CBT is on the rise as a preferred treatment.

More and more health authorities are using CBT as a preferred treatment for a number of different mental health issues and that number is set to rise. As a therapist who primarily uses CBT techniques as a main approach, I know just how effective they can be.

The basic assumption behind Cognitive Behavioral Therapy (CBT) is that one’s thoughts influence one’s emotions and behaviors, and that if negative thoughts are altered, negative  emotions  and  behaviors can be altered as  well. We are what we think, so to say. By  using a series of practical and easy to use methods, CBT looks at changing the “here and now” which means that less time is spent on delving into a clients’ past. This has a direct effect on a client’ s daily life and his ability to handle dysfunctional thought patterns that tend to affect mood  and  happiness.  In a therapeutic  alliance, the  therapist  and  client explore  and  try  to  change  these  thought  patterns.  CBT  has  a  strong  educational element to it in  the sense that the relationship built up in therapy serves as a model for other relationships. The  therapist  helps  the  client  to  formulate  problems  in  cognitive  terms,  and  is constantly inviting feedback from the client to ensure that he/she feels understood and can learn to contribute jointly with the therapist to the treatment. It is very much a problem – solving approach. Central to this approach is the use of Ellis’s ABC model which charts the relationship between a triggering event, the resulting behavior and how  dysfunctional  thought  patterns complicate  the  issue. The use of  homework assignments is used to consolidate what takes place in the session.  Goals are set in behavioral terms and potential solutions are tested out in practice: clients  are  encouraged to explore options for change  and evaluate  outcomes by comparing progress with previous experience and hence are encouraged to take an objective, scientific, view of their problems. In this way, clients are taught, in theory, to  become  their  own  therapists and  are thus  prepared  to  deal  with  relapse  and problems if and when they arise in the future.

Even though many studies have suggested that CBT is an effective treatment for a range of issues ¹, there are still dissenting voices who believe that other methods should be considered. For example, A.S Petridis PhD² wrote an article in 2009 questioning the evidence that CBT is any more effective than any other method and came to the conclusion that “there is clear evidence from studies that no  one method is any better or worse than any other”. Also, John   M. Grohol, PsyD, cited a study that directly compared psychoanalysis with CBT on study groups, a first of its kind, and wrote that the study revealed no real difference in effectiveness.³ Additionally CBT methods have been criticized, most notably by Dr Oliver James who started a debate among the medical community when he claimed:   “There is not a single scientific study which supports that claim ( that CBT is effective),” says Dr James.”Being cheap, quick and simplistic, CBT naturally appeals to the government. Yet the fact is, it doesn’t work,” added Dr James. This was quickly countered by other professionals.

However, the future development of CBT seems assured. A recent study by the Psychiatric Clinics of North America claimed that CBT is the method with the greatest amount of scientific evidence backing it  but that evidence also said that CBT needs to evolve and a number of new methods that could add to its effectiveness hold promise.  This was widely discussed in a study cited in Psychiatry News in 2006 *. Authors noted that several studies had revealed CBT is being used more often for bipolar and other severe mental disorders. There was also mention of drugs being developed to increase the efficiency of CBT techniques and the methods being used in a group therapy session. It is also becoming the treatment of choice for the justice system as well if an article from the Office of Justice** programs is to be believed . They stated the concept of taking responsibility and working on perceived entitlement as two areas where CBT is highly effective. All of this says that CBT has a bright future and will most likely become widely practiced in all areas of mental health care.

As a therapist with many years of experience, I tend to see myself as integrative .  I have always considered the ability to use more than one method beneficial for the client. This has been borne out in many therapeutic situations I have found myself in. I first came across CBT about ten years ago and have been a keen supporter ever since. Despite the criticism aimed at the method (see last section), I find it the most effective treatment for the widest range of issues available. I have used it in various situations over the years from depression to bipolar to clients with low self – esteem and interestingly also clients who have  lost a purpose in life due to job loss, grief or separation . In contrast to other methods, CBT really does make a difference in a clients daily life and as most sessions are based on dealing with present issues, one can say that it also goes a long way towards keeping clients in therapy. I once heard it described “CBT sessions mostly aim at making sure clients have a good week”. I believe this sums it up perfectly.   It is truly amazing to see people have that “aha” moment when they fill out the worksheets or realize by being challenged how they had been thinking wrongly over the years.  I have also found that CBT can be easily locked together with other therapies to give the client an individual solution. Those therapists trained in, for example, CBT and psychoanalysis can create a “package” that provides a solution for dysfunctional thinking in the present with a deep analysis of the origin of the client. Even though advocates of  these therapies often seem to be at odds with each other, I actually believe they can form a working alliance for the good of the client. I have often done this in an integrative approach when needed and had good results. In these cases, engaging in psychoanalysis actually helped strengthen the CBT methods by helping to put the past in perspective.

Dr. Nicholas Jenner is a Counseling psychologist in private practice working with individuals, couples, groups and companies. Apart from seeing clients face-to-face, Dr Jenner also runs a thriving online therapy business bringing help to those who are housebound or located in rural locations where therapy is difficult to find. For more information , follow the link to his website HERE

References

¹http://www2.som.uq.edu.au,et al

² http://soultherapynow.com/articles/cbt – effectiveness2.html

³http://psychcentral.com/blog/archives/2009/08/09/psychodynamic-therapy – vs-cbt-smackdown- for- anxiety/

* http://psychnews.psychiatryonline.org/newsarticle.aspx?articleid=109699

**  http://www. nij .gov/journals/265/therapy.htm

  9 comments for “CBT is on the rise as a preferred treatment.

  1. May 9, 2012 at 2:41 pm

    Interesting post, thank you.

  2. May 9, 2012 at 3:15 pm

    I do agree that CBT has been very useful to me, especially Mindfulness-Based CBT which was excellent. Keeping up the practice can be more challenging though and I think you need to use it in the milder stages of depression to prevent spiralling into full despair mode. Once you’re severely depressed I think it’s very difficult to “think” your way out of it- you’re so fatigued and slow and despairing and not with it, it’s hard to do anything!

    But as a preventative measure and to calm my anxiety I have found it very helpful.

    • May 9, 2012 at 3:37 pm

      Hi Rachel…That is the key. At the moment CBT is generally used with other methods as I tend to do but no-one could argue that used correctly, it is a very powerful tool.

  3. May 10, 2012 at 5:24 pm

    I had different types of therapy over the year..therapists, psychiatrists, group therapy (and even ect) and then finally the cbt . I found that I was on a treadmill with regular therapy from therapist/psychiatrist.. All we did was go over and over my past and hurts but never moved forward..just medication and talking. The ect while it troubled me greatly doing it ..in retrospect it likely saved my life at the time..I only had 3 treatments and I definitely benefited but only temporarily and I definitely lost some memory as a result. CBT is what finally got me out of the past and into my present reality of living ….I was going for several years, and during the past year ended my sessions finally as everything was going so well..and I am thrilled to say I was even able to stop completely the ‘maintenance’ dose of anti-depressant that I was on a few months ago…I must add that my Christian faith had a role in my care along the way because I had God with me during my time of depression and healing…….Diane

    • May 10, 2012 at 6:21 pm

      Hi Diane…thanks for the comment. I am pleased that you found something that really helped

  4. May 11, 2012 at 5:42 am

    **waving**

  5. Lawrence Leith
    February 8, 2014 at 11:12 am

    Hiya Dr. Jenner. I hope you are well.
    Just a weee concern about the readability of the the image which accompanies this article. I cant get it to display what it says on the word balloons! The res is way too low. Can you tell me what I’m missing out on, please?

    I run Smart Recovery groups in the UK, and the more I know, ther better!

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