Cognitive Behavioural Therapy
Cognitive Behavioural Therapy (CBT) is one of the few forms of psychotherapy. Cognitive therapy is designed to alter the way one percieves their surrounding environment, and subsequently react. CBT cannot resolve the individual's issues, however it can help them respond and address them in a positive manner.
This form of psychotherapy overcomes various issues that patients may experience e.g. unresponsive to medication, undergoing relapses, residual symptoms***. It also allows patients to replace false self-perceptions, with factual and realistic ideas. The concept of CBT is based ones mood is influenced by a thought inevitably dictating their behaviour. Distorted thoughts manifest into poor mood, Therefore by substituting unrealistic /exaggerated thoughts with positive and optimistic ones, it will enable the patient to perceive the environment and interact with others in a positive and realistic way which will in turn enhance a patient’s mood, self-esteem and eradicate the viscous cycle of negative thinking which lowers mood.
1. It is imperative that the patient understands that their mood will dictate their behaviour and subsequent reaction
2. Patients’ acceptation of perception/interpretation of reality may be false. Important to understand that this will result in negative thoughts.
3. Identify negative thoughts and include alternative thoughts that reflect reality more closely. Adopt different thoughts which mirror “reality more closely”.
4. The patient alone must decide which is supported more, the negative perception or the factual one.
When is CBT indicated?
In Stage 2 of the stepped care model, i.e. Mild- moderate depression.CBT can be as a “low intensity psychosocial intervention”. In mild-moderate depression, the patient receives guided self-help based upon this concept. (CCBT is also an option at this stage).
The patient must receive this therapy at duration of 9-12 weeks guided by a specialised practitioner. This may be conducted via telephone or consultation. Adequate information and reading materials must be provided to the patient according to the individual’s needs.
Stage 3 of the stepped care model – mild to moderate depression with poor response to treatment. And moderate to severe depression. Moderate to severe antidepressant medication is accompanied by a “high intensity” CBT or (IPT). High intensity individual CBT compromises of 16-20 sessions at a period of 3-4 months.
Also used in relapse prevention in patients who have (P37).