The Effects of Cognitive Behavioral Therapy (CBT) on Depression in Adults

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Introduction

It is hard to disagree that there is a vast number of mental disorders that prevent people from leading their normal lives and are quite challenging to treat. One such psychological condition is depression (Li et al., 2020). Since there is a social stigma of depression, and some of its symptoms are similar to the signs of mere tiredness, those who have it sometimes fail to access adequate treatment. Due to these facts, it is of vital importance to raise awareness of one of the most effective ways to treat various types of depression – cognitive behavioral therapy (CBT) (Pagán, 2020). The purpose of this paper is to prove the overall value of CBT as a method to help adults with depression, discuss some kinds of cognitive behavioral therapy, evaluate the after-treatment effects of this treatment, and also mention whether it is useful for patients with COVID-19.

Defining Key Terms

To begin with, it is essential to define what is meant by depression and CBT in this paper. According to Mayo Clinic Staff (2022), clinical depression or major depressive disorder is a severe condition that has to be treated. It causes loss of interest, persistent feelings of sadness, emptiness, and frustration, and can have numerous complications, interfering with one’s everyday activities. Further, CBT is an evidence- and goal-based therapy that “aims to reduce negative or unhelpful thoughts and behaviors … through practical problem-solving and homework assignments” (Skedel, 2022, para. 1). This intervention is quite brief, having the connection of actions, thoughts, and emotions as its foundation and helping patients learn about specific cognitive patterns (Cully et al., 2021). The overall objective is to apply coping mechanisms to challenge harmful behaviors.

General Effectiveness of CBT Interventions

An extended number of credible resources state that cognitive behavioral therapy is one of the best ways to treat depression. CBT successfully reduces symptoms of the psychological condition and decreases the risks of relapse, helping patients to return to their normal ways of life and feel much better. As indicated by Skedel (2022, para. 7), “when compared to antidepressant medication, CBT alone may be effective in continued recovery for depression”. Patients engaged in this talk psychotherapy are sometimes half as likely as people on drugs alone to face episodes of depression again within a year (Pagán, 2020). Consequently, it is highly recommended that all persons diagnosed with this mental disorder consider CBT and select experienced, skilled, and credible therapists.

There are many reasons why this treatment approach is one of the strongest interventions, but the key reason is the basis of CBT. According to Moorey and Hollon (2021), since cognitive behavioral therapy alters the way adults with depression think and view themselves, their attitudes, actions, and lives, the effects are prolonged. The primary idea of all CBT types is that “emotional states are created and maintained through learned patterns of thoughts and behaviors and that new and more helpful patterns can be learned through psychological interventions” (Moorey and Hollon, 2021, p. 1). Together with the therapist, the patient detects his intrusive thoughts, admits their harm, and changes to more positive and healthy ones (Skedel, 2022). The emotions and triggers of these negative thoughts are also addressed, and with their elimination, the actual reality of the situation becomes evident to the patient, causing them to alter their behavior.

It may be quite interesting to review an example of how CBT can help a depressed adult. Suppose Mr. N has a low motivation and does not want to communicate with people, believing in their negative attitudes towards him. This is why all social interactions, even the necessary ones, are avoided. These are simultaneously the symptoms and causes of Mr. N’s depression, placing him in a vicious circle. Then, together with the therapist, Mr. N replaces the concept of ‘negativity’ with the ‘positivity’ of attitudes and rewards himself every time he engages in communication with other people (Moorey and Hollon, 2021; Skedel, 2022). As a result, they manage to change the chemical outputs in the patient’s brain, ensuring the repetition of the benefiting actions.

Types of Depression CBT Can Address

It is necessary to note that CBT is most effective when addressing moderate and mild cases of depression but can also appear successful if a skilled therapist treats severe depression. According to Skedel (2022), this intervention is expected to bring positive results for adults with:

seasonal affective disorder,
persistent depressive disorder,
major depressive disorder,
situational depression,
bipolar disorder depressive episodes,
postpartum depression,
depressive type of schizoaffective disorder.

CBT Approaches and Techniques

A vast number of cognitive behavioral therapy techniques can help a patient become free from depressive and intrusive thoughts, states, and actions. First, cognitive restructuring assists in reducing cognitive errors and rationalizing distortions to eventually eliminate depressive emotions (Skedel, 2022). Next, activity scheduling promotes timely low-level activities to make the patient motivated and rewarded. Third, thought journaling is a great way to determine connections between triggers, feelings, and behaviors to then increase self-awareness. ABC analysis is similar to the previous technique and allows the patient to break down their behavior to the ‘Activating’ event, corresponding ‘Beliefs’ about it, and its ‘Consequences’ like reactions and emotions (Skedel, 2022). Finally, mindful meditation is another tool of CBT – it helps shift focus from negativity to positivity and remain in the present, as well as accept the presence of intrusive thoughts to eliminate them easier. The variety of these effective techniques makes cognitive behavior therapy even more powerful and practical because everyone can find the method that is most comfortable.

Computer-Assisted Cognitive Behavior Therapy

Further, it may be quite interesting to explore the success of computer-assisted cognitive behavior therapy (CCBT). Generally, CCBT involves regular CBT practices together with computer program lessons to educate depressed patients about the intervention’s tools (Wells et al., 2018). Some significant impacts of introducing CCBT that cannot be ignored are improved access to healthcare and patients’ reduced costs, making this intervention quite efficient (Wright et al., 2019). When comparing with treatment as usual (TAU), researchers find that the latter is usually severely outperformed by CCBT (Wells et al., 2018). Computer-assisted cognitive behavior therapy has more success in reducing symptoms of depression and also receives “higher favorability ratings from patients than TAU (Wright et al., 2022, p. 8). At the same time, to achieve the best results, it is recommended to use these approaches together.

Face-to-Face and Digital CBT

Digital CBT approaches are considered more accessible, but some people may doubt their efficacy when compared with personal meetings. As indicated by Kambeitz-Ilankovic et al. (2022, p. 144-145), “face-to-face approaches show superior clinical effectiveness in reducing depressive symptoms and psychosocial functioning but not in reducing comorbid anxiety symptoms”. Higher adherence to treatment is also reported in personal meetings (Kambeitz-Ilankovic et al., 2022). At the same time, the study still highlights the almost equal effectiveness of the two approaches and indicates the expected growing value of digital CBT.

After-Treatment Effects

Even knowing about the general success of CBT when treating depression, one may doubt whether these effects are long-term. It is mentioned earlier in the paper that those who select this therapy are less likely to face relapse during the following year than those relying on medications only, meaning that CBT has prolonged results (Pagán, 2020). Further, Veleda et al. (2019) also mention that, after the treatment is finished, the positive impact remains strong after six and twelve months. In other words, the benefits of CBT do not become weaker even one year after the intervention, and the severity of depressive symptoms at the baseline does not influence the outcomes or longevity of the treatment effect (Veleda et al., 2019). These conclusions indeed make cognitive behavior therapy one of the best approaches to addressing depression in adults.

Efficacy of CBT on Depression in Adults with COVID-19

Considering one of the most concerning processes of this decade – the coronavirus pandemic, it may be interesting to review the success of CBT in helping people diagnosed with COVID-19. Li et al. (2020) indicate that adults with coronavirus tend to experience higher levels of depression, with the latter being precisely the consequence of the disease, not a chronic state. Noticeably, “CBT can effectively improve the psychological health of patients with COVID-19”, not only improving short-term symptoms and reducing the risk of social anxiety disorder and PTSD but also enhancing self-efficacy and self-confidence of such persons (Li et al., pp. 8-9). Behavior interventions like frequent handwashing, self-monitoring strategies like breathing relaxation, and encouragement from medical staff are all proved to be beneficial in reducing the signs of depression in COVID-19 patients.

Conclusion

To draw a conclusion, one may say that the value of CBT in helping adults with moderate, mild, or severe depression cannot be overestimated. The findings of numerous studies prove the efficacy of this intervention and state that its positive results are long-term and sometimes even more powerful than the effects of medications. The presence of several different CBT tools makes this therapy available to an extended number of people. Finally, the recent introduction of computer-assisted and digital CBT allows saying that this treatment system develops further, bringing positive results to more patients.

Reference List

Cully, J.A., et al. (2021). A provider’s guide to brief cognitive behavioral therapy. Web.

Kambeitz-Ilankovic, L., et al. (2022) ‘A systematic review of digital and face-to-face cognitive behavioral therapy for depression’, NPJ Digital Medicine, 5(144), pp. 1-8.

Li, J., et al. (2020) ‘The effect of cognitive behavioral therapy on depression, anxiety, and stress in patients with COVID-19: a randomized controlled trial’, Frontiers in Psychiatry, 11, pp. 1-12.

Mayo Clinic Staff (2022). Depression (major depressive disorder). Web.

Moorey, S. and Hollon, S.D. (2021). Cognitive behavioral therapy for depression. Web.

Pagán, C.N. (2020). Does cognitive behavioral therapy treat depression?. Web.

Skedel, R. (2022) CBT for depression: how it works, examples, & effectiveness. Web.

Veleda, G.W., et al. (2019) ‘Effect of cognitive-behavioral therapy after treatment for adults with major depression’, Psicologia: Teoria e Prática, 21(3), pp. 345-365.

Wells, M.J., et al. (2018) ‘Computer-assisted cognitive-behavior therapy for depression in primary care: systematic review and meta-analysis’, The Primary Care Companion for CNS Disorders, 20(2), p. 1-7.

Wright, J.H., et al. (2019) ‘Computer-assisted cognitive-behavior therapy for depression: a systematic review and meta-analysis’, The Journal of Clinical Psychiatry, 80(2), p. 1-14.

Wright, J.H., et al. (2022) ‘Effect of computer-assisted cognitive behavior therapy vs usual care on depression among adults in primary care: a randomized clinical trial’, JAMA Network Open, 5(2), pp. 1-13.

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