Is CBT effective at all?

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Is CBT effective at all?

#1  Postby rejoin11 » Nov 13, 2020 1:45 am

I know CBT (cognitive behavioral therapy) is well accepted. I just wonder WHY.
What tends to be completely ignored is that CBT pretty much builds it's own selection-bias, it simply lacks double blind studies and often ignores confirmation bias in studies done about it. There's usually is not even a control group with people who didn't receive any treatment to compare cbts effectiveness to.

And how could anything objective be said about the effectiveness of a therapy that just excludes so many patients? CBT drop out rates were found to be 17% higher than other therapies in one meta-analysis.
(Cuijpers P, van Straten A, Andersson G, van Oppen P (December 2008). "Psychotherapy for depression in adults: a meta-analysis of comparative outcome studies". Journal of Consulting and Clinical Psychology. 76 (6): 909–22. doi:10.1037/a0013075. PMID 19045960. S2CID 23341989.)

If you simply aggregated the dropouts as "fails" into studies, would it be considered effective at all? Why is this not done? A therapeutic method is not a pill you can force somebody to swallow. People dropping out of it means it failed them - what else?

And the long term effects seem to be unclear too. All i found was a few flimsy studies, that again ignore the selection bias at the beginning. They don't worry much if a former patients lives turned out any better in comparison. Essentially they just ask "how are you? and are your symptoms better?" All in the context of "did our therapy help you. Confirmation bias and
social-desirability right there.
Do they even remember what they did during cbt? Shouldn't that be something that is asked?
Would they say what they learned in cbt is still effective?
What about medication? Shouldn't there at least be a control group that wasn't medicated and is still taking those meds?

My suspicion is that CBT is essentially a fashion. Its a theory of the mind that bows to a consumer-perspective. People today like problems solved in this manner. Quick and blunt. Instead of asking "Why do you want this?" a CBT-service-oriented-therapist says: "Tell me what you want, ill give you tools to make it happen". It pretends it's open-outcome - but its not. That's why we got the life-coaches industry springing up. Sports-training-mentality, clear instructions, short time period, low complexity. Any concept that is remotely vague is downplayed or ignored. (like the subconscious, reactance, underlying motivations) Its all a "black box". We'll just push your buttons. Some of them tend to work.
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Re: Is CBT effective at all?

#2  Postby aufbahrung » Nov 13, 2020 4:59 am

Tried it. Found it wanting and dangerous, for the person who only thinks about the present is likely to forget his past. Very useful with all the wars. It could be taught on a leaflet, hardly like taking LSD, where you require a guide.
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Re: Is CBT effective at all?

#3  Postby laklak » Nov 13, 2020 9:16 pm

We don't need no stinking guides.
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Re: Is CBT effective at all?

#4  Postby Ironclad » Nov 13, 2020 10:34 pm

I tried it a few years back. I had to wear a rubber band on my wrist and if I had a dark thought I was to stretch the band and cause myself a little pain, a distraction therapy really. I don’t think too much of it and gave up after a day. The therapist wasn’t happy when i told her what I thought of CBT and I was removed from the treatment. I’m sure it works for some.
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Re: Is CBT effective at all?

#5  Postby Svartalf » Nov 18, 2020 3:10 pm

Tried it, every time I had dark thoughts, I would sit down and give myself a handjob. Now my little soldier is worn to a nub, I'm still depressive as all hell, and dead tired to boot.
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Re: Is CBT effective at all?

#6  Postby Ironclad » Nov 19, 2020 6:28 pm

As a surprise bonus though, I expect the extra long foreskin doubles up well as a sleeping bag. Now.
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Re: Is CBT effective at all?

#7  Postby Tortured_Genius » Nov 29, 2020 6:25 am

I think it can be, but only for very specific psychological (rather than physiological) conditions. In my local authority area they tend to use it as a go-to and readily available panacea, but if you have an actual neurological condition the waiting list is (literally) years long.

Unfortunately I suspect its popularity is mainly down to its comparatively low cost rather than its efficacy.
None are so hopelessly enslaved than those who falsely believe they are free. - Goethe
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