Cognitive Behavioral Therapy: Principles, Science, and Patient Selection in Neurology, 2022, Carson and McWhirter

Andy

Andy

Retired committee member
Abstract

Cognitive behavioral therapy (CBT) is a widely used therapeutic modality in general psychiatric practice. In this review, we consider its application to neurological disorders. We examine the basic framework of CBT—that symptoms, emotions, thoughts, and behaviors are all interrelated and that therapeutic interventions that lead to change in thoughts or behavior may have the potential to reduce symptoms or emotional distress. We also outline specific methodological issues to consider when reading or planning studies of CBT interventions, highlighting important topics pertaining to quality control, control group selection, dropouts, and generalizability. We then review the evidence base for CBT's use across a range of neurological disorders. In doing so, we highlight where there is a clear evidence base, and where it is a technique with potential. The review is targeted at a general neurology audience as introduction to the topic not as an advanced guide for expert practitioners.

Paywall, https://www.thieme-connect.de/products/ejournals/abstract/10.1055/s-0042-1750851
 
Andy said:
Abstract

Cognitive behavioral therapy (CBT) is a widely used therapeutic modality in general psychiatric practice. In this review, we consider its application to neurological disorders. We examine the basic framework of CBT—that symptoms, emotions, thoughts, and behaviors are all interrelated and that therapeutic interventions that lead to change in thoughts or behavior may have the potential to reduce symptoms or emotional distress. We also outline specific methodological issues to consider when reading or planning studies of CBT interventions, highlighting important topics pertaining to quality control, control group selection, dropouts, and generalizability. We then review the evidence base for CBT's use across a range of neurological disorders. In doing so, we highlight where there is a clear evidence base, and where it is a technique with potential. The review is targeted at a general neurology audience as introduction to the topic not as an advanced guide for expert practitioners.

Paywall, https://www.thieme-connect.de/products/ejournals/abstract/10.1055/s-0042-1750851
Click to expand...

Not seen the full text, but reference 35 of this: 35 White PD, Goldsmith KA, Johnson AL. et al; PACE Trial Management Group. Comparison of adaptive pacing therapy, cognitive behaviour therapy, graded exercise therapy, and specialist medical care for chronic fatigue syndrome (PACE): a randomised trial. Lancet 2011; 377 (9768): 823-836
 
Mithriel said:
After all this time you would think that that "may" could be replaced by "often", "sometimes", "usually" or something more definite.
Click to expand...
The difference in language between what they report in papers and what they tell patients is basically the whole con. The very best they can admit to is that it "may" "help" "some", but nothing substantial, nothing that can be measured. But the public message is that this is basically 100% effective.

So there is no evidence, but they can "convince" patients by... lying to them. So the same as alternative medicine. In fact this is alternative medicine, they "feel" that it works, they just can't show you. And the patient has to bring belief into it, this is often admitted, although framed as motivation, or trust.

At the same time they are out there claiming this is solid, professional, well-validated, while privately the best they can frame this is as is this, it just "may" "help" "some" if you are very generous with the definition of every single word, while accepting that it's valid to redefine the problem entirely, making it all about thoughts and behaviors, the former being based on imaginary thoughts they ascribe to us, and the latter on the most superficial features.

But no one is willing to admit that the emperor is fully naked and always was. All those ideas are still fully derived from their origins with Freud and this is the only reason it's still happening. It's too much to admit this is all nothing but a giant con.
 
rvallee said:
The difference in language between what they report in papers and what they tell patients is basically the whole con. The very best they can admit to is that it "may" "help" "some", but nothing substantial, nothing that can be measured. But the public message is that this is basically 100% effective.

So there is no evidence, but they can "convince" patients by... lying to them. So the same as alternative medicine. In fact this is alternative medicine, they "feel" that it works, they just can't show you. And the patient has to bring belief into it, this is often admitted, although framed as motivation, or trust.

At the same time they are out there claiming this is solid, professional, well-validated, while privately the best they can frame this is as is this, it just "may" "help" "some" if you are very generous with the definition of every single word, while accepting that it's valid to redefine the problem entirely, making it all about thoughts and behaviors, the former being based on imaginary thoughts they ascribe to us, and the latter on the most superficial features.

But no one is willing to admit that the emperor is fully naked and always was. All those ideas are still fully derived from their origins with Freud and this is the only reason it's still happening. It's too much to admit this is all nothing but a giant con.
Click to expand...
The whole point of the treatment is the deceit and the patient is not to be taken seriously. I've seen doctors with published papers where they literally say there is no effective treatment for X and then when the patient (me) is in front of them they say yes psychotherapy cures everyone. Full on politics and grift.
 
Andy said:
We examine the basic framework of CBT—that symptoms, emotions, thoughts, and behaviors are all interrelated and that therapeutic interventions that lead to change in thoughts or behavior may have the potential to reduce symptoms or emotional distress.
Click to expand...

Translation and reality = All sick people are mentally ill and just don't think right. We'll give you CBT and that's all you'll get. If you don't like it, tough. You'll just have to suck it up, Sunshine.
 
rvallee said:
The difference in language between what they report in papers and what they tell patients is basically the whole con. The very best they can admit to is that it "may" "help" "some", but nothing substantial, nothing that can be measured. But the public message is that this is basically 100% effective.
Click to expand...

Yes, classic use of weasel words. After decades of research, you know the evidence base is weak if this is all they can manage.
 
Andy said:
The review is targeted at a general neurology audience as introduction to the topic not as an advanced guide for expert practitioners.
Click to expand...
Strikes me that they're saying:
  • if you're in the audience and you're informed/knowledgeable then we both know this is shit --- but you're not the intended audience, so don't tell us that were talking shit;
  • if you're in the audience and you haven't a clue well we can just tell you this nonsense.
Surely it shouldn't matter if the audience is informed or not - assuming you're providing an evidence based review?
 
FMMM1 said:
Strikes me that they're saying:
  • if you're in the audience and you're informed/knowledgeable then we both know this is shit --- but you're not the intended audience, so don't tell us that were talking shit;
  • if you're in the audience and you haven't a clue well we can just tell you this nonsense.
Surely it shouldn't matter if the audience is informed or not - assuming you're providing an evidence based review?
Click to expand...

There are no experts, so the joke is on them.
 
You must log in or register to reply here.
Back
Top Bottom