CBT The Almighty Cure

[MindBlock]

I know I am going to sound cynical but why is that mental health workers think that CBT is the answer for everything ?

[Phill2]

No idea
It certainly doesn't work for me

[MyNameIsTerry]

I guess it's because CBT is one of the two most studied forms of therapy in existence and also because CBT has a load of studies proving it's efficiency.

How about a curve ball for us in England & Wales? IAPT. From Wiki:

The UK's National Health Service announced in 2008 that more therapists would be trained to provide CBT at government expense as part of an initiative called Improving Access to Psychological Therapies (IAPT). NICE said that CBT would become the mainstay of treatment for non-severe depression, with medication used only in cases where CBT had failed. Therapists complained that the data does not fully support the attention and funding CBT receives. Psychotherapist and professor Andrew Samuels stated that this constitutes "a coup, a power play by a community that has suddenly found itself on the brink of corralling an enormous amount of money ... Everyone has been seduced by CBT's apparent cheapness." The UK Council for Psychotherapy issued a press release in 2012 saying that the IAPT's policies were undermining traditional psychotherapy and criticized proposals that would limit some approved therapies to CBT, claiming that they restricted patients to "a watered down version of cognitive behavioural therapy (CBT), often delivered by very lightly trained staff".

The more I speak to people on this forum about IAPT CBT, the more it backs them up. Some people have even said their therapists have said they only do exposure work now and that's only one element within CBT!

I learnt very little from mine, despite the therapist being lovely & friendly, and I learnt far more CBT later on my own!

So, from a UK point of view, do you think that we had a great big enormous list of people that couldn't be helped and then along comes this IAPT service and onto a new list we all pop? The government loves creating a new list and resetting the clock so everything looks on target, we get it every so often with unemployment. So, was CBT under IAPT stripped down to fit a "service gap" or was it truly driven by patient need. My thoughts are the former. Even now IAPT have introduced a new therapy for depression and guess what? Would you believe it slots neatly into the same number of required sessions as CBT. How convenient.

[NoPoet]

In my opinion, the effectiveness of therapy depends on many things, but primarily:

1. Your willingness and desire to recover.
How hard you'll work for it; how seriously you will take the therapy; your capability to stay in the fight when the therapy starts making you feel worse, which it is likely to do at times (this shows you've hit on one of your core problems); the amount of self-help you will do.

2. The skill, knowledge and experience of the therapist.
How good they are at listening to you and understanding you; the rapport they build with you; their ability to understand the science behind nervous illness; their ability to understand how it affects you.

3. Is it the right type of therapy?
Counselling is probably better suited to people experiencing emotional difficulties caused by life events, who need to talk about how they feel and find a way through. CBT is probably better suited to people with complex issues, or nervous illness that has come about due to protracted distress or difficulty (eg growing up with long-term illness or disability), or situations that require a life-changing response (eg changing the way you think and act).

4. Iain Duncan Smith is a moron.
Technically, this hasn't got anything to do with your therapy, but it's always worth repeating: Iain Duncan Smith is a moron.

I could go on forever explaining these things but the tl;dr is, it's about how much you want to get better and how good your therapist is.

[swgrl09]

Here is the short and simple answer: it's evidenced-based. In the USA, insurance companies support evidence-based practices .. aka therapy modalities that are backed up by research. If it's not backed by research, they are less likely to cover it. I'm guessing the NHS works in a similar fashion. CBT is well-known, well-researched, and can be done "briefly." Brief treatment means less than a certain number of sessions to have effectiveness. Basically it costs less money because it is shorter and has research showing it is effective.

CBT isn't for everybody and there are other evidence-based practices out there. I can't speak for the NHS, but here in the states we use a lot of different modalities, including DBT, ACT, group therapy, etc. But in the end it's all about length of treatment, evidence for the treatment being effective, and cost.

---------- Post added at 12:25 ---------- Previous post was at 12:24 ----------

Although interestingly enough, research REALLY shows that the number one most important factor in therapy being helpful is your relationship with your therapist

[MyNameIsTerry]

4. Iain Duncan Smith is a moron.
Technically, this hasn't got anything to do with your therapy, but it's always worth repeating: Iain Duncan Smith is a moron.

You will be enjoying the news today then. Of course, you will just have to delete out the name and replace it with another one.