Cognitive Approach to Depression

Outline of the Cognitive Approach to Depression

Cognitive psychology explores all mental processes and functions – everything that happens in the brain, including decision-making, memory processes, learning, perception, thought processes, and attention.

It studies how people process and store the information they receive from their environment, draw conclusions, and react based on that information.

This study, then, allows researchers and psychologists to identify different ways by which mental illnesses can be treated. Let's take a look at how the cognitive approach is able to treat depression.

The cognitive Approach to Treating Depression

Within its framework, cognitive psychology helps us better understand ourselves and others. It gives psychologists a deeper insight into developing new ways to help people improve cognition. This deep insight has contributed to two ways depression can be explained: the cognitive approach: Ellis' (1977) A-B-C three-step model and Beck's (1967) cognitive triad.

These explanations allow professionals to develop a plan to help treat depression. But before we move on to depression treatments, let's discuss the explanations in more detail.

Albert Ellis' Cognitive Approach to Depression: the A-B-C Three-Stage Model

Ellis emphasised that a person's mental health can tip in either direction depending on their beliefs and assumptions about their life experiences.

Some people's assumptions about their life events are irrational and guide them to take inappropriate actions that affect their chances of living a happy and pain-free life.

Fig. 1 - Negative thoughts can lead to irrational interpretations of the situation, which contribute to an individual's overall beliefs and feelings

He suggested that it is not a single negative event that triggers depression but results from irrational thoughts triggered by negative events. Ellis proposed the three-stage A-B-C model, which explains how depression can result from irrational thinking.

The first component of the model is the activating event.

It is something that actually takes place, and while it doesn't lead to depression directly, it does contribute to it.

The second com[ponent of the model is beliefs. It is when any event that occurs is interpreted rationally or irrationally.

Let's take the above example and discuss both variations of interpretations.

And the final component of the model is consequences.

Irrational beliefs lead to unhealthy consequences. Again, keeping the above example in mind, let's see how.

Cognitive Approach to Depression: Beck's Cognitive Triad

Similar to Albert Ellis' cognitive approach to depression: the A-B-C three-stage model, Beck proposed that cognitive factors cause the onset of depression. However, both theories differ in opinion regarding which factors contribute to depression.

Beck's theory proposed a cognitive explanation of depression consisting of cognitive bias, negative self-schemas, and a negative triad.

Beck proposed that cognitive biases lead people with depression to misinterpret and analyse information distortedly.

Beck has developed many cognitive biases, two of which are overgeneralisation and catastrophising. Let's take a moment to understand these better.

Chances are, this has happened to you at some point, but you may not have realised. Let's take a look at a typical example.

Overgeneralisation and catastrophising may sound similar, but that's not the case; one is often a consequence of the other. Let's take a look.

Cognitive Approach to Depression: Beck and Schemas

According to Beck, individuals struggling with depression tend to have negative self-schemas about themselves resulting from negative childhood experiences such as criticism or bullying. This negative self-image can be a cause of cognitive biases.

Beck suggested that individuals living with depression have cognitive biases and negative self-schemas, which makes it difficult for them to view any situation positively. Together, these result in what we have discussed as the negative triad and occur automatically - especially if cognitive biases and negative self-schemas are present.

Now that we have understood two explanations of the cognitive approach to depression, it's time to evaluate this approach!

Evaluation of the Cognitive Approach to Depression

Since we've discussed two different explanations for depression that fit under the cognitive approach, it would only be right to evaluate these separately to get a complete picture.

Cognitive Approach to Depression: The A-B-C Three-Stage Model by Albert Ellis

• Ellis' ABC model significantly contributed to the treatment of depression, as it successfully combats negative, irrational thinking. Two types of this model include Cognitive Behavioural Therapy (CBT) and Rational Emotional Behavioural Therapy (REBT).

• However, this model is essentially based on correlation. It is not clear whether depression causes this irrational thinking or vice versa. Thus, cause-and-effect relationships can't be established.

Cognitive Approach to Depression: Beck's Cognitive Triad

• Lewinsohn et al. (2001) studied adults in which they measured their self-esteem and depression-related cognitions for one year. He found that negative thinking was an existing risk factor in depression, supporting Beck's model. However, this was only for participants with intermediate scores for dysfunctional and negative attitudes, not those with very low or high scores.

• A weakness of the cognitive approach (both Ellis' and Beck's models) is that it does not consider genetic factors in the cognitive explanation of depression.

• The causal relationship between pessimistic thinking and depression has not yet been proven.

Okay, so we've understood and evaluated the explanations offered by the cognitive approach for depression, but how can it be treated?

Cognitive Treatment for Depression

In cognitive behavioural therapy, irrational and distorted thought processes are challenged to change the patient's behaviour based on the new thought pattern. Therapists help patients identify the negative patterns in their logic that make them depressed. Then, they guide them to use alternative ways of thinking and interpreting life events.

Many psychologists use the cognitive approach to treat psychological disorders or problems. Treatment of depression using the cognitive approach involves therapy to help change cognitive processes.

An example of how a client-therapist interaction in CBT may go is shown in the example below.

Cognitive Approach to Depression: Rational Emotive Behaviour Therapy

Rational emotive behaviour therapy (REBT) is a form of cognitive behaviour therapy that challenges irrational thoughts and beliefs by disputing them. The therapist confronts the patient by questioning the logic behind their irrational beliefs and replacing them with effective beliefs. Two ways of doing this are:

• Challenging the logic behind the patient's beliefs with logic disputes, e.g., asking, 'Does this way of thinking about this situation make sense to you?'.

• Using empirical disputation, the therapist looks for evidence to support the patient's belief, e.g., 'What evidence leads you to believe that your belief is true?'.

Fig. 2 - By challenging negative beliefs with the help of therapy, individuals can change how they interpret situations, which further helps them with their feelings

At the same time, in behavioural therapy, the therapist gives the patient homework to check their negative beliefs. The motive for this homework is for the patient to recognise their unrealistic beliefs and consider them false.

The idea with any form of therapy is that it's based on the individual's needs and what they want to achieve by the end of it. While there may be an overarching framework for what the different types of therapy tend to include, the characteristics of it are unique to each individual.