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RE: CBT has well-demonstrated merits... « Adam

Posted by Dr. Bob on January 28, 2002, at 1:00:44

In reply to Re: in defense of CBT « sid, posted by Dr. Bob on January 25, 2002, at 15:58:27

[Posted by Adam on January 27, 2002, at 19:01:30

In reply to http://www.dr-bob.org/babble/20020124/msgs/91422.html]

> Ahh, the old debate.
>
> FWIW, one can scan the literature and look at CBT's track record. It's been been tested in numerous nicely-designed studies, has shown efficacy on par with meds in many of them, and is generally regarded as having at least the effectiveness of any other psychotherapeutic modality. This is simply a fact.
>
> Most certainly, it doesn't work for everyone. No particular treatment works for everyone, sadly.
>
> I found both straight behavioral therapy (for an OCD-spectrum disorder) and CBT (for depression, etc.) far, FAR more helpful than psychodynamic therapy, and for a long time was convinced that PDT was complete horseshit, based on those experiences.
>
> I've changed my mind: Whatever works, use it. Different people are different. They need different things. Nobody really knows why. If one thinks David Burns, MD is an idiot, try something else, and best of luck. Whatever one thinks of Burns, though, one should keep in mind that, as an advocate of CBT, there's a lot of good reasearch to back up his convictions. If he has different ideas about the etiology of depressive disorders, he is in good company. IMHO, "depression" is too broad a term, so asking "what causes depression" is bit like asking "what causes cancer"? Well, lots of things, some of them heritable, some of them environmental, with different ratios of either depending on the particular disease. Appropriately, there are different surgical and pharmacuetical treatments one ought to use, depending on the characteristics of the neoplasia, and the person with it. Lots of new technologies are making the choosing of appropriate treatment strategies easier for cancers. I can only hope some similar progress is made on "depressions" before too long.
>
> I personally have come to regard Burns as a bit of a showboat, but I can't blame him for making money. If his going on Oprah and shamelessly plugging himself is what it takes to help a few people out, so be it. He makes a buck, somebody maybe gets a little better, tries CBT on for size with a therapist because of what they've read...worse things could happen, I suppose.
>
> > Out of curiosity, have you tried CBT or other talk therapy, and if so what did you think of it? (My experience with CBT was much like Cecilia's.)
> >
> > > He also admits bipolar disorder is heavily biological and genetic, but denies depression is biological. LOL
> >
> > So he buys the idea of a biological basis for some mental disorders, but denies that depression is one of them, huh? Personally I've never heard of *anyone* with serious depression who was cured by CBT.
> >
> > Yes, the brain gets sensory input from external experiences, and in the long term these experiences affect what we call "personality," but whether or not a major depressive episode will occur is largely predetermined, probably at least in part by genetics. (There may be other factors, such as autoimmune conditions.) So I don't think that people with depression that has recurred for more than a couple times are likely to benefit from personality or behavior modification (the supposed effect of CBT).
> >
> > -elizabeth


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