Is Cognitive Therapy an Efficacious Treatment for Depression?

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Is Cognitive Therapy an Efficacious

Treatment for Depression?

Tesni Rowlands

Deakin University Waurn Ponds

Subject: HPS308 Psychopathology

Assignment: Assignment 1 Essay

Student No.:  700165229

Unit Chair: Dr Eric Koukounas

Tutor: Shannon Hyder

Submitted: 25 August 2010

Word Count: 2016

Is Cognitive Therapy an Efficacious Treatment for Depression?

Introduction

Major depressive disorder, better known as clinical depression, is a mental disorder which is characterized by symptoms such as feelings of worthlessness, loss of sleep, loss of interest and an inability to experience pleasure for a period lasting longer than two weeks (Barlow & Durand, 2005). Traditionally, depression was treated using antidepressant medication (ADM) and was seen as the most standard treatment for severe depression (Dimidjian, Hollon, Dobson, Schmaling, et al., 2006). However, ADM was not useful for all forms of depression, with some patients refusing to take medication due to the harmful side effects. Therefore, psychotherapy techniques, such as cognitive behavioural therapy (CBT) and interpersonal psychotherapy (IPT) became increasingly popular for the treatment of depression and were given a high level of credibility. The way in which CBT was used to treat depression was to identify and alter negative thinking styles and replaced them with positive beliefs and attitudes. Similarly, IPT emphasised resolution of interpersonal problems and builded interpersonal skills. However, recent studies have questioned the efficacy of CBT and IPT in treating depression, suggesting that the effectiveness of treating depression with psychotherapies were grossly over estimated and it is not as effective as pharmacotherapy. Therefore, the controversial topic of whether CBT is an efficacious treatment for depression needs to be explored further before a conclusion can be made on how to effective CBT is in treating depression.

Efficaciousness

Evidence based practice (EBP) refers to preferential use of mental and behavioural health interventions for which systematic empirical research has provided evidence of statistically significant effectiveness as treatments for specific problems. EBP is an approach which tries to specify the way in which conclusions are made by identifying evidence and rating it according to how scientifically sound it may be. The main goal is to eliminate unsound or excessively risky practices in favour of those that have better outcomes. Within EBD, randomized controlled trials are a preferred form of research; however meta-analysis is also used. The type of evidence that RCTs provide about treatments is called evidence of efficacy (Bower, 2003). Efficacy, or clinical efficacy, is defined as the strength of an intervention as assessed under highly controlled scientific conditions. To determine clinical efficacy, the experiment must establish whether the intervention is better than no therapy, non-specific therapy or an alternative therapy. Comparatively, effectiveness, or clinical utility, is concerned with the treatments strength when tested in clinical setting and its overall benefits. It is also concerned with external validity, the extent to which internally valid intervention is effective in different settings and the different circumstances in which they were tested.  When evaluating treatments for psychological disorders, it is important to establish clinical efficacy and clinical utility to establish their effectiveness in treating psychological disorders, such as depression (Barlow & Durand, 2003).

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Efficaciousness of Cognitive Therapy

Cognitive behavioural therapy (CBT) has previously been suggested by professionals to be a highly effective treatment for depression; however an increasing amount of research has contradicted these proposals. One of the largest and most influential treatment outcomes ever conducted in determining the best treatment for depression is the Treatment of Depression Collaborative Research Program (TDCRP). A sample of 250 unipolar depressed patients at three different sites where randomly assigned to one of four treatment conditions; CBT, IPT, imipramine plus clinical management (ICM) and a pill-placebo control group. Initially, the findings suggested few differences between the four ...

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