Wiles' Study of the Effectiveness of CBT (AQA GCSE Psychology)
Revision Note
Written by: Claire Neeson
Reviewed by: Lucy Vinson
Antidepressant medications compared to CBT to treat depression
For some people antidepressant medications alone are not a suitable treatment for depression (known as ‘treatment resistant’)
Being treatment-resistant means that a patient fails to show any signs of improvement in depressive symptoms several weeks after beginning antidepressant medication
Cognitive behavioural therapy (CBT) offers a side effects-free alternative to drug treatment
Combining drug therapy with CBT may increase treatment effectiveness as each treatment takes a different approach but taken together they complement each other
Antidepressants work to reduce the symptoms of depression while CBT works to re-frame irrational thoughts and behaviours around depression
Wiles et al. (2013) instigated CoBalT to investigate the efficacy of combined drug and CBT therapies as follows:
Aim: to investigate how effective combined therapy is for people with depression who are treatment-resistant
Sample: 469 treatment-resistant patients with depression from Bristol, Exeter and Glasgow, recruited via their GP practice
Procedure: the patients were randomly allocated to one of the following two conditions:
Condition 1: Usual care (each patient continued to take the antidepressant they had been prescribed)
Condition 2: Usual care + CBT (their usual antidepressant plus 12-18 sessions of CBT lasting an hour per session)
The patients’ symptoms were measured using Beck’s Depression Inventory (BDI)
Results:
Condition 1: Usual care: 21.6% of the patients had a 50%+ drop in depressive symptoms
Condition 2: Usual care + CBT: 46.1% of the patients had a 50%+ drop in depressive symptoms, plus after one year they showed a better rate of recovery than the patients in condition 1
Conclusions: A combined therapy of drugs + CBT is more effective in reducing depressive symptoms than drug therapy alone
Examiner Tips and Tricks
This is a NAMED STUDY on the AQA specification which means that you could be asked to answer specific questions on it in the exam.
Evaluation of Wiles’ study of the effectiveness of CBT
Strengths
Combined therapy is a more holistic approach to treating depression as it addresses and deals with the whole person (thoughts, behaviour, lifestyle) rather than simply treating the physical aspect of the disorder
The study used the BDI to assess depressive symptoms which is a replicable measure, meaning it could be used on large samples to obtain reliable data
Weaknesses
Use of the BDI could give rise to social desirability bias, with some participants playing down the extent of their symptoms: this would affect the validity of the findings
The study was conducted across three cities in the UK which means that it may be ethnocentric and not generalisable to other (collectivist) cultures
Worked Example
Here is an example of a question you might be asked on this topic - for AO1.
AO1: You need to demonstrate knowledge and understanding of key concepts, ideas, theories and research.
Question: Explain what is meant by a holistic approach. Refer to Wiles’ study of the effectiveness of CBT to support your answer. [3]
Model answer:
A holistic approach involves considering all aspects of the whole person e.g. upbringing, family life, personality, job etc. rather than attempting to draw conclusions based on scant, overly simplistic evidence.
Wiles et al. (2013) takes a holistic approach to treating depression as it combines drug therapy with CBT: drug therapy alone is a reductionist approach to treating depression.
CBT addresses the whole person: what motivates them, their fears, their irrational thoughts and behaviours: this combined with drug therapy covers all of the ‘bases’ necessary for successfully treating depression.
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