The Conversation: Why CBT should stop being offered to people with schizophrenia

Keith Laws, professor of Cognitive Neuropsychology, University of Hertfordshire in The Conversation:
Why CBT should stop being offered to people with schizophrenia

Cognitive behavioural therapy, or CBT, has in the past decade become a standard tool for helping people with schizophrenia deal with their symptoms. Recent developments, however, raise serious questions about how effective this talking therapy really is for this illness.

Despite strongly advocating that all people with schizophrenia should be offered CBT, the National Institute for Health and Care Excellence (NICE) – the organisation that evaluates treatments for the NHS – has inexplicably neglected to update its evidence base since 2008. In the intervening years the number of randomised controlled trials – the gold standard for clinical research – assessing symptom reduction through CBT has doubled, and many of them cast doubt on the institute’s recommendations.

Very few trials had reported on the impact of CBT on social and professional functionality, or quality of life, so with this in mind we recently published the first meta-analysis assessing the impact of CBT on these aspects.

The results were not positive.

 

As i said in the other Schizophrenia-CBT thread ignoring ones problems won't make them go away. At best it can help a symptom or two for a moment.

This is something psychology needs to understand but they are at about a 5 year old level of understanding of psychology and actively fight new information because they have the arrogance to think they already know everything.

 

"Why CBT should stop being offered to people with schizophrenia" - that's a strong title, particularly as I've seen some people criticise Law's position on CBT for schizophrenia for being anti-patient choice. I wonder if it would be better to focus on the need to be honest with patients about the lack of good evidence supporting the efficacy of CBT.

 

I have a friend who teaches neuroscience to medical students as part of her Uni work in the USA.

She told me that one of the neuroscience professors says that soon psychology will be redundant as we learn more about the brain and it will all come under biomedical -based neuroscience.

(Her other topics were on cell biology. She has a Biochemistry degree from Oxford and has always taught from a science perspective)

 

https://twitter.com/user/status/1028007642780848128

 

All sounds very familiar:
"These earlier trials spuriously inflated the apparent benefits of CBT five or six times over."
"“The measurement and reporting of adverse effects in trials of psychological interventions for psychosis (and other conditions), is extremely poor.”"

apart from
"Furthermore, a Cochrane review, an authoritative voice on evidence-based healthcare, concluded that CBT showed “no clear and convincing advantage”"............but I guess they didn't have the leading PIs of the trials guiding them.

 

It's really shocking how far they are taking things with this CBT stuff. I've seen no methodologically adequate studies to show that this therapy works for anything other than simple phobias.