1. Cognitive explanation of depression

2. Starter- Based on your flipped homework on the cognitive explanations of depression
link any of the following words together and write a brief description of why they are linked.
Irrational thoughts
Ellis
Activating event
Beck
Negative self schemas
Emotion
The negative triad
Self-blame schema
Irrational Belief
Mustabatory thinking
Cognitive bias
Overgeneralisation

3. Use what you know about Ellis’ cognitive ‘abc’ model of depression to explain why the person did not become depressed

4. Knowledge check activity
Answer the exam style questions below:
Outline Ellis’ ABC model (4 marks)
Ellis proposed the key to mental disorders, such as depression lay in irrational beliefs. The source of these irrational beliefs lies in mustabatory thinking. What is meant by the term mustabatory thinking? Give examples in your answer (4 marks)
Explain why mustabatory thinking increases the likelihood of depression and what it is (4 marks)
Outline Becks’s cognitive triad (4 marks)

5. Question 1
Two marks for naming and explaining A (activating event), B (belief), C (consequence). Two subsequent marks for examples illustrating each component A, B,C.

6. Question 2
One mark for explaining that this involves thinking certain ideas or assumptions must be true in order for the person to be happy.
Two marks for identifying 2 of the irrational beliefs Ellis identified (3 possible answers)
and one mark for using a suitable example to demonstrate these beliefs.

7. Question 3
One mark for stating that the person who holds the irrational belief risks becoming depressed when the ‘must’ is not fulfilled. Often musts reflect very unrealistic standards so disappointment in likely.
One mark for giving an example e.g. depression occurs due to irrational belief regarding failure “ I must always do well so failing the test means I am stupid”

8. Exam practice
Ewan has just been diagnosed with depression having felt overwhelmed with despair for the last 12 weeks. His doctor suggested that the cause of this was the fact that Ewan’s long-term partner walked out on him three months ago. When this happened, Ewan convinced himself that he would never find himself another boyfriend.
Using Ellis’ ABC model, explain why Ewan is suffering from depression (6 marks)

9. Becks negative triad
On the following slide are some true or false questions
If it is true then expand on the answer
If it is false then correct the statement.
Group 1- statement 1+2
Group 2- statement 3+4
Group 3- statement 5+6
Group 4- statement 7+1
Group 5- statement 2+3
Group 6- statement 4+5
If you finish: what are the similarities and differences between Beck and Ellis’ explanations?

10. True or False?
1.Aaron Beck developed a cognitive explanation for all mental disorders.
2. Beck believed that if our thinking is biased towards negative interpretations of the world, we are likely to suffer from depression.
3. A schema is a cognitive framework that helps organise and interpret information. Schemas help us to make sense of the world.
4. Depressed people have developed a negative schema during childhood.
5. Negative schemas are activated whenever a person encounters a new situation that resembles the original conditions in which the schemas were learned
6. Negative schemas lead to systematic behavioural biases
7. Negative schemas and cognitive biases maintain what Beck calls the negative triad: a pessimistic and irrational view of the four key elements in a person’s belief system.

11. Answers: False: explanation focused specifically on depression
True: depressed patients also lack any perceived control over events in the world
True: could give an example e.g. schema for restaurant means we know how to act when visiting a new establishment for dinner
False: developed during childhood due to a variety of factors, including parental/peer rejection, criticism by teachers
True: example of expecting to fail (schema) and exam (event) could be given
False: leads to ‘cognitive biases’ in thinking
False: there are three key elements.

12. True or False?
1.Aaron Beck developed a cognitive explanation for all mental disorders.
False
2. Beck believed that if our thinking is biased towards negative interpretations of the world, we are likely to suffer from depression.
True
3. A schema is a cognitive framework that helps organise and interpret information. Schemas help us to make sense of the world.
4. Depressed people have developed a negative schema during childhood.
5. Negative schemas are activated whenever a person encounters a new situation that resembles the original conditions in which the schemas were learned
6. Negative schemas lead to systematic behavioural biases
7. Negative schemas and cognitive biases maintain what Beck calls the negative triad: a pessimistic and irrational view of the four key elements in a person’s belief system.

13. Application
Rupert recently failed a mock A-level exam. He feels very down about it and is experiencing other symptoms of depression too. He thinks he is useless and worthless, and feels guilty for letting everyone down. He now finds he can’t motivate himself to work or do anything to improve next time.
Explain ’s Rupert’s depression in terms of Beck’s negative triad
In Ellis’ terms, identify and explain the ABC of Rupert’s experience.

14. AO1 ‘selectivity’ task Key term Summary (25 words)
“Describe and evaluate the cognitive approach as an explanation of depression” (16 marks)
Plan what you would write in the AO1 section for this exam question.
There is lots of information in your pack so you must select 6 key terms that you think are the most important things to include.
You have to summarise these in approx. 25 words.
Remember it is only worth 6 marks!
This activity should be done with no notes but you can discuss in pairs or on your table.
Key term
Summary (25 words)

15. Evaluation
Take a few minutes as a group to remind yourself of what you discussed last lesson on the cognitive explanations of depression
What evidence (research studies) is there to suggest faulty cognitions play a role in depression? You will need to look these up in textbook/pack
Do irrational thoughts cause depression or does depression cause irrational thoughts?
Who does the cognitive approach blame for depression experienced?
Why is the above a problem?
Why is the cognitive approach seen as a more positive/useful approach than a biological approach?
THINK: how might biological factors be involved in the development of depression?

16. Bubble technique
This activity is designed for you to create developed evaluations that show consideration of two sides of an argument.
I would like you to record your ideas in your own words do not copy from the pack! The point of the PES has been done for you.
This activity is essentially planning an evaluation section to the essay title:
“Describe and evaluate the cognitive approach as an explanation of depression” (16 marks)

17. Cognitive treatment for depression

18. Greta suffers from depression
Greta suffers from depression. She often experiences feelings of hopelessness and worries constantly that she is a burden to others; she feels guilty for having depression. This has affected her work, as she believes she cannot cope; some days she finds it difficult to even get up let alone travel to work. She reports losing interest in food and finds sleeping difficult. Previously, Greta was in a relationship which she describes as very controlling. Following the breakdown of this relationship, Greta found herself staying home more, avoiding friends and losing enthusiasm for life in general. Although she now realises her partner was very manipulative, she blames herself for how she was treated. Following a discussion with her GP, Greta has been referred to a psychologist for cognitive behavioural therapy.
Using your knowledge of the characteristics of depression, identify as many characteristics as you can (these must include behavioural, emotional and cognitive characteristics).
Can you identify anything in the scenario which would link to Beck’s cognitive triad?
Can you identify the ABC (Ellis) in the scenario?

19. Quick recap based on homework
On wall-boards:
Bullet point what can you remember/what you know about cognitive behavioural treatments?
Here are some key aspects of CBT below:
Identifying automatic negative thoughts about the self/world/future (thought catching)
Identifying the activating event and the negative irrational belief that has resulted from it
Effort to challenge maladaptive thoughts
Engagement in empirical and logical dispute (attempts to get the client to consider if their interpretations are based on sound evidence or if they are logical)
Encouragement to engage in activities (behavioural activation)
Evidence that the client is beginning to change their interpretations to become more positive in their thinking

20. https://www. youtube. com/watch
From the video clips, write down specific examples for the following aspects of cbt:
Identifying automatic negative thoughts about the self/world/future (thought catching)
Identifying the activating event and the negative irrational belief that has resulted from it
Effort to challenge maladaptive thoughts
Engagement in empirical and logical dispute (attempts to get the client to consider if their interpretations are based on sound evidence or if they are logical)
Here’s a video giving more info on Behavioural activation

21. Evaluating Cognitive Treatments
In groups:
Firstly, organise the evaluation points given to you into whether they are an positive or negative points on CBT. Note: there may be some points that could be considered both.
Extend: Have a go at organising the points into logical order relevant to answering the following question: ‘Evaluate cognitive treatments of depression (10 marks)’.
Now, individually answer the questions on MWB’s given on some of the points to elaborate further. You can still talk about these with others.
Extend: could you link some of the points together? What ‘anchor’ words (e.g. A strength of CBT is…/However/On the other hand etc) could you use in between the paragraphs to help make the points flow together better?

22. Plenary: Apply it! Research methods: Clinical trial of CBT
The table opposite shows the outcomes for a trial of CBT vs more old fashioned behaviour therapy without cognitive techniques. A higher score indicates greater depression. Q1: Calculate how much improvement each patient showed. Put the data from your calculations in a table (2 marks). Q2: Plot the improvement for each patient against the number of CBT sessions they received on a scattergram (4 marks). Q3: What would you conclude about the relationship between number of sessions and reduction in symptoms? (2 marks)
Plenary: Apply it! Research methods: Clinical trial of CBT