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07:06 PM on 07/12/2010
I find it disturbing that so many people still do not know about this kind of therapy. I have seen it do wonders for a friend with serious OCD/anxiety disorder. He got therapy several years ago and recently told me that even though he still has the same tendencies he now knows how to use the techniques he learned to talk himself out of his unreasonable thoughts.

The research on the effectiveness on the effectiveness of this therapy is extensive. People learn to become aware of their own dysfunctional thoughts and assumptions and how to change them. This fits with all the extensive, high quality research on the effects of a pessimistic outlook on mental health, happiness, success and many other things.
05:16 PM on 07/12/2010
No one mentions the fact that Cognitive Behavior Therapy is not available to most people who need it.
The insurance companies usually only cover 50% of the cost if they cover it at all. Most don't cover it at all. In addition the majority of those who could use it don't have insurance at all. The lack of coverage by insurance means most mentally disturbed patients will have to be content with pill popping.

The state mental welfare systems are overwhelmed and the patients are lucky to see a real psychiatrist or psychologist once a month. The state mental health systems are loaded with people whose primary problem is drug addiction. I feel extremely sorry for anyone with mental health problems, but especially the the young and poor.

The reason you see continual new ads on TV for the latest antidepressant is because none, I repeat none, work for all people. The ones that do work are not often very effective for the majority. It is actually only a small percentage who can pop a pill and become what would be considered "normal" in their own eyes. In addition, the cost of the latest psychiatric drugs is very expensive. It is only a small number who can afford drugs and therapy of any kind.
04:16 PM on 07/12/2010
I've had 35 years of therapy, on and off, individually, in groups, and using all different approaches. Last year, I tried four therapists before settling on one that does NOT practice the Cognitive Behavioral approach. I would like to see CB therapists be more honest and up front about the fact that CBT, while statistically "successful", is not a universal panacea & has some serious shortcomings. Not everyone falls into statistics. If 66% of people are helped, great, but what about the other 33%?? In my experience, because its core belief is that you "create your own reality", CBT also does very little to help with trauma, post-traumatic stress, or the results of domestic violence/relationship abuse because "create your own reality" tends to blame victims. So victims coming to the realization that they are NOT responsible for the abuse they suffered is inconsistent with CBT's core principles. CBT also exacerbates narcissism and can be spiritually offensive because "creating your own reality" promotes a lie of omnipotence, puts people in the position of God, denies a power greater than oneself, and makes very little allowance for Mystery. In short, a conscious, head-focussed therapy is not for everyone. Many people benefit far more from somatic (bodywork) therapies, inner child work, and art therapy. It's wise to remember that a client also becomes a revenue stream for a therapist. So as helpful as a therapist might be, they still want you to be "sold" on their therapeutic model.
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GabeSmall
11:14 AM on 07/13/2010
My experience with CBT (which my therapist used and taught me but wasn't evangelical about) was not at all about creating my own reality. It was simply about taking control over my thought patterns, which is very different.

If he wanted to keep me as a revenue stream, he might have been better off with psychoanalysis or something because once I mastered the techniques, I didn't need him anymore.
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yogini4
Think deeper!
12:45 PM on 07/13/2010
As a therapist who specializes in trauma I agree with you. I've had more than my share of CBT "refugees". Too often the patient interprets their therapy as some kind of internal deficiency. Also CBT does not focus on strengthening sense of self which is usually crucial in trauma clients. Well said.
03:09 PM on 07/12/2010
As an integrative CBT therapist myself, I think this is a good and helpful summary of what CBT has to offer. It can't do everything, and needs to integrate with other effective approaches (which it shows it can do with e.g. Mindfulness approaches), but it's the approach with the most basis in the findings of psychological science.
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03:16 PM on 07/12/2010
i totally agree with your claim that to be truly effective, other techniques should accompany CBT. i'm an LCSW, and i use mindfulness meditation and acceptance & commitment therapy along with cbt.
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12:54 PM on 07/12/2010
But CBT requires effort, can't I just pop a pill?
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yogini4
Think deeper!
12:46 PM on 07/13/2010
How about a good multivitamin?
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Wolfwoman
11:30 AM on 07/12/2010
The value of CBT has been underestimated. It is a powerful healer. CBT clients that benefit make conscious efforts to explore their patterns of automatic responses to stress and change the patterns to new relief measures. If a person slips and reverts to former maladaptive patterns, the good news is that the therapy can be successfully resumed.
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Kmuzu
Rolling dem bones
12:11 PM on 07/12/2010
Living in the moment - taking responsibility - being conscious - owning your emotions.
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saami
Cranky old lady
01:20 PM on 07/13/2010
Being here now. Being alive.
10:42 AM on 07/12/2010
Thank you, Dr. Beck, for a great summary of CBT.
10:39 AM on 07/12/2010
To anyone suffering from anxiety and depression: please read Dr. David Burns' "Feeling Good." It's extremely helpful, and the exercises in it actually help bring down anxiety, particularly during a panic attack. Dr. Burns is very well respected in the CBT community.
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Kmuzu
Rolling dem bones
11:44 AM on 07/12/2010
Great book - I listed it below as well - really made a tremendous difference - however, if you're new to CBT it can be difficult to accept what he is explaining. It took me a good year to understand the principles.
11:48 AM on 07/12/2010
I was just about to recommend Dr. Burns' book when I scrolled down and saw your comment. This book was very valuable to me in "rewiring" my own brain to cope with feelings of anxiety and low self-image. In fact, I think it helped me more than talking with my therapist (who was the person recommending it to me). The written exercises are really helpful.
10:32 AM on 07/12/2010
Thanks to CBT, I have overcome anxiety and depression. It took a long time, over two years, but my thinking patterns are now completely different than they used to be. I no longer ruminate about things that make me anxious to the point to bringing on depression. That's not to say I'll never battle depression again, but I'll be a hell of a lot better equiped to fight it off. I'll forever be grateful to my CB therapist. She helped me changed my life and really enjoy it.
02:37 PM on 07/12/2010
I am glad you had a good experience with therapy. It can be a marvelous, transformative thing.
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LoyalOpposition
10:06 AM on 07/12/2010
There is an excellent movie on video with an unfortunate name which doesn't exactly fit, but deals with aspects of this: It is a comedy with a wallop: "Dirty Filthy Love," with Michael Sheen and Shirley Henderson. Warrants viewing.
08:42 AM on 07/12/2010
Great article and intriguing running commentary. One theme which has run throughout the discussion but has not really been addressed has been the entanglement of therapist, client and insurance company. Is there any way we can impact this? Could we restructure (lower) the cost of our therapies provided to treat more people and take the insurance companies out of the loop in more situations? It's funny, insurance companies are run by humans, but I have not found them to be humane.
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GabeSmall
10:49 AM on 07/12/2010
I know many therapists will take cash on a sliding scale.
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Kmuzu
Rolling dem bones
12:17 PM on 07/12/2010
I think there are really three categories

Psychiatrist (PhD and MD) - drug dealers - just kidding - but they prescribe the medication, you meet with them every six months or so - meeting last about 15 minutes

Psychologist - (PhD) - therapist works with you regularly on cognitive issues - does not prescribe drugs. Do not go to a Freudian psychotherapist.

Therapist - Counselor - (Masters) Diagnosis and behaviorism. Good for substance abuse, eating disorders, gambling, - other behavioral problems.
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Eartha
Live and learn from fools and from sages
07:35 AM on 07/13/2010
Many licensed therapists with master's degrees practice CBT. Behavioral change is not separated from the equation; as your post suggests, due to a therapist's credentials.
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Lexie
07:39 AM on 07/12/2010
I had CBT with an excellent therapist for about 6 months several years ago. She was very intelligent and the approach was rational and evidence-based. It depended heavily on me observing my behavior and emotions closely to understand triggering events and chains of behavior. The relationship was one of collaboration. I respected the therapist very much, but I also felt that she respected me. I think, however, and I say this from my own experience, if one is strongly invested in a certain view of things, it is hard to "believe in" CBT, which will often counter that view. You have to be willing to "give up" some of your more cherished ideas about yourself and others, and give in to the evidence.
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saami
Cranky old lady
01:25 PM on 07/13/2010
Yes, you must give up the cherished ideas that cause you to use the old scripts over and over again ad nauseum. You don't even need the other person or persons to be there you know the script so well you can do everyone's part. It is a bit scary to just accept life as it comes and deal with things one at a time without presuming anything and allowing life to unfold. Usually you are so busy getting out the old scripts, reminding people where their lines are and getting them to say them with feeling that life is passing you by. Don’t let that happen. This is not a dress rehearsal you don’t get another chance.
05:06 AM on 07/12/2010
I am about to begin one of the worlds best treatment courses that contains a great deal of cognitive therapy. Hospitals and treatment centers from all over the world come to train here to learn how to use cognitive therapy in conjunction with physiotherapy to bring people back into society who suffer long term chronic pain.
I suffer nerve damage and pain after 3 surgeries on my spine and have been unable to leave my home for 18 months due to limited movement. The course uses cognitive therapy and physiotherapy to target MY problems to enable me to live a normal life again.
Cognitive therapy has been proven to work in these instances and the course is now in its 22nd year and continues to help people. Most pain is in the head - cognitive therapy helps people to learn new ways to deal with it.

For any people left in doubt - look for the Walton Centre for Neurology and Neurosurgery in Liverpool. This is one of the best places in the world for neurological problems and the pioneer of this course which uses cognitive therapy to bring folks back into society after suffering long term chronic pain.

Respondents need to realize how cognitive therapy can help people. Positive results are the proof that it works, but when being used in conjunction with physiotherapy if you don't have the passion to be better, you won't accept any changes that need to be made both physically or mentally.
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thepill
My micro-bio is half-full.
08:15 AM on 07/12/2010
Best wishes for every success in the program from Maryland, USA!
10:33 AM on 07/12/2010
I wish you the best. Good luck to you!
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MerrieWay
03:05 AM on 07/12/2010
Cognitive therapy may work, but the therapist is an important factor. Choose wisely.
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CaveatLector
07:49 AM on 07/12/2010
Big points for your statement. I have had limited success with CBT, but mostly because I cannot find a therapist who isn't more messed up than me. My last treatment provider was a perfectly nice woman who would suddenly just walk away from you without saying 'goodbye.' It was unsettling and when I asked her about this odd behavior, she said that 'saying goodbye could trigger a psychotic episode in her."

I didn't come back.
09:35 AM on 07/12/2010
Some get into this field due to their own personal situations for sure
10:23 AM on 07/12/2010
Good for you. Clearly your intuition is intact. If you feel you need therapy, please don't let this unfortunate behavior on her part stop your quest for what you need.
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plaidsportcoat
02:54 AM on 07/12/2010
Wow. Will it help me get a JOB??
zanzy
your micro bio is empty, just like our democracy.
03:04 AM on 07/12/2010
Let's play CBT:

Patient. I am so depressed b/c I have been looking for a job and it is so difficult. I am so stress.
Dr. It is important to know that you are not alone. So many people a re looking for a job. It is not you.
Patients: I am so stressed out.
Dr. Well, let's do something constructive. I want you to write all the reasons done why you do not have a job and bring it next time and we will discuss. ANd I want you to sent out three resumes by next, or a least start the process.

I think this is CBT!
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Kmuzu
Rolling dem bones
03:14 AM on 07/12/2010
It's better than .. let's talk about your mother .. or tell me about your dreams
10:09 AM on 07/12/2010
No, that isn't CBT.