Depression is a mental health issue that occurs due to extreme exposure to negative thoughts, situations and so on and hence, it is also referred to as a mood disorder. Treatment of depression ranges from medical, behavioral to cognitive and psychodynamic amongst others. Various therapies for naturally treating depression are also provided as per the client’s requirements and need.
The aim of the report however, is to analyze the two therapies namely cognitive Behavioral Therapy (CBT) and Person or Client-centered Therapy to treat depression. The report will first provide a brief explanation of depression as a mental health issue and then discuss the treatments available. Then, the report will provide a brief description of the two therapies followed by the similarities and differences. The report will also highlight the ethical considerations required for treating depression with the two chosen therapies.
When the symptoms of sadness, loss of interest, pleasure and feeling down or low continue to persist then it becomes a matter of concern. It then starts to affect the normal life and harms it substantially. The increase in severity of these symptoms then results in depression. Depression is one of leading mental health issues globally. As per the World Health Organization, more than 300 million people are diagnosed with depression each year. In addition, the WHO also found, “depression is the leading cause of disability worldwide, and is a major contributor to the overall global burden of disease” (Who.int, 2018). It has also been the cause of nearly 800,000 suicides worldwide.
The discussion above clearly shows the severity of the mental disorder and therefore, it is important to learn about it deeply and spread awareness. The depressive disorder has been categorized into mild, moderate and severe levels. The depression could be either episodic or chronic depending on the treatment and the timing of it. An untreated episodic depression could turn into a chronic depressive disorder.
With an intricate interaction between the social, biological and psychological factors, depression develops and persists. Adverse events in life such as unemployment, separation, trauma and so on experienced by people are more likely to be depressive and it escalates due to further stress.
Healthcare providers provide several treatments that help treat depression. These include psychological therapies like CBT, behavioral activation, interpersonal psychotherapy (IPT), and medications such as serotonin and tricyclic antidepressants and so on. While some recommend medications for treating depression, others opt for psychological treatments. Olatunji et al. (2013) however suggest that the treatment differs as per the severity of the illness. The various psychological treatments that are often considered effective include face-to-face interactions with the patient that are mostly supervised by the therapists. McHugh et al. (2013) researched some patients with depression and found that most people preferred psychological treatment for depression as opposed to the pharmacological treatment. The study further found that younger patients and women mostly preferred psychological therapies. The cognitive behavioral therapy (CBT) and Person-centered approaches for treating depression are becoming more popular amongst the clients owing to the advancement in technology.
The therapy, abbreviated as CBT, is a psychotherapy in which the therapist engages in an interaction with the patient and hence, it is also known as talk therapy. The therapy is based on the assumption that negative feelings and actions are results of present distorted thoughts or beliefs and not unconscious occurrences from the past. As the name suggests, it is a combination of cognitive and behavior therapy where cognitive therapy targets thoughts and moods and behavior therapy attends to behaviors and actions. The emergence of technology has enhanced the CBT further and it is now conducted through the internet as well.
In this therapy, non-authoritative approach is used allowing clients to take the lead in discussions and in the process, discover solutions of their own. The role of the therapist is very crucial in this therapy because he or she has to make sure that the patient is comfortable sharing. The therapist has to be compassionate and listen to the patient without coming to unnecessary conclusions or diverting the discussion. Unconditional positive regard, congruence and empathetic understanding are the chief requirements for a Person-centered therapist (Joseph & Murphy, 2013). The approach used singularly or with the combination of other therapies to treat depression.
The CBT and Person-centered therapy, both have many similarities while some differences are there as well. Comparing and contrasting of the two therapies shall be done to reveal the effectiveness of both in treating depression. First, the comparison shall be done.
In both CBT and Person-centered therapy, support is provided to the client of patient through addressing of their individual matters. Both the therapies include counselors who help the client recover. One of the most common similarity however, between the two is that both the therapies belong to the psychological approach to depression. According to Charlesworth et al. (2015) the relationship between the client and the counselor is crucial in both the therapies. In terms of treating depression, the two therapies have been quite successful and opted by many patients due to their focus on the client. Elliott (2013) further provide another fundamental similarity between the two therapies. The authors state that both approaches support the notion that the underlying principle for changes appear from the patient’s own insight rather than the therapist’s insights.
However, some contrasting features are also found between the two therapies, which shall be discussed in this section. The fundamental difference is that although both are often considered psychological approaches, Person-centered therapy is actually a humanistic approach. Further, the roles of the counselors or the therapists differ in both the cases while treating depression. In CBT, the therapist is the one who instructs or guides the client what to do or not to do. In contrast to this, the therapist in Person-centered approach takes a backseat and lets the client be her or his own guide. In this therapy, the counselor has to be compassionate, empathetic and honest while listening to the problems of the client. Another contrast between the two therapies is that while Carl Rogers introduced the Person-centered therapy back in the 1940s, CBT is a relatively new approach. Person-centered approach is based entirely on positive regard, authenticity and empathy whereas CBT focuses on negative thoughts of the patients that result in depression.
In case of treating depression however, the two therapies are used in combination most often. As Elliott (2013) observes, the Person-centered therapy has several weaknesses that make it inferior to CBT when it comes to treating anxiety or depression. According to the authors, results of the researches carried out for analyzing the effectiveness of Person-centered approach indicate “clear inferiority to CBT”. The authors find that the CBT therapists often used Person-centered approach as the starting of the counseling session.
The CBT is an effective treatment for depression because it combines other psychological approaches as well including the Person-centered therapy. In this way, the CBT counselor is able to go to the root cause of the problem and suggest ways to the client to recover. The suggestions might also include intake of certain medications as well. Watts et al. (2015) while testing the efficacy of CBT in treating anxiety and depressive disorders found that most patients treated with CBT showed signs of improvement much earlier than those treated with TAU or treatment-as-usual. It is important to note than depression is a mental health issue and it could only be treated with direct communication with and attention to the patient.
Both CBT and Person-centered therapies although effective and quite often used, mostly in combination, include certain ethical considerations as well. While treating patients with depression using any evidence-based psychological therapy such as CBT, it is important that the counselor does not cause exacerbation of symptoms. In the observation of Altis, Elwood and Olatunji (2014), most of the exposure treatments that include CBT have been empirically tested to be more effective and ethical in treating depression or other anxiety disorders. Biegler (2018) furthers the argument claiming that depression is a disorder where “autonomy is routinely and extensively undermined and that physicians have a moral obligation to promote the autonomy of depressed patients”. In this case, the CBT becomes the top choice of health practitioners to treat depression while taking care of the ethical considerations.
Conclusion
In the end, it can be stated that both the CBT and Person-centered therapy provide effective treatment for depression although CBT has an upper hand. The analysis in the report found that CBT has been a widely used and referred treatment especially for psychological disorders include depression. The Person-centered approach on the other hand, had been effective at some time previously but it lost its efficiency on the way and began to be used in combination with CBT. The report further found that both the therapies have some similarities although the differences are more visible. The report then analyzed the ethical considerations related to the treatment of depression and found CBT to be most ethical compared to other treatments.
References:
Altis, K. L., Elwood, L. S., & Olatunji, B. O. (2014). Ethical issues and ethical therapy associated with anxiety disorders. In Ethical Issues in Behavioral Neuroscience (pp. 265-278). Springer, Berlin, Heidelberg.
Biegler, P. (2018). The Ethical Treatment of Depression. Retrieved from https://mitpress.mit.edu/books/ethical-treatment-depression
Charlesworth, G., Sadek, S., Schepers, A., & Spector, A. (2015). Cognitive behavior therapy for anxiety in people with dementia: a clinician guideline for a person-centered approach. Behavior modification, 39(3), 390-412.
Elliott, R. (2013). Person-centered/experiential psychotherapy for anxiety difficulties: Theory, research and practice. Person-Centered & Experiential Psychotherapies, 12(1), 16-32.
Joseph, S., & Murphy, D. (2013). Person-centered approach, positive psychology, and relational helping: Building bridges. Journal of Humanistic Psychology, 53(1), 26-51.
McHugh, R. K., Whitton, S. W., Peckham, A. D., Welge, J. A., & Otto, M. W. (2013). Patient preference for psychological vs. pharmacological treatment of psychiatric disorders: a meta-analytic review. The Journal of clinical psychiatry, 74(6), 595.
Olatunji, B. O., Davis, M. L., Powers, M. B., & Smits, J. A. (2013). Cognitive-behavioral therapy for obsessive-compulsive disorder: A meta-analysis of treatment outcome and moderators. Journal of psychiatric research, 47(1), 33-41.
Watts, S. E., Turnell, A., Kladnitski, N., Newby, J. M., & Andrews, G. (2015). Treatment-as-usual (TAU) is anything but usual: a meta-analysis of CBT versus TAU for anxiety and depression. Journal of affective disorders, 175, 152-167.
Who.int. (2018). Depression. Retrieved from https://www.who.int/news-room/fact-sheets/detail/depression
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