Cognitive behavioural therapy for depression

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23 March 2020

Cognitive behavioural therapy (CBT) has been proven effective as a form of talk therapy to help manage problems relating to how we think, feel and act.

This form of therapy is based on the idea that our distorted beliefs and thoughts root from negative actions or feelings, and not unconscious forces from the past.

CBT can be used to treat a variety of mental health conditions but is most commonly used to treat anxiety and depression.

In this piece, we’ll focus on cognitive behavioural therapy for depression. As well as its benefits, we’ll also delve into its effectiveness for treating depression and recommend some CBT exercises you can recommend to your staff.

However, for urgent enquiries about CBT and its use for mental health issues in the workplace you can contact the Health Assured experts today on 0844 891 0350.

What is CBT?

It’s a type of psychotherapy that can help people manage their problems by changing the way they think and behave.

It uses a blend of cognitive and behavioural therapies to identify and manage negative thoughts and behaviours. It then replaces these thoughts and feelings with other realistic and healthier ones.

We base CBT on the concept that thoughts, feelings, physical sensations, and actions are interconnected, and those negative thoughts and feelings can trap one in a vicious cycle.

But why is CBT used in the treatment of depression specifically?

CBT for depression

The NHS has emphasised the effectiveness of CBT for depression. According to a study carried out by various academic institutions, a cognitive approach to treating depression can:

reduce the symptoms of depression in people who fail to respond to drug treatment”.

Various studies highlight the link between CBT and depression. The potential to use cognitive therapy for depression was first highlighted by Aaron T. Beck and Albert Ellis in the 1950s and early 1960s.

Both psychologists were believed to have played a vital role in pioneering the use of CBT for treating depression and other mood disorders. They developed procedures to challenge negative assumptions and beliefs to help sufferers learn how to change their thoughts and adopt a more realistic approach.

How does cognitive behavioural therapy work?

CBT aims to change thought processes which influence behaviour.

The CBT model of depression states that the events in people’s lives do not influence them but the view they take of the events do.

The thinking process and negative appraisal of life events lead to the development of dysfunctional cognitive reactions. So, if you tackle these thoughts, then the reactions will be eliminated.

So if someone has regular negative thoughts as a symptom of depression, such as ‘what is the point of getting out of bed?’ or ‘my colleagues will think I’m worthless no matter what I do’, then attending sessions on CBT can be useful.

A therapist will work with them to identify any recurring negative or irrational thoughts they may have and will work towards replacing these beliefs with healthier and more practical thoughts.

How long does CBT take to work for depression?

It’s considered short-term therapy; therefore, CBT treatments often require anything from 10 to 20 sessions. The exact amount will depend on a variety of elements including:

  • The type of depression (major, manic, chronic, etc)
  • The severity and duration of the symptoms being experienced
  • The level of stress it’s causing
  • The amount of support being received (from friends, family, work, etc)

Individual sessions normally last for 30 to 60 minutes, once or twice a week.

Strengths and weaknesses of CBT for depression

But how effective is CBT for depression, and does it work?

Professionals often cite CBT as the most effective form of psychotherapy that currently exists. Alongside medication, medical professionals even find CBT for major depressive disorders the most effective form of therapy.

Using CBT, mental health professionals can delve deeper into the root causes of mental health problems. This form of therapy takes a more pragmatic and problem-solving approach than other forms of psychotherapy.

There are instances when CBT does not work for depression. In these scenarios, experts will recommend a combination of antidepressants and therapy.

The study mentioned above found that over 12 months, patients that received CBT with antidepressants were around three times more likely to respond to treatment and see a reduction in their depression symptoms.

This form of therapy aims to use the skills learnt during the sessions to manage problems and stop them from having a negative impact.

Benefits of CBT for depression

It is a long term skill, Because many of the techniques for managing thoughts and behaviours can be applied to any situation.

Once you have completed several CBT sessions, the effectiveness of the treatment in preventing your depression from returning can help you reduce the impact of depression on your life well into the future.   

While this form of treatment might not be suitable for everyone, according to the NHS, CBT therapy for depression can be as effective as taking medicines such as antidepressants. Other advantages include:

  • Resolving relationship difficulties
  • Managing anger
  • Preventing addiction
  • Identifying negative thoughts
  • Teaches practical strategies for managing negative thoughts and beliefs

Limitations of CBT for depression

However, CBT cannot treat all forms of depression effectively. Depression can be very debilitating, and CBT is a very involved form of therapy, which could be beyond someone in that position.

Because CBT only addresses current problems and focuses on specific issues, it does not address the possible underlying causes of mental health conditions, such as an unhappy childhood. It does not address wider problems in systems or families that often have a significant impact on an individual’s health and wellbeing.

Here are some of the limitations:

  • To benefit from CBT, patients need to commit the process.
  • Attending regular CBT sessions and carrying out any extra work between sessions can take up a lot of your time.
  • As CBT can involve confronting emotions and anxieties, causing initially more anxious or emotionally uncomfortable feelings.
  • CBT focuses on the individual’s capacity to change themselves

CBT exercises for depression

Various researchers have identified and developed a number of cognitive behavioural therapy interventions for depression.

Using a mixture of mental exercises and worksheets, sufferers will not only understand CBT on a theoretical level, but also be equipped with the tools to apply it to their daily lives.

CBT examples for depression include:

  • Journaling
  • Exposure and response prevention
  • Cognitive restructuring (reframing negative thoughts)
  • Activity scheduling
  • Relaxation and mindfulness
  • Roleplay
  • Imagery-based exposure

CBT alternatives for depression

As we mentioned above, while CBT may work for some people, it may not work for others. Before resorting to antidepressants, there are other alternatives for those suffering from depression and other mental health conditions.

  • Electroconvulsive therapy: Or electric shock therapy is normally used as a last resort to treat more severe forms of depression.
  • Lithium: When antidepressants don’t work, a doctor will most likely recommend lithium to use in conjunction with the current treatment.
  • Support groups: These self-help groups help vocalise identify negative thoughts through talking. It eliminates the feeling of isolation by meeting people in similar circumstances.

Supporting employees with CBT

Employee assistance programmes support your staff when they need it most.

It’s a benefits programme that helps employees address problems that might affect their work performance or wellbeing.

Health Assured’s EAP service offers a range of trauma-specific interventions, one of which includes cognitive behavioural therapy. Also included as part of this service:

  • 24/7 access to counselling
  • Telephone support
  • Access to our health hub
  • An online portal, etc.

Contact us today for more information on recognising and managing depression at work on 0844 891 0352

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