THEORY
Strengths - Cognitive Approach to Treating Depression:
1. Effectiveness:
- REBT and CBT in general have received praise. CUIJPERS et al (2013) reviewed 75 studies concerning the outcome of treatment for depression and found that CBT was superior to no treatment. Interestingly, Cuijpers review also found that CBT was especially effective if combined with drug therapy.
- Effectiveness of REBT is demonstrated by DAVID et al (2008),who compare REBT, Beck's cognitive therapy and antidepressant drug therapy. All three were equally effective at the end of the treatment, however, at a 6-month follow-up, evidence suggested that REBT was more effective than the other two types of therapy.
- Despite initial expense, CBT may be more cost-effective than drug treatment in the longer term. DeRUBEIS et al (2008) found that relapse rates are lower with CBT. This is an important advantage as it means that the client is better able to get on with their work, family and social activities after their episode of depression. Therefore the initial higher cost may be worthwhile in the long run.
Limitations - Cognitive Approach to Treating Depression:
1. Effectiveness:
- Effectiveness of CBT may depend on many factors, one being that therapist competence might explain the variation in CBT outcome. KUYEN & TSIVRIKOS (2009) suggests that as much as 15% of the variance in outcome might be attributable to therapist competence.
- Fails to address environmental causes of depression, such as abusive marriage or overly critical boss. These may continue to produce irrational thoughts and maladaptive behaviours.
- Ignores possible biological basis of abnormality EG: imbalance of neurotransmitters. RUHE et al (2007) suggests that low levels serotonin result in depression.
- CBT is not a quick fix to depression. It requires commitment, motivation and effort. ELLIS believes that on average 27 sessions are needed to complete the treatment. It may be unsuitable as a treatment for individuals who are very rigid in their thinking, or who are unable/unwilling to engage in the hard work required.
- There can be ethical problems with a therapy that tells the patient that they are the cause of their own depression. Unless carefully handled, this might be interpreted as criticism and lead to self-blame and guilt.
- An expensive form of treatment for depression (unless provided for by the NHS - where therapists are in short supply). Therapists charge £40 - £60 per session. Many individuals would struggle to afford this treatment, and so many choose to opt for anti-depressants, which are a much cheaper alternative to CBT (and if correctly prescribed) will reduce the symptoms of depression in a few weeks, requiring little effort from the depressive.