This research essay is to explore whether or notCognitive Behavioural Therapy is an effective treatment for depression. Cognitive Behavioural Therapy is a form of talking therapy that can helppatients manage their own problems by changing the way they think andbehave (Beck, 1976). Royal College of Psychiatrists(2013) describes Cognitive Behavioural Therapy as being based on the theorythat your thoughts, feelings, behaviors and actions are connected and thatnegative thoughts and feelings can have you going round in a circle unableto break the cycle. Resources according to Beck (2011) may include setting anagenda for the therapy session, thought challenging, activity scheduling, behaviouralexperiments, goal setting, solving problems, role plays, education around the conditionand relaxation techniques such as mindfulness. Cognitive Behavioural Therapy has some positive effects forpatients who have depressive symptoms.
Depression as defined by World HealthOrganisation (1994 pp 131) is a “mild, moderate or severe depressive episodewhere the patient suffers from lowering of mood, reduction of energy anddecrease in activity”. To measure theeffectiveness of the reduction in depressive symptoms several tools can be used.These include The Beck Depression Inventory (Beck, 1996) and The HospitalAnxiety and Depression Scale (Zigmond and Snaith 1983), although the assessmentis recommended to be used as a screening tool for depressive symptoms. A common difficulty is thediagnosis of depression in people with learning disabilities, thereforeCuthill, Espie and Cooper (2003) created the Glasgow Depression Scale for peoplewith a learning disability (GDS-LD). When exploring Cognitive Behavioural Therapyand the effects it has on depression there is a lot of evidence supporting thetherapy. NHS Choices (2016) made public their findings with regards to the benefitsfor Cognitive Behavioural Therapy as well as looking at the negatives for thistherapy.
They discussed it beingeffective due to the therapy being a short intervention which helps patientsfind new ways of using practical skills once the course is complete. Thisallowed the writer to explore research into what other forms of CognitiveTherapy were available and the different resources used to facilitate this. Some alternative ways ofoffering the therapy were found, including Internet Cognitive BehaviouralTherapy.
Anderson and Cuijipers (2008) suggestthat even small interventions can have a big impact on depressive symptoms.They also indicate many problems with this therapy, which include loss of data,diagnostic issues, small effects and acknowledging the need for human supportin a condition such as depression, where motivation to change is a majorissue’. However, once these issues are rectified, online Cognitive BehaviouralTherapy should be considered as part of primary care where most patients areseen and treated, such as general practitioner surgeries. Although Richards et al (2016)agrees that Cognitive Behavioural Therapy is effective, he discussed it beingan expensive form of therapy. He completed a trial to explore if BehaviouralActivation has the same benefits as Cognitive Behavioural Therapy or if indeedit was less effective. Behavioural Activation according to Richards, et al(2017) means looking at situations instead of ruminating on them to exploregoals and values within their life. Hetrialed the completion of Behavioural Activation by trained Mental HealthWorkers instead of Cognitive Behavioural Therapy which is completed by highlyskilled therapists.
During the trial Mental Health Workers were trained in lookingat behavioural activation interventions. His findings concluded that boththerapies appeared to have a reduction in depressive symptoms. Although NICE(2009) recommends Cognitive Behavioural Therapy as the therapy of choice fordepression, Richards, et al (2017) argues that Behavioural Activation needs tobe considered as an alternative due to the cost implications that Cognitive BehaviouralTherapy may have on services.While the two articles both agree that CognitiveBehavioural Therapy is effective in the reduction of depressive symptoms, Lancet (2016) wants to allowpeople to look at a more cost effective way of providing this service to peoplein primary services. In conclusion, NICE (2012)recommends “individual CognitiveBehavioural or mindfulness-based cognitive therapy (MBCT) as psychologicalinterventions for relapse prevention in people who are at significant risk ofrelapse is recommended”. It is also the Psychological Therapy of choice fordepression in the general public (Ponsford et al 2016).
Within the role of theAssociate Practitioner (Wheeler 2017), Cognitive Behavioural Therapy is used asa treatment within person centered pathways of care which cite NICE (2012). Thereis an argument that looking at a more cost effective talking therapy such as BehaviouralActivation could be used with in primary care services. This would allow patientsto access early interventions to help support with depressive symptoms.