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Beck

Cognitive Behavioural Therapy. Developed by Beck Aim – Teach ‘clients’ to rethink and challenge their negative perceptions/cognitions. Beck. Cognitive Behavioural Therapy. Beck’s Cognitive Therapy. Stage 1 Therapist & client agree on nature of problem & goals for therapy. Stage 2

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Beck

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

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

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