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CBT "does not work” says second high-profile clinical psychologist

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*Sapphire*

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CBT "does not work” says second high-profile clinical psychologist

I have to say I agree.......

http://www.psychminded.co.uk/news/news2009/march09/oliver-james-cbt003.htm

......

A second high-profile clinical psychologist has delivered a hard-hitting criticism of cognitive-behavioural therapy (CBT) claiming it is simplistic and “does not work”

Dr Oliver James accused government ministers of being "downright dishonest” when they claimed that new NHS CBT-trained therapists will cure half of 900,00 people of their depression and anxiety.

"“There is not a single scientific study which supports that claim,” 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.

His attack in a newspaper column follows that of clinical psychologist Dorothy Rowe. Writing for psychminded.co.uk Dr Rowe said CBT was a "Labour quick fix”.

But CBT supporters say Dr Rowe’s views represented an "out-of-date tirade”.

The National Institute for Health and Clinical Excellence states CBT has a solid evidence base for effective treatment for a number of diagnoses, including depression and schizophrenia.

But Dr James quoted a review of CBT by Professor Drew Weston and colleagues in the 2004 Psychological Bulletin (130, 631 663).

"Weston found that two years after treatment, two-thirds of those who had CBT have relapsed or sought further help." said Dr James.

"If given no treatment, most people with depression drift in and out of it. After 18 months, those given CBT have no better mental health than ones who have been untreated," added Dr James. Findings for anxiety are similar, he said.

"Methods which go beyond the symptoms to the heart of the matter are infinitely preferable to CBT," argued Dr James.

"One is cognitive analytic therapy. Initial treatment is for 16 sessions, of which the first four are devoted to the childhood causes. Another helpful treatment is the Hoffman Process, a nine-day programme which tackles the origins of depression."

Dr James’s criticism comes after the Department of Health announced earlier this month that it is speeding up its access to psychological therapies programme whereby 900,000 people with depression and anxiety will be referred to CBT-trained therapists. Half would be cured, said ministers..............

The government said it would invest an extra £13 million into the programme.
 
A

Ainsworth

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i tried CBT and wasnt ready for it. found it very difficult to apply :unsure:
 
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riverofdragons

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I found it over simplistic and generally patronising.

As it turns out I needed antipsychotics to deal with the paranoid thoughts and not CBT. They didn't investigate enough to begin with and it cost the NHS 12 hours salary of a clinical psychologist.
 
rollinat

rollinat

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I agree - I've never had formal CBT but tried to do a web-based course a couple of times and it was very hard to apply - knowing something intellectually and believing it are very different. Using a "one size fits all" approach to mental health is surely simplistic and a waste of a lot of people's time.
 
S

*Sapphire*

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Personally I found it completely invalidating. In fact I felt that CBT was re-inforcing my negative experiences of living in a completely invalidating environment rather than helping.

In fact I liked Arj Subanandons quote following on from that article about it being like a plaster. Without having read that article before I have often described CBT as a poor plaster over a very deep wound.
 
Scared with BPD

Scared with BPD

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Third time around - CBT

I do understand what you are all saying about it being invalidating and sometimes patronizing as it does appear to have such stringent rules. BUT, and I have to point his BUT out as I had given up on it too many years ago.

Recently, in fact only last week, I had a session with a DD Specialist who introduced it again. My first instinct was to say, been there, done that, know it theoretically inside out. I didn't. I let him talk me through it and we made a great break-through. Now, whether that was because I was feeling incredibly open because he is great to talk to or the way he introduced the exercise using stuff we were talking about already as a way in, I really don't know. But he cracked the topic that I had managed to avoid with Counsellors, CPNs, Psychologists and Psychiatrists for many years. I left there feeling elated. Yes, I have the homework to do which you always have to with CBT and no, I haven't filled out any paperwork yet, I am not saying that he has turned my mind around altogether. The final but is, he did make me ponder and see things from a different angle and although that may sound pathetic to some of you, that is a massive breakthrough for me.

Guess what I'm really saying is, don't down the ideology of the treatment, look at the practitioner.

Sorry, they've upped my meds by 20mg so I may just be seeing things through "happy eyes" at the moment. Apologies if that is the case!

Claire
 
iffybob

iffybob

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The thing isnt....

The prob I alway had about the idea of CBT is , that it would be alright for stable people to apply to learn new brainwashing , er sorry I mean new behavyours..........

How does some one who is not stable, think in a stable stait esp for long periods of time.... thus applying what wa learnt.......

. then again nobody has tried it with me, I dont think they are likely to.... I am damed hard work........ (y)

...my 2p ........ boB.......:evil:
 
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Apotheosis

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I didn't think we were?
Personally I don't think that many even know what other methods there are concerning recovery & alternative/psychological methods.

For the majority it's either meds or nothing - & anything other than meds is poo pooed & ridiculed, denied & ignored.
 
S

*Sapphire*

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I agree with that.

I have done it myself! It is hard to get that conditioning out of your mind as it is so entrenched in our society.
 
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Apotheosis

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telemetry9

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This is at the core of how mental illness is treated simplistically. CBT for all and it will work for most of them. It's plainly dishonest to claim that.

CBT is great for teaching coping skills and can save lives for people who are having their first and only episode of mild or reactive depression/anxiety. It can really make a big difference. But CBT is the beginning of treatment - it is not an end in itself for people who have long term and recurring mental illness.

For people with recurring and endogenous depression those coping skills learned from CBT will be a big help - but many will still have to live with their episodes of depression or daily struggles with the illness. Coping skills are NOT a cure to a chemical imbalance and to claim otherwise is dishonest.

There is also a point were CBT might start to work against the person who has long term mental illness. It begins to sound very repetitive and patronising after you've already gotten what you needed from it. CBT does not have the complexity to move onto the next stage of helping people who live with long term mental illness and who have already had CBT. It just goes over old ground.

This can be very frustrating and begin to erode individual confidence and start to work against the person and the daily struggles they face. Coping skills are not enough for people with chemical imbalances - understanding is the next step in the way. No longer just the "changing thinking" of CBT that actually becomes harmful to someone who is already doing what they know they have to do and uses those coping skills but yet - still lives with their illness daily and is struggling to survive.

CBT is great for the beginning for SOME people. It doesn't have long term adaptability or flexibility and does not allow people to discuss the major events that may have led to their depression and mental illness. This is simply out of the question with CBT as the actual events in someone's life are avoided and those trained in CBT are told not to go near that reality. But if we don't understand what MAY have led someone to become ill (stress factors triggering possible genetic factors leading to clinical depression/anxiety/schizophrenia); then how can we tailor treatment for them? How can you help someone who you don't understand and whose story you have edited for the sake of the rules surrounding CBT and its avoidance of life events and traumas.?

If only life were that simple...
 
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intelgal

intelgal

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I think CBT can work but the problem is many services do not offer it reguarly enough. It needs to be weekly and for a significant period of time. I had some mixed results from it. It does help with copin but do feel the craks are still there underneath.
 
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Apotheosis

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