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Cognitive Therapy for Depression and Anxiety


Updated March 25, 2010

There are many different approaches to psychotherapy. Some therapists identify with a particular orientation, while others draw from different orientations. Many therapists use some form of cognitive or cognitive-behavioral therapy at times.

Types of Cognitive Therapy

Cognitive therapy seeks to help people change how they think about things. One example of this is rational emotive behavior therapy, developed by Albert Ellis. Ellis considers strong emotions to result from an interaction between events in the environment and our beliefs and expectations. Some of these beliefs are too strong or rigid (such as, "everyone should like me"). The patient learns to modify the belief so that it is less extreme and less likely to interfere with their live (such as, "I would like for people to like me, but I realize that not everyone is going to").

Aaron Beck developed a treatment for anxiety and depression based on cognitive theory. Patients tune into their internal dialogue in order to change maladaptive thinking patterns. Beck developed specific procedures to help challenge a depressive client's assumptions and beliefs. Patients learn how to change their thinking.

It has been difficult to research the effectiveness of psychotherapy, since the term can refer to so many different activities. Cognitive therapy, however, lends itself well to research. It tends to be short- to moderate-term, in contrast to some other orientations.

Medications or Psychotherapy?

Depression and anxiety can be treated with medications, or psychotherapy, or both. Some research has shown that the combination of medications and therapy can be particularly effective. While some anxiety medications can result in dependence, this is rarely true of antidepressants.

Managed care companies sometimes encourage family doctors to prescribe medications rather than refer to a mental health professional for psychotherapy. There are times when this may be appropriate, but there are other times when psychotherapy is clearly indicated. If you are taking an antidepressant or an anxiety medication and you believe that part of the problem is not being addressed, consider seeking help from a mental health professional.

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