Is Cognitive Behavioral Therapy the Gold Standard for Psychotherapy?

TiredSam said:
I have never suffered from depression or had to be treated for it, so I can't speak to that.
Click to expand...
At least here they don't take that too axactly. :) it's like getting depression or somatic disorder automatically. And automatically you qualify for the according treatment. How is it elsewhere?

Here, there are a few doctors (private practitioners, one clinic) who can diagnose "CFS" (ME); the number is smaller than 10, and the clinic only takes locals at this time. Whenever you go to a GP, neurologist or...they won't be able to recognize ME. My PENE/PEM description got totally ignored, PET results couldn't be interpreted, I was told this or that is not school medicine (in the US it is)... How is that in other countries?

This in mind, I naturally got psychiatric diagnoses. After getting the correct diagnosis ME, I was informed that I cannot get a new social aid block from my health insurance, because not diagnoses count, but symptoms, and our health (and so judical) system says depression and ME have the same symptoms.

But I do have ME. And being told that what I need is a treatment which may be effective for dealing with trauma, childhood emotional abuse, phobias or depression annoys me greatly. I do not want my illness to be wrongly categorised just so that "they" (the government, the medical profession, health insurance companies, DWP, certain territory-grabbing psychologists of the BPS variety) can say they have an effective treatment for it, because ME sufferers being forced to go along with their fiction, sometimes to the detriment of their health and under threat of sanctions, is an appalling situation that has gone on for too long. It has also delayed the search for real treatments for ME.
Click to expand...

Well-said.

How is it in the UK? Or in the US? Or Israel, Ireland, Australia...? If you get a new CFS diagnosis, what will happen? What will happen if you depend on social aids? Does this affect your free decision against or for a certain treatment, especially CBT and GET? The answers to that will tell how important it is to keep on invalidating those studies with real scientific facts. And maybe we can coordinate that. (I saw on pubmed several articles against PACE - there must have been some coordination. This is powerful.)
 
Inara said:
At least here they don't take that too axactly. :)
Click to expand...
I am "here" - I have been living in Germany for the last 25 years. I know ME sufferers who have accepted a diagnosis of depression just to get half a pension - if they carry on insisting they are not depressed and have a physical illness called ME, they get no money. As they are too ill to work, the money runs out and in the end they say "ok, I'm depressed, can I have some money for food now".

Inara said:
Hihi! ;)
Click to expand...
I think you meant "hee hee"? ;)
 
TiredSam said:
I am "here" - I have been living in Germany for the last 25 years. I know ME sufferers who have accepted a diagnosis of depression just to get half a pension - if they carry on insisting they are not depressed and have a physical illness called ME, they get no money. As they are too ill to work, the money runs out and in the end they say "ok, I'm depressed, can I have some money for food now".
Click to expand...

That's what I heard several times, also from people with back injuries or severe spinal illnesses. (I will have to experience that, too, since I will have to apply for pension. I was told, due to my age, I will most probably get no pension at all.)
 
Quite old, but I just came across that. Interesting thoughts from someone suffering depression who underwent CBT:

However when CBT is forced on someone with a legitimate mental illness and all the positive logical thought fails to regulate mood or calm anxiety…It is basically causing their self esteem to crumble. If simple positive thought and logic cured mental illness, none of us would bother with pills and therapy. No one would ever need a shrink or meds or hospitalization.
Making someone with a mental illness believe that they can “think” themselves out of a depression or manic episode or panic attacks is borderline negligent as well as defeating the purpose and cruel.
Click to expand...

https://morgueticiasmentalhealthmausoleum.wordpress.com/2015/04/28/cognitive-bullshit-therapy/

PS/this does not belittle the experience of those who were helped by CBT. IMO, a good psychotherapist is what is more important. The harm comes when a bad psychotherapist with no intuition relies only on bad theories and standard practices applied without questionning.
 
Cheshire said:
Falk Leichsenring, DSc and Christiane Steinert, PhD

The authors hightlight several problematic points:
- Limited Study Quality
- Weak Empirical Tests
- Uncontrolled Researcher Allegiance
- Central Mechanisms of Change Not Corroborated
- Limited Efficacy
- No Clear Evidence of Superior Efficacy

http://sci-hub.cc/10.1001/jama.2017.13737
Click to expand...

Not available. Could this be the same article?

https://jamanetwork.com/journals/jama/fullarticle/2654783


If so, they got two replys - both named "The Evidence for Cognitive Behavioral Therapy".

Although we agree that outcome research may have limitations and must be appropriately interpreted, the authors’ arguments are unconvincing for at least 4 reasons.
Click to expand...

Third, the methodological issues mentioned by the authors are in no way inherent or limited to CBT research. It remains to be seen how other approaches perform in the so-called “weak empirical tests” that CBT has been subjected to so far.
Click to expand...

https://jamanetwork.com/journals/jama/fullarticle/2673536

That argument doesn't even make sense? The criticism is unconvincing because other parts pf psychology have the same methodical weakness...?


The term gold standard is not meant to describe a treatment or assessment that is known to be far superior to all possible known alternatives and for all time.5 Instead, it applies to a practice that appears to be best supported by the currently available evidence. With this context, it is appropriate to consider CBTs the gold standard psychotherapy.
Click to expand...

https://jamanetwork.com/journals/jama/fullarticle/2673533we

So if you have weak evidence, it's still ok to call it "gold standard" - because it's the least bad....?
 
Last edited:
Alvin said:
Same with antidepressants and depression, they work because they are chemical crutches, not because they treat mythical biochemical imbalances.
Click to expand...

well, I don't think we really know why they work. I doubt it's as simple as that they're "chemical crutches." I got on anti-depressants when I was 25, before the SSRIs came out. They tried me on about eight or nine before finding one that alleviated some of the suffering. If I only needed a chemical crutch, I might have felt better after the first or third or fifth. But I didn't. That's not "proof," of course. But it does not seem to me that the chemical crutch theory matches my experience. Not to say I know what depression actually is.
 
As expected, most of the "efficacy" is down to poor accuracy, bias and reliability, mostly dissipates when higher standards are used:
In the few high-quality studies available for depressive and anxiety disorders, CBT was found to be less efficacious than in low-quality studies, mostly reducing the efficacy of CBT in panic disorder and social anxiety disorder.
Click to expand...
The biggest problem with cognitive therapies remains identifying when there actually is a behavioral element, which can't reliably be tested for. Those probably make a trivial percentage of what is commonly labeled as mental health issues and no one can tell the difference anyway, even compared to severe chronic diseases. It even appears that the "experts" actually fare worse, since they consider almost everything, including most medical symptoms, to be behavioral.

So there's a stalemate. It clearly doesn't do as advertised but too much has been invested in it to accept defeat. The inevitable collapse of IAPT will likely be the tipping point, but it could go on and on for a while until that happens.
 
You must log in or register to reply here.
Back
Top Bottom