort to challenge maladaptive thoughts Engagement in empirical and logical dispute (attempts to get the client to consider if their interpretations are based on sound evidence or if they are logical)
Cognitive Behavioural Therapy: Role Play Now it’s your turn to have a go at CBT! Instructions Half of you will be allocated to the role of client, and half to the role of therapist If you are a client, you will be given details of your case. Find another client with the same case as you. Together you will write a diary of events of things that have happened to you during the past week. Some of them must be positive If you are a therapist, you will initially be working in pairs. You will be given a sheet to record your therapy session. You should think about questions you might ask your client to identify negative thoughts (thought catching) and how you might go about challenging those thoughts using their diary. You will see two clients You have five minutes
Cognitive Behavioural Therapy: Role Play Now each client will find a therapist to work with NOW SWAP THERAPISTS. Clients, you must now choose a therapist who has not worked on your case previously
Exam practice: Answer the following question individually without notes: Outline the procedures involved in cognitive behavioural therapy for depression (4 marks) Now swap your answer with the person sitting next to you and award marks according to the guidance on the next slide
Exam practice: Mark scheme Award marks for the following: CBT assists patients to identify irrational and maladaptive thoughts and alter them (1 mark) or therapist identifies automatic negative or irrational thoughts about the world, the self and the future, known as ‘thought catching’ (1 mark) The therapist encourages a depressed patient to be more active and engage in enjoyable activities (1 mark). This is called behavioural activation and will provide more evidence for the irrational nature of beliefs (1 mark) Once identified, these thoughts are challenged. This is a central part of therapy (1 mark). As well as challenging these thoughts directly, the patient must also test the reality of their beliefs (1 mark) Patients are asked to keep a diary in which they record times when they have enjoyed an event or when someone was nice to them (1 mark). This is used in future sessions to challenge the client’s negative beliefs, by pointing out information in the diary that is inconsistent with them (1 mark) REBT is based on the ABC model but extends it to ABCDE, incorporating the concepts of dispute and effective new beliefs (1 mark). A central part of REBT is to identify and dispute irrational thoughts and beliefs (1 mark) The therapist will dispute the patient’s irrational thoughts using empirical dispute (1 mark) This involves asking the patient for proof that their thoughts or beliefs are true (1 mark). They will also use logical dispute which involves asking if the belief is logical or based on common sense (1 mark)
Evaluation of Cognitive Behavioural Therapy On MWBs: What two factors do we consider when evaluating a treatment? Appropriateness and effectiveness
Evaluation of Cognitive Behavioural Therapy Look at the following case studies and in pairs, decide if CBT would be an appropriate treatment for each of them. You must have reasons why Ling-Mae has been suffering from depression for the last four weeks. She has not been able to go to work for the last three weeks and has been sacked by her employer as she did not obtain a medical certificate from her doctor. Her motivation is so weak that she has not been able to bring herself to book an appointment. She is not sleeping much and is hardly eating. Her landlord has now threatened to evict her as she is now two weeks behind with the rent No. Sh treatme e needs a qu ick nt to ge track a t h e r b s soo ack on CBT is n as possible no an solutio t a short-term d n motiva. Also, as he unlikel tion is so low r y she it is engage would be ab le to with th e thera py
Evaluation of Cognitive Behavioural Therapy Look at the following case studies and in pairs, decide if CBT would be an appropriate treatment for each of them. You must have a reason why Sophie has been suffering from depression since the birth of her child five months ago. She feels that she is not coping No. Ev some o en though sh well with the demands of motherhood. She cries a lot and e has f the pattern negative thin s as king feels like she is letting her baby down because she does not dep ression sociated with feel any sense of enjoyment when looking after her becam , the fact that e depre s ssed af he giving daughter. She feels as if she is doing everything wrong and th ter birt ere is a h suggests th at hormon that people are judging her negatively a l b a he si r depre ssion s to
Evaluation of Cognitive Behavioural Therapy Look at the following case studies and in pairs, decide if CBT would be an appropriate treatment for each of them. You must have a reason why Bob has always been prone to feeling a bit miserable. He tends to worry about the negative consequences of situations much more than his friends do. Recently, Bob’s low mood has become more severe following the death of Yes. Bob’s his father, who he was very close to, and he has now been to be linkeddetporession seems diagnosed with clinical depression. He is still able to work actthi inking, and thheisr negative va e and look after himself, but sees life as being a bit pointless that tsieng event (fathewr ads an emed t o trigge ying) and doesn’t think it’s ever going to get better r the ill ness
Evaluation of Cognitive Behavioural Therapy Look at the following case studies and in pairs, decide if CBT would be an appropriate treatment for each of them. You must have a reason why Gemma has been suffering from depression on and off for No. The around 5 years. Several members of her family have been fact tha family h istory o t there is a diagnosed with depression, including her mother and her sugges f depre ssion, ts that great uncle on her mother’s side. Her mother has, in the t here m biologi ay c been g al element tha be a past, spent some time in a psychiatric hospital as she was en t has such a etically trans mi sl treatment resistant and was eventually given a course of Also, th ow serotonin tted, levels. e fact s ECT. Gemma has had long periods of time where she is he has where p not able to work or function because of her depression, but suggestssthhe is not depresesrieods a d she also has periods where her mood is pretty much normal is unlikelyt tnoegative thinkin, g play a p a rt
Evaluation of Cognitive Behavioural Therapy Now complete the worksheet on the evaluation of cognitive behavioural therapy
Cognitive Behavioural Therapy Take the Quizlet to see what you can remember. .
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