Cognitive-Behavioral Therapy Declining
Jul. 12th, 2015 05:37 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
ysabetwordsmithThis article talks about the declining effects of cognitive-behavioral therapy. I am fascinated to explore why something that used to work pretty well is now not working as well.
I can think of some possibilities not mentioned in the article:
1) The longer a therapy is around, the wider it is known. That means more people have access to it before official therapy. You can go online and find CBT theory, techniques, thought distortions and how to fix them, worksheets, and other tools. This raises the chance that someone already knows CBT and has tried at least some of its methods before seeking professional help. So if the therapist then does more CBT, it looks less effective measured from the start of therapy, because the client already did some of that stuff and got whatever benefit they got from it earlier. In this case, CBT only has a high rate of helpfulness for people who really need guidance and/or advanced techniques that don't work well alone.
2) CBT is terrific at treating certain types of problems, but mediocre or useless for others. If you have bad tape, this is a go-to therapy for fixing that, and you should definitely try it. Same with any other logical or practical problem. It's also ideal for people who do better with facts, logic, numbers, or other objective things than with subjective things. But if you are feeling unheard, your emotions are bent, unacknowledged memories are gumming up your subconscious, or your biochemistry is out of whack, then CBT is not ideal for those problems and won't help much. It is possible that certain types of problem are more or less common in different decades. If the problems presenting now are something other than logical/practical ones, this therapy will seem less useful overall.
Bottom line: If you have head problems that you need help with, start by identifying them as best you can. Then look at the available options for treatment. Each type of treatment is good at some things and bad at others. Pick one that's a good match for your problem(s). Try it for a while. If it doesn't help, drop it and try something else.
I can think of some possibilities not mentioned in the article:
1) The longer a therapy is around, the wider it is known. That means more people have access to it before official therapy. You can go online and find CBT theory, techniques, thought distortions and how to fix them, worksheets, and other tools. This raises the chance that someone already knows CBT and has tried at least some of its methods before seeking professional help. So if the therapist then does more CBT, it looks less effective measured from the start of therapy, because the client already did some of that stuff and got whatever benefit they got from it earlier. In this case, CBT only has a high rate of helpfulness for people who really need guidance and/or advanced techniques that don't work well alone.
2) CBT is terrific at treating certain types of problems, but mediocre or useless for others. If you have bad tape, this is a go-to therapy for fixing that, and you should definitely try it. Same with any other logical or practical problem. It's also ideal for people who do better with facts, logic, numbers, or other objective things than with subjective things. But if you are feeling unheard, your emotions are bent, unacknowledged memories are gumming up your subconscious, or your biochemistry is out of whack, then CBT is not ideal for those problems and won't help much. It is possible that certain types of problem are more or less common in different decades. If the problems presenting now are something other than logical/practical ones, this therapy will seem less useful overall.
Bottom line: If you have head problems that you need help with, start by identifying them as best you can. Then look at the available options for treatment. Each type of treatment is good at some things and bad at others. Pick one that's a good match for your problem(s). Try it for a while. If it doesn't help, drop it and try something else.
Re: Thoughts
Date: 2015-07-14 08:00 pm (UTC)It certainly helps to spot it, and to figure out the extent of the damage before doing other things to fix it. One tool in the toolkit, really.
>>How will we know if the treatment is helping, having no effect, or actively making matters worse?<<
That's a good point! I live in a world of design/test/check/retest and tend to forget that not everyone does, and particularly in the wild and hairy world of mental injury and illness, not having this sort of a pattern in effect seems like a good way to run right off a cliff.
>>Media portrayals show a lot of the mistakes that actual therapists make. <<
..which can be useful as an anti-pattern but is a disaster when trying to assess when one needs help, and what kind, and to what extent. Gah.
Your stuff is pretty awesome. Honestly? Came for the Avengers, stayed for the good representations of mental harm and recovery.
This is incidental to this conversation, but I owe you thanks: I took training last week for my company's emergency handling plans, and am adding EFA to my study list in earnest, largely because of your writing.
Re: Thoughts
Date: 2015-07-15 05:54 am (UTC)If I didn't keep that process snugly in hand, I'd be dead by now. My body and mind are too far from the bell curve to take anything for granted. Everything new is effectively an untested experiment. My whole frigging life is a science experiment.
>>...which can be useful as an anti-pattern but is a disaster when trying to assess when one needs help, and what kind, and to what extent. Gah. <<
Yeah, that has its ups and downs. I have tried to portray at least a few good examples of therapy, but honestly, a majority of stories I hear are bad.
>> Your stuff is pretty awesome. Honestly? Came for the Avengers, stayed for the good representations of mental harm and recovery. <<
Thank you! That is exactly what I hope to accomplish with the fanfic, attracting new readers.
>> This is incidental to this conversation, but I owe you thanks: I took training last week for my company's emergency handling plans, and am adding EFA to my study list in earnest, largely because of your writing. <<
:D I am so delighted that I managed to turn you onto that. Yay, patch import!
This is my favorite handbook:
http://www.bluedolphinpublishing.com/firstaid.htm
There is not a lot of EFA in this world yet, but there are a few books and courses on it.
Re: Thoughts
Date: 2015-07-16 10:40 pm (UTC)Sympathies - that's a rough spot to be in. I'm not quite that far from the bell curve, but it's enough to make supposedly-mundane things nontrivial a pretty good chunk of the time. (If you ever want to rant about this, I'm open to it.)
>>This is my favorite handbook:<<
I've purchased a copy. :)
Re: Thoughts
Date: 2015-07-16 10:49 pm (UTC)*hugs* Thanks.
>> I've purchased a copy. :) <<
Yay! I haven't found a good advanced volume yet, but that one is awesome beginner-to-intermediate stuff that covers all the everyday basics. I'm glad I could turn you onto it.