The Effectiveness of CBT toward Depression

Depression

Depression is an intense feeling of sadness, being moody which lasts for an extended period. At times, depression can happen for no obvious reason, and it can affect an individual’s mental and physical health. According to world Health Organization, depression is third highest disease (Sudak, 2006). Depression is as well the highest ranking psychiatrist disorder concerning the reduction of the longevity of human life. Both syndromes characterize it and as a disease (Dubicka et al., 2010). As a syndrome, it encompasses the different episodes that result in sadness, interest loss, loss of appetite, loss of the sexual desire and change like the sleep patterns (Dobson & Dobson, 2006). It is also characterized by a reduction in the level of motivation, increased pessimism, and frequency of suicidal thoughts as well as increased negative energy where individuals view themselves as inferior beings.  

As a disorder, it can be characterized as an illness that includes body, mood and thoughts. It can affect a person’s daily routine and healthy functioning. It can cause pain for the individual and also family and friends. The depressive disorder occurs in various forms among them, major depressions (Okumura & Ichikura, 2014). The disease is triggered by different symptoms that affect an individual’s ability to perform chores, study, and sleep.  The disorder can occur once or various times in a person’s life. Another common depressive disorder is the dysthymic disorder which includes long-term less severe symptoms (Dubicka et al., 2010). The symptoms do not disable a person they rather keep one from functioning properly. Other examples of depressive dysfunctions include psychotic depression that occurs when some episodes of psychosis accompany an extreme depressive illness (Greenberger, Padesky & Beck, 2015). The events can include a break with reality, and illusions. Another type of depressive disorder includes postpartum depression. The depression mainly occurs among new mother, and they usually occur one month after they deliver.

Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) that is well suited for addressing the various issues as well as the long-standing problems that are associated with the affected individuals (Okumura & Ichikura, 2014). According to CBT, there is an interaction between how we think our emotions and behavior. In this case, a person’s feelings and behaviors are determined by the way they think. Even though the fundamental techniques and principles are direct, various treatments fall under CBT (Hofmann & Reinecke, 2010). The treatments include cognitive therapy, dialectical behavior therapy, rational-emotive behavior therapy, problem-solving therapy and rational-emotive therapy. The important role of cognitions in influencing and upholding psychological problems is stressed (Petersen, Sprich & Wilhelm, 2015).  According to the CBT model, psychopathology occurs when information is processed in a faulty manner thus causing negative emotions and maladaptive behaviors.

            The primary element of CBT practice is self-guided activity. CBTs educational and self-help principles empower a person to become their own therapist. The achievement of homework assignments outside session strengthens this learning experience.  Self-guided activity can be highly diverse, starting from reading self-assistance document to taking up behavioral experiments (Okumura & Ichikura, 2014). Mainly, it is created collectively with a coherent rationale for treatment purposes.  As the therapy continues and the patient becomes more accustomed to CBT, they can embrace a notably independent role in generating homework with declining levels of therapist participation (Wright et al., 2006). CBT concise duration is highly enabled by the completion of self-guided activity outside session allowing therapy to happen regularly in the patient’s time. Successful self-guiding activity completion has been linked with enhanced therapeutic results. In this case, clients who continuously complete the entire process show better results than those who do not. 

The Case of Depression

In depression, a person may show a high degree of struggle due to lack of motivation which subsequently can result in changes in their behaviors such as increasing their tearful rates and irritability (Antony, Ledley & Heimberg, 2005). A person can as well exhibit a certain degree of change in his or her physical symptoms in that he or she had more eating as well as sleeping strains and struggle.  A person may also be de-motivated whereby, they may have default thought and assumption and expectation of failure (Knaus, 2012). An individual may exhibit a lower sense of the individual efficacy, and he or she may have perceived inability to have sufficient coping ability. One may view himself as an incompetent person who has little to accomplish in his life and as such he may be constantly indecisive, and he may have low ability to finish and see his daily targets go through (Segal et al., 2013).  A person may also be exceedingly isolated from the rest of the population in his sphere of existence and as he may have withdrawals that are ever curtaining them from establishing social connections (Gallagher & Thompson, 2010). A depressed person may also show signs of fatigue as well as the low energy that may hinder him from carrying out life tasks.  All the symptoms highlight that a person has negative energy.

The Application of CBT

Cognition

            CBT mainly centers its efforts on exploring the relationship that is already established amongst the affected person’s feelings, their thoughts as well as their behaviors. The professional using the technique is helped to uncover the unhealthy patterns that are established in the thought pattern of the individual that could be the central reason as to why the person is undergoing the self-destructive ways due to negative beliefs as well as behaviors (Ravitz et al., 2013). The central pathway in which the procedure of CBT aid in resolving of the involves the patient and as well the therapist collaboration with the core aim of developing very constructive ways of the persons thought pathway that would lead to the production of healthier behavior as well as a belief system. CBT, for example, can aid the person in the replacement of the depressing set of thoughts that are resulting in the lower self-esteem and as such sustain the mood of the affected within a narrow range that does not turn into phases through the depression process (Gilson, 2009). The process is initiated through the principle of identifying the negative as well as the false belief system and then progressing into testing as well as restructuring these systems into better life changing ones (Whitfield & Davidson, 2007). A depressed individual under this method of treatment usually has sessions that they take sets of homework and as such they have both sessions to practice the skill of replacement of the negative thoughts with those that are better, more realistic as well as healthier lifestyle driven.

Through the various studies undertaken its effectiveness in the treatment of depression has resulted in a change in the activities of the brain and research has shown that it can be used in the transformation of the brain functioning (Bieling, McCabe & Antony, 2009). The method is backed by ample scientific data that is supporting as well as used by the existing mental health professionals who are best encompassed with CBT skill. A person may also apply mindfulness to issues that include stress and anxiety. The therapy is also utilized in depression disorder (Hofmann et al., 2012). An individual may use meditation so as they can train oneself to become aware of their wondering thoughts. A person is, therefore, able to concentrate on the present. So as to gain significant results with treatment of depression it is important to meditate for more than one month. Meditation based cognition therapy includes mindful breathing, eating a raisin and mindful stretching.

Behavior

Depression can cause various drastic changes in a person’s life, everyday workouts and practice. Many times it is the changes that make the depression worse and stop the depressed individual from improving.  Lack of motivation and energy can make a person to cut back his activities and neglect their everyday activities (Hofmann et al., 2012). One way to deal with depression is to increase one’s activity level. One can participate in fun activities and handling one’s responsibilities in a realizable and practical. By doing this, one will be able to set themselves to accomplish something.  Increasing one’s activities assist a person to feel better.  It can as well help a person to have a clear mind thus enhancing their thinking. It can also help one to feel less tired.

Behavioral activation is another technique utilized to deal with depression. Unlike other techniques Behavioral activation seeks to assist individuals to comprehend environmental sources of their depression.  The method also focuses on behaviors that can uphold or make the depression worse.  Behavioral Activation focuses on inertia, whereby its approach is to work from outside. A therapist can schedule activities and utilize graded task assignments to permit the patient to begin gradually to enhance their chance of having activity confidently improved.  On the other hand, Behavioral Activation emphasis on avoidance, it is believed that the results of behavior are critical compared to the form of the behavior (Cuijpers et al., 2013). For instance, a person may be sitting outside the house which is the normal setting. Nevertheless, one can be sitting outside the house to escape from an argument with their parents. In this case, it is an escape or evasion behavior.

 Various activities can be used to motivate an individual they can include exercising, learning new skills and activities, and also participating in any work-related objectives. It is as well critical to scrutinize sleep routines and eating habits and work towards normalizing them. To help in learning how a person’s activities impact an individual’s mood an individual is required to complete activity monitoring (Hofmann et al., 2012). In this case, one may be needed to write down the activities that they do in a day or week. During the process, there is the mood rating for every activity. By doing this, a therapist can learn patterns in behavior and avoidance. It assists in enhancing engagement in behaviors that are connected to enhancement in moods. At times, a therapist may additional approaches are required to assist a person to remember to complete their daily routine. They also contribute to acquiring the different skills that are necessary for performing a different assignment. Most treatments have failed to address the Avoidance behavior.

Effectiveness of CBT Vs Other Techniques

Group CBT is an engaging psychological intervention due to its probable cost and time efficiency for treating various patients (Kaslow et al., 2002). CBT is mainly placed on the minimum intensity and high-intensity involvements. Current meta-analyses of randomized control tests have shown the effectiveness of group CBT for depression (Drewes, 2009). Nevertheless, there was no difference between the utilization of non-active controls, medium intensity, minimal intensity and high intensity.  However, research conducted to compare the effectiveness of the treatments with CBT showed that CBT is more effective compared to non-active controls (Dubicka et al., 2010). A meta-analysis of twenty-eight studies was done to prove the results. The study had two thousand one hundred and ninety-two participants. The research showed that CBT had high effectiveness (SMD=-0.68, 95% CI [-0.83, -0.54]) and a related acceptability (RR=1.05, 95% CI [0.81, 1.36]) evaluated to non-active controls.  However, there is an insignificant indication on the effectiveness and applicability of group CBT over high-intensity and low-intensity.

Research also shows that CBT is more effective in treating adult depression compared to alternate intervention. According to the study control conditions capitulated an enormous ES in support of CBT (g=0.71).

CBT vs Psychotherapy

On the other hand, it was discovered that psychotherapy as a treatment for depression is similarly efficient in younger and older adults (Cuijpers et al., 2013). It is also clear that the combination of CBT and pharmacotherapy is more effective that the use of pharmacotherapy treatment alone.  According to study, CBT seems to show signs of limited effectiveness when compared with other psychotherapies. The research showed that ESs was between –0.02 and 0.25. Minimal indication highlighted that CBT was more efficient compared to non-directive supportive therapy. It as well showed minimal evidence that it was more efficient than BA therapy, psychotherapy, and other psychotherapies (Dubicka et al., 2010). However, the study showed intermediate results when CBT was compared with psychodynamic psychotherapy. It had a wider confidence interval (-0.07 to 0.58). Hence, it shows that CT1 is no more efficient than other types of CBT.

Another working treatment procedure that helps in the correction of the depression is the Exposure Therapy that is used in the treatment of depressions. It is said to slow working results after the individual has identified the triggers of the distress and latter layering some techniques that will help one to avoid performing the ritual more often resulting in the pain (Dubicka et al., 2010). The patient is then suggested to confront what is causing the depression in a more controlled environment until they have the mental and the physical boldness to face the whole problem creating a challenge. Interpersonal therapy is related to CBT in that they have similar goals of improving the personal social skill by increasing better and efficient interpersonal communication. It differs gradually in that it is only narrowed to the development of the relationship one has with both the environment they exist as well as the individuals in those surroundings.

Outcome of taking CBT

Application of CBT has overall outcomes that include enhancing an individual general energy level. It also enhances a person’s way of life, whereby they may start enjoying their sleep and also have improved appetite (Drewes, 2009). A person may start participating in activities. The CBT also helps a person to handle stress more effectively. It also helps a person to have a positive mood, and they may start to enjoy to spend time with their friends and families.

Depression has been proved to be life demeaning disorder, but the current trends in the field of therapy have offered more than way out of the vice. The right procedures if determined with the close working of both the patient and their psychiatrist can aid in the development of a life-saving solution.

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