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,sex, fod, scial interactions) and recurrent thoughts of death and suicide MDD is a debilitating and complex psychiatric disorder that involves multiple neural circuits and genetic and non-genetic risk factors (Sahay et al, 2007).Wether environmental factors or genetic factors play a major role in the pathogenesis of MDD is still debated.Tere may also be a component of glucocorticoid resistance related in part to impaired functioning of the glucocorticoid receptor, wich, i turn, my contribute to excessive as well as hyperactivity of corticotropin releasing hormone and sympathetic nervous system pathways, wich are known to contribute to a variety of diseases as well as behavioral alterations.
I feel IAPT training is potentially exposing vulnerable people to harm, because of the brief IAPT training that does not focus on the quality of the relationship, awareness of the counsellor, and the lack of knowledge that some CBT and primary well-being practitioners have about counselling and psychotherapy.
I hope that this essay will offer me the chance to explore my assumptions about CBT and thus influence my practise and views.
In my conclusion after considering the theory and evidence that is for and against CBT, I will then give my opinion of CBT, what I have learned from doing this essay and how it will change my practise in future.
The reason I have chosen to explore the arguments for and against CBT is because I am due to start working for the NHS as a Primary Care Counsellor and will have the opportunity to study a certificate in CBT.
I has been proposed that certain chemical imbalances in the brain cause clinical symptoms in MDD.
Tese imbalances are said to occur in certain neurotransmitters like serotonin and noradrenaline.Having introduced the essay, I will now explore the theory of CBT, against other approaches.The cognitive behavioural approach is the most scientific approach to counselling (Mc Leod, 1998), it is a scientific psychological approach (Gilbert & Leahy, 2007) that argues that what a human thinks directly effects how they behave and feel (Dobson, 2001), this includes physical reactions and can lead to changes in the social environment (Greenberger & Padesky,1995).Whilst there is a behavioural component within CBT, CBT places more significance on the role of conscious thoughts within its model, contrary to Behavioural Therapy which focuses on the doing aspects (Garland, Fox & Williams, 2002).Weight gain, isomnia or hypersomnia, lw energy, ftigue, o increased agitation, dcreased interest in pleasurable stimuli (e.Hwever, n single gene has been attributed to this so far probably because of the possibility of many genes involved in a complex manner (Nestler et al, 2002).Te environmental factors which are implicated in the etiology of depression are viral infections, rduced omega-2 fatty acids in diet, sress, rduced sleep, eotions and insults during brain development et al, 2002) and sometimes even trivial brain injury (Rapoport et al, 2003).I prolonged conditions of stress, te levels of glucocorticoids are elevated for a long time and may damage hippocampal neurons especially the CA3 pyramidal neurons (Nestler et al, 2002).Tis reduces the inhibitory control of hippocampus on the Hypothalamic-Pituitary-Adrenal axis leading to further increase in glucocorticoid levels and further hippocampus damage.Main Components of CBT There appears to be agreement within research and theorists that CBT has the following key components: case formulation, collaborative empirical knowledge base and therapeutic alliance (Beck, 1983, Persons, 2008).Patients remain active participants in the development and review of case formulation, which acts as a hypothetical framework to provide perspective on present day difficulties (which may be more overt to patient and therapist) and underlying psychological interaction between beahviours, thoughts and feelings (Persons, 2008).