Cognitive behavioral therapy, or CBT, despite its incredibly unfortunate acronym, was once the most revolutionary psychiatric treatment, according to a June 18, 2021 Clinical Psychology in Europe article.
Nowadays, the narrative around CBT sounds awfully like people from our parents’ generation saying that their favorite artist from the 1960s was the “best to ever do it.”
Invented by Dr. Aaron Beck, CBT is a type of psychological treatment based on the principle that psychological suffering stems from faulty cognitive patterns and maladaptive behaviors, according to the American Psychological Association.
CBT aims to teach skills to shift thought patterns, ultimately changing maladaptive behaviors, according to a May 4, 2022 Harvard Health Publishing article.
CBT is the most widely used treatment for a reason: it is incredibly effective for some people with a wide array of anxiety and depressive disorders, as well as conditions like obsessive compulsive disorder and substance use disorder.
CBT was invented over 60 years ago, according to the Beck Institute. Simple logic would dictate that new, improved and more specialized treatments would have been invented since before a man walked on the moon.
If you have ever attended a psychology course at UVM, you could be forgiven for thinking CBT is the only researched-backed therapy, the gold standard to Sigmund Freud’s psychoanalytic nonsense.
One major reason CBT is an overemphasised treatment is that it’s not effective for every condition.
For example, a recent meta-analysis found that CBT was no more effective in the treatment of borderline personality disorder than the control groups, according to an April 2017 article in JAMA Psychiatry.
Linehan’s biosocial theory posits that borderline personality disorder is formed when a person biologically predisposed to feel emotions more intensely is raised in an emotionally invalidating and traumatic environment, according to a June 15, 2009 Psychological Bulletin article.
If a treatment structure emphasizes that the way the patient thinks is wrong, it’s reasonable to feel invalidated, especially if many of their cognitive patterns come from trauma and abuse.
In fact, until dialectical behavioral therapy was invented, BPD was thought to be at best resistant to all treatments and at worst incurable, according to a July 31, 2009 Psychiatric Times article.
Dr. Marsha Linehan invented DBT in the late 1980s, as she felt available psychiatric treatments were ineffective for her own BPD, according to the official DBT website.
Though once thought to be an incurable condition, 77% of BPD patients no longer met criteria for the condition after just one year of DBT, according to the widely cited Dec. 18, 2014 Berlin Borderline study.
While invented to treat BPD, DBT has become a research-backed and incredibly effective treatment for many other conditions, according to the DBT website.
DBT operates on the idea that your emotions and thoughts are valid because you are experiencing them. However, if you change the way you respond to those sensations, not only will life improve, but the way you feel in the first place will change, according to the DBT website.
Further, it emphasizes mindfulness, the mind-body connection and interpersonal effectiveness as core tenets of the treatment, according to the DBT website.
DBT therapists are also available for and encourage phone coaching outside of session, allowing clients in extreme distress to get assistance without going to the hospital.
CBT isn’t for everyone, yet it’s often presented as the only option.
UVM should be educating students at all levels of psychology courses about the wide variety of treatments.
A nurse, doctor, counselor or social worker should know what therapies are best for their patients. Everyone should know their options.
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