Re-Evaluating Beck's Cognitive Model of Depression

Beck’s cognitive model and resulting therapeutic approach, Cognitive Behavioural Therapy (CBT), has underpinned the treatment of depression for decades. However, CBT’s precise mechanism of action is still unknown, and the variability in the therapy’s efficacy suggests that Beck’s cognitive model may not capture the entire mechanism of depression. Moreover, numerous studies suggest that CBT is no more effective than other psychotherapeutic interventions, which raises further questions as to the completeness, or indeed validity, of Beck’s model. This article seeks to re-evaluate Beck’s model through the prism of third-wave therapies, psychedelics, and emerging research on metabolic and inflammatory pathways. By analysing the theory, mechanism of action, and efficacy of these new therapies and approaches, it will be possible to assess whether mechanisms of action other than those posited by Beck are at play in depression. In turn, this might open the field for new treatments other than, or in combination with, CBT.