Discuss the Cognitive Approach to Treating Disorders.
Cognitive approach (12 marks)
Becks cognitive triad is the first model. It describes how people’s disorders can be caused by negative views about themselves, about the world and about the future. These beliefs can feed into each other which continues disorders such as depression. Then there is Ellis’s ABC model also explains abnormality through beliefs and behavioural consequences. This model suggests that an activating event causes beliefs these are either rational or irrational. These can lead to consequences; desirable or undesirable emotions and desirable or undesirable behaviour. It is the irrational beliefs and consequences that maintain disorders such as depression. Cognitive biases can be internal, global or stable. Depressed people use cognitive biases to view the world.
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A strength is that there is clear evidence for cognitive biases. Clarke found that individuals with panic disorders exaggerate the significance of physical symptoms. In addition, therapy based treatments are effective in treating anxiety disorders and depression e.g. CBT and REBT.
A weakness of the approach is the idea of schemata and NATS are vague and unexplained. It’s not clear how irrational thoughts are designed and measured. Also the approach is reductionistic as it reduces psychopathology down to a simple set of factors which reduces the validity of the approach. Lastly, it’s not clear if the negative thoughts lead to disorders such as depression or depression leads to negative thoughts. Therefore the cause and effect cannot be inferred reducing the validity of the approach
One treatment for the cognitive approach is Beck’s CBT. The first stage is when the therapist and client agree on nature of problems and goals for the therapy. Stage 2 is when the therapist challenges the client’s negative thoughts and aims for client to realise irrational thoughts and encourage positive thoughts. And the last stage is when the client engages in behaviour between sessions in an attempt to challenge these negative thoughts.
CBT is shown to be as effective as drug treatment therapy for treating depression and anxiety, improvements may last longer. Also CBT assumes that the cause of depression for example, lies in maladaptive thoughts so it is targeting the cause of abnormality not just the symptoms.
However, CBT is effective for depression and anxiety, it is less effective for phobias than systematic desensitisation and severe disorders such as schizophrenia are not suited for CBT. Also cognitive approach ignores genetics and biological factors in abnormality. CBT also avoids in depth probing associated with psychoanalysis. Some may find the diary keeping and self-monitoring associated with CBT stressful. Lastly, emphasis on CBT is on cognitive change or restructuring and behavioural change, without cognitive change is unlikely to help a depressed person.
Another treatment is Ellis’s REBT (rational emotive behavioural therapy). An event activates irrational thoughts which lead to negative emotions. Ellis believes people maintain negative emotion by always telling themselves how inadequate they are. The first stage the therapist and client identify negative situation. Then the therapist helps rationalise the situation and show them a realistic perspective.
This therapy is more confrontational approach than beck which makes this therapy more effective.