The effectiveness of Cognitive Behavioural Therapy in the Treatment of Depression in Adults.
In this critical evaluation we will go into depth and review findings of relevant and recent research in regards to the effectiveness of Cognitive Behavioural Therapy (CBT) linked with depression in adults, and whether or not there is an appropriate range of academic sources that are comprehensive and accurately up-to-date with this research topic. The focus of this paper will be on the central findings of this topic as well as delving into a greater understanding of CBT and depression. Therefore, it is seen through vast and in depth research that Cognitive Behavioural Therapy is effective in the treatment of depression in adults. Nevertheless, there are still many arguments surrounding this finding, all attempting to provide evidence and support for their own findings of this topic, that gives way to significant and essential interpretations and understandings of CBT’s effectiveness with adult depression. Depression is a well-known mental illness that can affect everyone at different age ranges, however in this case, adults. And CBT is also a well-known and used form of psychotherapy that focuses on changing negative behavioural and emotional patterns, that is known to be effective in the treatment of adult depression. Therefore, CBT is effective in the treatment of adult depression.
There have been many studies ranging over many years that have delved into the topic of CBT and whether or not it is an effective treatment for depression. Depression is a common and thoroughly researched mental illness that has been prevalent in society for hundreds of years. It has been reported that in Australia, one in eleven adults (8.9%) have reported having depression in 2014-15 (Australian Bureau of Statistics, 2015). Depression is a treatable mood disorder seen in adults (and other age ranges), and it known to be one of the world’s largest public health concerns, and can also be associated with an number of effective treatments that are widely available to the public, such as treatment with medications such as anti-depressants (Randolph, 2016; Thase, 2016). Therefore, many sources have agreed that depression is a treatment illness, and are suggestive that there are many symptoms and causes for this disorder, however, it continues to largely go untreated in the greater population. It can be seen through research that effective and working treatments of depression are able to reduce symptoms that are associated with the disease, as well as being able to improve the overall function and negative effects that can cause a physical toll on the person suffering from depression (Thase, 2016).
Depression ultimately affects the psychosocial functions such as how a person feels, acts and thinks, therefore, impacting and diminishing their quality of life (Bland & Streiner, 2013; Malhi & Mann, 2018). There are several forms of depression that have been defined through exploration, such as major depression and persistent depressive disorder and also postpartum depression (Randolph, 2016). Many studies have suggested that there are an increasingly growing number of factors that are known to play a role in depression, and in a depressive episode, such as social and cultural factors, trauma, stress and other biological and genomic factors as well as other health-related illnesses, medications, drugs and alcohol (Malhi & Mann, 2018; Bland & Streiner, 2013; Randolph, 2016). And because of this, there are many long-term consequences that are impar with depression such as reduced quality of life, risk of suicide and stigmatization Bland & Steiner, 2013). Consequently, Malhi & Mann (2018) and Randolph (2016) have suggested that the most common period for the onset of one’s depression encompasses mid-adolescence to mid-40s. Studies have also suggested that depression is more common in females than in men, peaking in both genders in the second and third decades of their life, suggesting that depression is increasingly common in adults (Malhi & Mann, 2018; Monroe & Anderson, 2013; Randolph, 2016).
Depression is known to be completely unpredictable, therefore, causing the duration, the number of depressive episodes and the duration of said episodes to seem completely random (Malhi & Mann, 2018). The DSM-5 has suggested that most of the symptoms of depression are recognisable as common feelings states of a person, that include emotional and physical responses. Therefore, suggesting that to some degree depression is a part of everyday life, and part of human functioning, while also being linked to a severe disorder (Monroe & Anderson, 2013). Many studies have suggested the same recommendation in the fight to reduce the prevalence of depression and untreated depression, which is the screening for this mental illness to be conducted better, to respond more flexibly and decisively to adult patients (Bland & Streiner, 2013; Thase, 2016). Therefore, many published studies have been in agreement with the fact that depression in adults is increasingly common and impactful of their everyday lives. However, consistent findings were obtained despite research coming from different samples, methods and writing, therefore, this is indicative of a robust finding that is able to define adult depression appropriately.
Cognitive Behavioural Therapy
Cognitive Behavioural Theory (CBT) is a psychotherapy that attempts to help and change negative patterns and emotions of a human in order to alter unwanted behavioural patterns (Chawathey, 2016; Hazlett-Stevens & Craske, 2004). It is most commonly used in regards to the treatment of depression and anxiety. It is seen that in CBT, the therapists are focused on how negative thoughts are impacting their patient and their emotional state and behavioural functioning, thus sharing the understanding that mental disorders and psychological distress are continuously maintained by cognitive factors (Cuijpers & Andersson, 2009; Hofmann, Asnaani, Vonk, Sawyer, & Fang, 2012). The core premise of this therapy approach was done by Beck (1970) and Ellis (1962). They suggested that maladaptive cognitions highly contribute to behavioural problems as well as emotional distress, hence creating a basic model of therapeutic strategies that help lead to changes (Hazlett-Stevens & Craske, 2004; Hofmann et al., 2012; Beck, 1970; Ellis, 1962).
Since the 1970s, CBT has been applied to a wide range of disorders, such as depression, anxiety, bipolar disorder, substance abuse and many others (Butler et al., 2006). Thus, in future analyses of CBT, it would be recommended that further research be put into whether CBT is an effective treatment for this wide range of disorders. Earlier meta-analyses have suggest that CBT is more effective and successful in treatment than other types of psychological treatment of disorders, particularly depression. Also suggestions have been made by Hofmann, Asnaani, Vonk, Sawyer, and Fang, (2012), that further analyses should be delved into specific subgroups, such as ethnic minorities and low socioeconomic samples in regards to CBT treatment and effectiveness. However, Cuijpers and Andersson’s (2009), though not terribly recent, has suggested that there is no indication that CBT is more successful than other psychological treatments. Therefore, suggesting that, though CBT is effective, it is just as effective as other types of psychological treatments.
CBT is a highly regarded psychotherapy that has been thoroughly researched and analysed by many. With an estimated 325 published studies showing the outcomes of CBT interventions that have looked into the overall effectiveness of CBT with different disorder (Butler et al., 2006). Butler, Chapman, Forman and Beck (2006), have also suggested the idea that CBT works better than antidepressants in the treatment for adult depression, all the while, continuing to be a superior treatment method for other disorders; such as depression, anxiety and obsessive-compulsive disorder. However, questions are still asked regarding the overall effectiveness of CBT, and many studies have suggest that it is efficacious, however, it is not the most effective psychotherapeutic treatment for disorders, in fact, CBT is seen to work exceptionally well with anxiety disorders over other disorders (Hofmann et al., 2012). Evidence of CBT is suggestive of the matter that the effects of CBT do not last after treatment has finished, however, given CBT’s focus on the modification and the changing of one’s negative thoughts, it would be expected that treatment lasted over a long time frame (Butler et al., 2006).The timeframe for CBT treatments are known to be brief and time-limited, though they were still noted to be able to cause significant improvements relative to other forms of psychotherapy (Butler et al., 2006; Hazlett-Stevens & Craske, 2004; Hofmann et al., 2012). There are many specific and essential features of CBT, such as that symptoms, negative thinking and dysfunctional behavour are being cognitively mediated, thus improving the overall standard of living for the patient (Butler et al., 2006). Therefore, this shows that there is a gap in literature, as well as a contradiction that yes CBT is efficacious but the effectiveness, short-term and long-term is still questioned by many sources.
Cognitive Behavioural Therapy and Depression
Cognitive Behavioural therapy is suggested to be the most researched and used form of psychotherapy for adult depression (Cuijpers et al., 2013; Dimidjian et al., 2006). There have been many implications of CBT and its form of treatment with adult depression. CBT is seen to be an effective treatment style for adult depression, and although there is limited evidence to suggest that CBT is the primary and best psychotherapy to use, it still remains the most-studied style of therapy for this disorder. Many studies have been suggestive that through the combined treatment of CBT and pharmacotherapy, it is seen to be highly more effective in treating adult depression then just pharmacotherapy by itself (Cuijpers et al., 2013).
A meta-analysis that was done in 1989 showed that cognitive behavioural therapy for depression in adults showed a positive relationship between both. However, it was also seen in a more recent analysis, including Cuijpers and Andersson (2013), that the relationship between CBT and adult depression showed no indication that CBT was more effective in the treatment of adult depression than other psychological treatments, thus suggesting that, although CBT is successful and effective in the treatment of depression in adults, there are other psychological therapies that are just as, or more, successful then CBT (Cuijpers & Andersson, 2009; Cuijpers et al., 2013; Hazlett-Stevens & Craske, 2004; Hofmann et al., 2012). The research into the effectiveness of CBT and adult depression has had very mixed theories and answers, some studies suggested high levels of support and evidence that CBT is an effective treatment, however, other studies have shown the opposite and have even gone as far as suggesting that strong effectiveness in some studies is because of overstimulation due to a publication bias (Hofmann et al., 2012). Through the analyses of research journals, meta-analyses and peer-reviewed articles, it has become apparent to me that further research is to be advised. More research is needed to explore the results of these analyses further, in regards to how these other psychological treatments are more effective then CBT, and how CBT can work in the longer term, because depressive disorders are chronic and can come back at any time.
Therefore, through a vast variety of thorough research, it has been highly suggestive of the notion that Cognitive Behavioural Therapy is highly efficacious in the treatment of depression in adults. However, it is noted to be more effective when combined with pharmacotherapy, as well as suggesting that even though CBT is an effective psychotherapy, other psychotherapies are just as successful, or more successful in the treatment of adult depression. Depression is a serious mental illness in today’s society, not only for adults suffering through it, and thus, measures and treatments need to continue to adapt and get better at treating this disorder. Therefore, founded through qualified and current research, Cognitive Behavioural Therapy is an effective treatment approach for depression in adults.
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