The Treatment of Depression: Cognitive Behavioral Therapy

Subject: Psychiatry
Pages: 7
Words: 2063
Reading time:
9 min
Study level: College

Cognitive-behavioral therapy (CBT) is a common approach used to treat depression. It has been linked to lessening the severity of depressive symptoms due to its interventions’ ability to replace negative thoughts with more positive ones. In addition, CBT has been identified as a better treatment method than antidepressants due to its long-lasting impacts on a patient’s health and low recurrence rates. Similarly, other CBT formats such as the internet or electronic-based strategies have helped increase the accessibility of health services to many patients, even those in remote areas. The alternative formats have proven to be as effective as a face-to-face intervention in reducing depressive symptoms. Additionally, studies show that CBT is the most effective psychotherapy approach making it more appropriate in the treatment of depression.

Depression is a leading cause of disability in the world today. Research indicates that over 280 million people globally suffer from depression. It has also been linked to over 700,000 suicide-related deaths that occur globally every year (World Health Organization, 2021). In the United States, about 4.7% of individuals aged 18 years and above are battling depression. In addition, 11.2% of emergency visits have been associated with depression cases (Center for Disease Control, 2022). The COVID-19 pandemic has exacerbated the incidence and prevalence of depression. Due to the pervasiveness and severity of the disease, the use of therapy has been recommended as an effective treatment method. The cognitive-behavioral therapy (CBT) is one of the most common approaches used in the treatment of depression. CBT is a treatment approach that assists individuals in identifying and altering destructive thought patterns, which have a negative impact on their emotions and behavior. Through the CBT method, individuals recognize their negative thoughts and strive to replace them with more positive and realistic ones. Cognitive-behavioral therapy has proven to be effective in the treatment of depressive disorders.

Literature Review

CBT is efficient in reducing the symptoms of depression, whether as an independent treatment approach or if combined with medications. According to Luo et al. CBT assists individuals in identifying false or maladaptive thinking patterns. It also teaches the patients new skills to reframe their thinking, which helps counter the negative thought patterns, thus improving their thinking and behavior (2020). The study is supported by the findings of Ling et al. (2020), which affirm that CBT lessens depressive symptoms by detecting dysfunctional cognitive patterns, testing them against reality, and restructuring them through diverse strategies. Research has also linked CBT to helping patients comprehend their emotions, develop mindful awareness, and undergo cognitive reformation, decreasing depression signs (Lungu et al., 2020; Bogucki et al., 2021; Gautam et al., 2020). CBT techniques such as psychoeducation, social skills training, and token economy have proved to be efficient in changing emotional and behavioral problems among the adolescents (Walter et al., 2021). Therefore, it is evident that CBT eliminates negative thinking patterns and improves individuals’ thoughts and behavior, thus lessening depressive symptoms.

The CBT approach is effective in the treatment of different depressive disorders. Based on Fordham et al.’s findings, CBT is the most effective form of therapy because not only does it increase the quality of life, but it is used in the treatment of clinical depression (2021). Research also suggests that CBT has proven to be more effective in treating depression than medications such as antidepressants (Walter et al., 2021; Wojnarowski et al., 2018; Luo et al., 2020). For this reason, international directives recommend CBT as the first-line treatment for depression, particularly for adolescents. The studies are supported by Gautam et al.’s findings, which stress that CBT is effective in treating depression (2020). The authors also suggest that CBT is more functional in managing depressive illnesses when combined with pharmacotherapy rather than when using medications alone (Gautam et al., 2020). Similarly, Cuijpers et al. affirm the efficacy of CBT in the treatment of acute depression (2019). Thus, CBT improves patients’ quality of life by easing the depression symptoms and is also critical in treating depression, especially when combined with the appropriate medications.

There are fewer or no relapse incidences associated with CBT treatment procedures. Depression is mostly associated with extremely high rates of recurrence or relapse. Research suggests that major depressive disorder (MDD) has the highest relapse rates, with many patients likely to experience one or more episodes in their lifetime (Wojnarowski et al., 2018; Zhang et al., 2018). However, Gautam et al.’s findings indicate that the relapse incidences of patients using CBT are considerably lower than those treated with medications alone (2020). These findings are consistent with Wojnarowski et al.’s study, which emphasizes that CBT has a lasting impact on patients compared to medications (2018). The long-term effects of CBT considerably assist in lowering patients’ relapse rates. The study maintains that the continuation-phase interventions which have been incorporated into CBT increase the long-term impacts of the therapy. These interventions include mindfulness-based cognitive therapy (MBCT) (Wojnarowski et al., 2018). Zhang et al.’s findings also demonstrate that MBCT is significantly efficient in preventing recurrence among patients with three or more episodes of depression. It also affirms that MBCT is more effective in averting relapse than antidepressant medications.

Several formats of CBT have increased patients’ access to mental health services. Although CBT has proven effective in managing and treating depression, accessing CBT services has become increasingly difficult for many patients. This has been linked to a limited number of specialists, high costs, long waiting lines, and stigma associated with visiting therapists (Lungu et al., 2020; Cuijpers et al., 2019; Luo et al., 2020). As a result, new formats of CBT have emerged to reduce the gap and privatize mental care. According to Lungu et al. (2020), the use of internet-administered CBT (iCBT) has become pivotal in managing depression. In this case, patients can interact with their therapists through face-to-face chats or videos to receive the needed support. They can also access text, audio files, and other contents over the internet. The study indicates that the patient-therapist interaction through the internet is as effective as the face-to-face patient-therapist engagement in real life (Lungu et al., 2020). Therefore, iCBT is efficient in lessening the symptoms associated with depression. Additionally, other key benefits of iCBT include greater geographical coverage, cost-effectiveness scalability, and treatment fidelity.

The importance of various CBT formats in the treatment of depression is also discussed in a 2019 study by Cuijpers et al. The authors stress that diverse CBT formats such as individual, telephone, group, and guided self-help treatment interventions have proved effective in managing depression among the adults. The study deduced that for acute depression cases, telephone, group, and guided self-help treatment formats are equally as effective as individual CBT. This implies that CBT presents a wide array of depression-related services because there are many alternatives that work in alleviating the symptoms associated with the disorder. Similarly, all the CBT formats have been proven to have long-term effectiveness (Cuijpers et al., 2019). Another study by Luo et al. suggests that electronic CBT (eCBT) is more efficient than face-to-face CBT in decreasing the severity of depression symptoms (2020). Additionally, the authors stress that eCBT is less costly and more convenient for patients. Therefore, CBT is efficient in managing depression, whether through direct therapist-patient contact or other formats such as the internet or phones.

The presence of a moderator in CBT considerably improves its effectiveness in treating depression. Studies show that the efficiency of CBT interventions in managing depression highly depends on the therapist’s presence (Lungu et al., 2020; Cuijpers et al., 2019). According to Lungu et al., iCBT interventions involving human support resulted in better health outcomes than those with no therapist mediation (2020). Additionally, the iCBT strategies with human support had more long-lasting impacts and increased adherence rates than the unsupported ones. The iCBT interventions with no therapist involvement were characterized by low motivation and increased dropout rates (Lungu et al., 2020). This implies that therapists play a crucial role in motivating the patients to change and embrace new behaviors. Lungu et al.’s findings are supported by Cuijpers et al.’s study, which affirms that unguided self-help therapy may not be as efficient as professional-guided interventions (2019). Furthermore, Walter et al.’s research indicates that CBT interventions in the treatment of depression are more effective when delivered under a routine care environment involving a therapist’s involvement. Therefore, the presence of a therapist positively influences the implementation of CBT interventions leading to improved depression management.

CBT increases patients’ adherence to the recommended treatment plans resulting in better outcomes. Based on research, poor medical compliance is one of the biggest challenges hindering the treatment of depression, particularly MDD (Xu et al., 2020). For this reason, the combination of CBT and medication has been recommended to improve patients’ health outcomes and prevent cases of relapse (Gautam et al., 2020; Xu et al., 2020). According to Xu et al., various CBT interventions such as social skills training, tracking moods, and engaging in homework assignments considerably improve drug compliance among depression patients. Similarly, the study shows that incorporating CBT after a patient has been introduced to antidepressants improves drug adherence and prevents recurrence once the medication has been discontinued (Xu et al., 2020). To support Xu et al.’s findings, Bruijniks et al.’s study shows that CBT improves patient outcomes because its interventions include regular supervision, meetings, and a mutual goal between the therapist and the patient (2018). CBT allows psychotherapists to modify the treatment methods if found non-effective or comply with the clients’ preferences, thus increasing medical adherence.

The CBT approach is less costly than antidepressants, making it more productive in treating depression. According to research, the initial treatment plan recommended for depression, especially MDD, is either CBT or second-generation antidepressants (Ross et al., 2019). Wojnarowski et al. highlight that CBT is cheaper than pharmacotherapy due to its long-lasting impacts. In this case, the initial cost of CBT may be high; however, by examining its efficiency in managing depression in the long term it is more cost-effective than medication use (Wojnarowski et al., 2019; Ross et al., 2019). Additionally, the iCBT, eCBT, telephone, and other self-help management interventions have increased the cost-effectiveness of CBT in depression management (Lungu et al., 2020; Cuijpers et al., 2019; Luo et al., 2020). Thus, the long-term effects of CBT interventions in the treatment of depression make it more cost-effective compared to antidepressants.

CBT is the most effective psychological approach used in treating mental disorders, including depression. CBT has been identified as the ‘gold standard’ in the field of psychotherapy (David et al., 2018). The evidence was gathered following an extensive meta-analysis of several publications and academic programs. The data was also collected from multiple professional experts in the field. Based on the study’s findings, CBT is the most superior therapeutic method due to its efficacy and also because its models align with the current paradigms of human behavior. Similarly, CBT presents evidence-based information which is guides many clinical processes. Moreover, many psychotherapists prefer CBT as their reference treatment method due to its efficacy. This may explain why it was recommended as a first-line treatment for various disorders, including depression (David et al., 2018; Gautam et al., 2020). In this case, CBT has been proven as the most effective therapeutic intervention compared to other psychological methods. It also presents better patient outcomes compared to antidepressants, making it the most appropriate treatment method for depression.

In conclusion, CBT is effective in treating and managing depressive disorders. Its intervention strategies help restructure negative thinking into healthier and positive thoughts that help ease the depressive symptoms. Additionally, CBT’s long-lasting effects and increased adherence to medical treatments make it more efficient in managing depression than antidepressants. Furthermore, CBT has fewer or no relapse incidences than pharmacotherapy, making it a better alternative for treating depression. Equally important, due to its diverse formats such as iCBT, eCBT, telephone, and self-help interventions, CBT has increased access to critical depression health services, making it more cost-effective and convenient. Moreover, research indicates that CBT is the most efficacious therapeutic approach proving its efficiency in treating depression. However, CBT can be impaired due to the low number of qualified specialists administering counseling services to patients and the high initial costs. It is evident that a therapist’s role is fundamental in the effectiveness of CBT interventions; therefore, there is a need to increase the number of professionals in the field. This will offer more access to patients in need of mental health services.


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