How Effective is Cognitive Behavioral Therapy

Running head: HEALTHCARE
How Effective is Cognitive Behavioural Therapy in Treating Mental Health Patients with
Depression
Name of the Student
Name of the University
Author Note

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Introduction
Cognitive Behavioural Therapy (CBT) is defined as a talking therapy that works by
changing the way of one’s thought process (Robertson, 2019). It is commonly used for the
treatment of the mental health complications like anxiety and depression (National Health
Services (NHS, 2019). The following evidence-based practice research is aimed towards
elucidating the effectiveness of CBT for treating mental health patients suffering from
depression. The research will undertake a qualitative research approach by conducting
systematic review of literature. The paper will initiate with a detailed search strategy that was
used for the selecting the articles from the online databases. This will be followed by the
critical discussions of the selected set of articles followed by a summative overview of the
entire paper. The conduction of this research is important as systematic review of literature
over CBT is important for the establishment of the evidence-based practice (EBP) guidelines
in the mental health nursing. EBP deals with conscientious usage of latest yet relevant
evidences in making decisions about patient’s care (Ruzafa-Martínez et al., 2019). It is
defined as a problem solving approach in clinical practice. The main steps of generation of
EBP include conduction of systematic research through critical appraisal of relevant
evidences in order to answer an alarming clinical question. The information evolved through
critical review of literature is aligned with the clinical expertise of the healthcare
professionals and the patients’ preferences in order to design the customised interventions
(Melnyk et al., 2017). There are different EBP practice models that are helpful in the field of
mental health nursing like Stetler model, Iowa model, Rossworm and Larrabee model,
D.Censo model of EBP. Stetler model is popular in nursing research (Dang and Dearholt,
2018). It emphasizes practitioner oriented EBP and give importance to both external and
internal evidences. The phases of Stetler model include preparation (phase 1), Validation
(phase 2), Comparitive evaluation or Decision making (phase 3), Translation/application

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(phase 4), Evaluation (phase 5) (Nilsen, 2015). The steps of the Iowa Model in the EBP
include selection of the clinical question, formation of the team, retrieving of evidences,
grading of the evidences, development of the EBP standards, implementation of EBP and
evaluation of the nursing outcomes (White and Spruce, 2015). CBT is regarded as gold
standard for the psychological treatment. However, recently, few researchers have argued
plurality in the psychotherapeutic interventions while questioning the status of the CBT as the
gold standard for the treatment of depression (David, Cristea and Hofmann, 2018). Thus
conducting EBP research will in clearing the doubts towards efficacy of the EBP model in
depression management.
Search
Search terms
A well constructed search strategy is defined as the core of the systematic review
(Mendes et al., 2019). One of the important aspect of search strategy is proper selection of the
search terms. Search terms are popularly known as key words that are selected based on the
scope of the research questions. The proper use of the keywords helps to broaden the
probability of finding relevant research hits from the electronic databases (Ferrari, 2015). The
main search terms that are used in this research are included in the table below:
Keyword
s
Keywords Boolean
Operato
r
Synonym
of Keyword
Boolean
Operato
r
Synonym
of
Keyword
Boolean
Operato
r
Synonym
of
Keyword

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Keyword
1
depression OR depressive
disorder
OR depressiv
e
symptom
s
major
depressiv
e
disorder
Boolean
Operator
AND
Keyword
2
Cognitive
Behaviour
al Therapy
OR CBT OR Cognitive
Behaviou
r Therapy
OR
Boolean
Operator
AND
Keyword
3
efficacy OR effectivenes
s
OR impact OR Outcome
Table 1: The keywords that are used for search
Boolean operators are used in order to combine the keywords. Grewal, Kataria and
Dhawan (2016) stated that Boolean Operators (AND and OR) are modifiers that helps to
obtain different combination of keywords and thus increasing the probability of getting
relevant hits.
Databases
The two electronic databases that were used for the search of the articles are CINAHL
and PubMed. CINAHL indexes several nursing journals that assist the researches to search
articles by the use of the search terms. CINAHL is user-friendly interphase for the search of
the literary articles. Since the focus of CINAHL database is primarily on the nursing journals,

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it is selected as the prime database of choice (Scala, Price and Day, 2016). PubMed is the
second database that was selected for the search of the nursing articles. PubMed contain
access to several peer reviewed journal articles. According to Vassar et al., (2017), systematic
review must aimed towards reviewing significant number of articles from different journals
in order to reduce the probability of selection bias. Thus, selecting PubMed as one of the
databases for searching journal articles helped to gain access of diverse papers from different
international journals and thereby minimizing the selection bias.
Inclusion and Exclusion Criteria
The initial search of the articles by the use of the keyword combinations highlighted
in the Table 1 helped in the identification of 1912 articles from CINAHL. This was followed
by refining of the search articles. The refining the number of the articles obtained from the
literature search is done by the use of the inclusion and exclusion criteria. Aveyard and Sharp
(2013) argued that proper use of the inclusion and exclusion criteria. The inclusion and
exclusion criteria that are used for refining of the search are highlighted in the table below:
Factors Inclusion Criteria Exclusion Criteria
Year of publication 2009 to 2019 (last 10 years) Articles published before 2009
Language English Other than English
Population People suffering from
depression
People suffering from other
mental health complications
where depression is not a
significant concerns
Type of articles Primary articles and secondary
articles
Grey literatures and
dissertation

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Table 2: Inclusion and Exclusion Criteria
Articles that were published within the last 10 years are included in the research.
Parahoo (2014) stated that for the generation of the EBP critical analysis of the articles that
are published within the last 10 years is important. This helps to achieve a detailed overview
of the previous work one over the selected clinical questions. Both the secondary and primary
articles were selected for the review. DiCenso, Guyatt and Ciliska (2014) stated that
secondary articles like systematic review of literatures or review of the randomised control
trail (RCT) belongs to level 1 of the hierarchy of evidences. Thus selection of systematic
review of RCTs will help to increase the overall strength of this EBP research. People having
depression as principal mental health complications or as one of the prime co-morbidity are
selected as the main population of choice during the selection of the articles in order to align
with the main scope of research. English was selected as the main language of choice under
the inclusion criteria as it s the official language of UK and used internationally for research.
Selection of English as the foremost language of research will help to increase the overall
acceptance of the research (Kendig et al., 2017).
The application of inclusion and exclusion criteria as filters in the database research in
CINAHL helped in the identification of 291 articles. The similar set of inclusion and
exclusion criteria were used for the finding the research articles from the PubMed database.
The keywords that are used in order to refine the search for are: cognitive behavioral therapy
AND depression OR Mental Illness AND efficacy. Different set of keywords are used for
CINAHL and PubMed in order to refine the search. Using keywords for CINHAL for
PubMed yielded 14745.
The total articles retrieved from the PubMed search was 293. Both the articles
retrieved from PubMed and CINAHL were examined in order to eradicate the redundant