A little more conversation

people_meeting.jpgThe Guardian recently published an article on the effectiveness and concerns about the push to promote cognitive behaviour therapy as a treatment for a wide range of health problems.

Cognitive behaviour therapy is one of the most researched and effective forms of psychotherapy, but there are worries it is nonetheless being oversold as a panacea for things for which there are currently little evidence for its effectiveness.

There is no couch, no “tell me about your childhood/dreams/father”. Barely any mention will be made of her past. Instead, the therapist tries to encourage Katie to rationalise her thoughts now, to see the connection between her feelings and her actions. He tries to recognise unhelpful patterns of behaviour (“I ate a whole loaf of bread, then made myself sick because I felt ugly and fat”) and replace these with more realistic or helpful ones (“I don’t need to binge. I have other ways of controlling my emotions, like calling a friend or going kickboxing). This very practical, proactive approach is rather different from the classic modes of therapy, which one CBT convert describes as “frustratingly fluffy and meaningless” and “encouraging you to feel you are not responsible for your own personal wellbeing”.

But while there are few, if any, mental health specialists prepared to dismiss CBT out of hand, there are a significant number of experts who feel that CBT is being grossly oversold. The primary objection seems to be that it doesn’t work for everybody (not even nearly, say some), and that this one-size-fits-all approach may ride roughshod over more traditional forms of therapy which can be just as – if not more -worthwhile in many cases. A year ago, there was even a debate at the Institute of Psychiatry entitled: “CBT is the New Coca-Cola: This house believes that cognitive behavioural therapy is superficially appealing but overmarketed and has few beneficial ingredients.”

Link to article ‘A little more conversation’.

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