CBT as Scam?

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"Unfortunately, shiny services tend not to last. CBT fails to address the root cause of many people’s problems, which often stem from traumatic experiences during their childhood."

"The therapies proven to work long-term, such as psychodynamic therapy, would not be so cheap because they require more sessions’ he said."

Such garbage. Honestly just...garbage.
 
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If you are going to make claims like "CBT fails to address the root cause of many people’s problems, which often stem from traumatic experiences during their childhood." and "CBT is no more effective than placebo in treating anxiety or depression" I would like to see some scientific sources.

One person's opinion on The Daily Mail is not a scientific source.

Not to come off as rude or lacking kindness, but the fact that you post topics like this might contribute to why your opinion gets ridiculed in other threads.
 
It does seem that you are just trying to piss people off at this point...
 
A Blue Duck said:
It does seem that you are just trying to piss people off at this point...
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Not trolling at all. There was a newspaper story, and I wanted feedback on it. So your feedback is you're pissed off?
 
WisNeuro said:
Just trollbait, James is an entertainer. It's easy to claim things without evidence when you're trying to sell a book or television special.
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Good to know. I had not heard of him.
 
LAPsyGuy said:
So what. They're still reporting a real story.
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Do you believe everything you read in the Daily Mail? If so, I hope you don't read it too often as it's really seen as a joke publication. Also, I skimmed the article and didn't see any citations other than this one person's opinion as a psychologist. Correct me if I'm wrong, as I skimmed, but my opinion as a, um, not yet psychologist is that the article sucks.
 
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LAPsyGuy said:
Not trolling at all. There was a newspaper story, and I wanted feedback on it. So your feedback is you're pissed off?
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No.

I said, "It does seem that you are just trying to piss people off at this point..."

I'll let you conduct a comparative analysis between my statement and, "I am pissed off." Hopefully you will see they are not the same. You can't just go around making improper inferences and then use said inferences as a foundation for further argument.

Well, you can...but you can't expect continued patience and kindness from others when you do so.

I already gave my feedback on the article....it is trash journalism.
 
A Blue Duck said:
No.

I said, "It does seem that you are just trying to piss people off at this point..."

I'll let you conduct a comparative analysis between my statement and, "I am pissed off." Hopefully you will see they are not the same. You can't just go around making improper inferences and then use said inferences as a foundation for further argument.

Well, you can...but you can't expect continued patience and kindness from others when you do so.

I already gave my feedback on the article....it is trash journalism.
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So you're impatient?
 
LAPsyGuy said:
You seem to love to tell people what to do.
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Of course I do! Nobody wants to be middle management the rest of their life. lol
 
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erg923 said:
Of course I do! Nobody wants to be middle management the rest of their life. lol
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Given your style, I think you're probably stuck there, but it fits nicely. Enjoy.
 
Erg said he wanted to joke around and break some balls. What did I miss?
 
Even people in bad programs know to read everything critcalyl. the fact that you did not do your research before posting suggest you either 1. are a troll 2. are clearly uneducated in how to critically think. if 2 is the case, please learn to use google scholar, it is your friend. you will find overwhelming evidence that cbt is one of the best course of treatments for depression. please do some research before posting things that can be easily researched in as much time as it took to write this post. good day.
 
psychtalk1274 said:
Even people in bad programs know to read everything critcalyl. the fact that you did not do your research before posting suggest you either 1. are a troll 2. are clearly uneducated in how to critically think. if 2 is the case, please learn to use google scholar, it is your friend. you will find overwhelming evidence that cbt is one of the best course of treatments for depression. please do some research before posting things that can be easily researched in as much time as it took to write this post. good day.
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You misconstrued my intent. I'm posting something found in the media. This is the sort of thing we, as a profession, are up against. I'm not endorsing it, but simply sharing something making its way through popular culture. Sorry for any confusion.
 
I would agree that it's a viable point to address--we understand that the piece isn't supported by evidence, but much of the public might not be aware of that. Therefore, our options are 1) to scoff and suggest that the article is obviously bunk, or 2) actively (pro- and re-) address the misconceptions it might cultivate.
 
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In the voice of Frank Constanza, he says: "You want a Avatar stand-off? You got one!"
 
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what is up with the avatar change @LAPsyGuy, I didn't even realize it at first until I read a couple of posts and thought, @erg923 wouldn't say that, lol
 
Therapist4Chnge said:
Trololol'ing. Just other posts make that readily apparent.
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i do troll sometimes, but his post isn't trolling. I was posting this to start a conversation about how complex systems of treatment are handled in the media. I find it fascinating.
 
For future reference if that was your intent then perhaps you should have stated so in the topic post. More useful discourse likely would have been generated if you had provided some direction for the topic discussion rather than simply posting a link.
 
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Wow! CBT doesn't work anymore? I better stop using it for my poor unsuspecting patients.

Obviously, I am being facetious. Many of the principles/techniques of CBT have been demonstrated to be effective through solid research. I don't believe that CBT is the only way to conceptualize and treat patients, but to call it a scam is just ridiculous. After all, many of my patients appreciate the symptom relief that is provided and it has also been demonstrated to have long term benefits superior to medications for both depression and anxiety disorders.
 
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Icculus8 said:
For future reference if that was your intent then perhaps you should have stated so in the topic post. More useful discourse likely would have been generated if you had provided some direction for the topic discussion rather than simply posting a link.
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Good point. I will try to be better about that in the future.
 
Icculus8 said:
If you are going to make claims like "CBT fails to address the root cause of many people’s problems, which often stem from traumatic experiences during their childhood." and "CBT is no more effective than placebo in treating anxiety or depression" I would like to see some scientific sources.
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For mild and moderate forms of depression, antidepressant meds and placebos produce largely equivalent post-treatment outcomes (Fournier et al., 2010; Kirsch et al., 2008). Generally, in the treatment of depression, antidepressants and psychological treatments do not differ in post-treatment outcomes (Billion and 2 studies).

By extension, it is not crazy to presume that psychological treatments do not significantly differ from placebos in post-treatment outcomes.
 
Fournier doesn't include any long-term outcome data, the majority of data points come from 8 weeks or less of treatment. Generally CBT outcomes do not differ in short time windows but outstrip medication long-term. See the TADS study. There is also a much lower risk of suicide with CBT in the short- and long-term when compared to placebo and drug treatment. Also, CBT doesn't tend to have the fun side effects of weight gain, sexual dysfunction, and needing to be on it forever.
 
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WisNeuro said:
Fournier doesn't include any long-term outcome data, the majority of data points come from 8 weeks or less of treatment. Generally CBT outcomes do not differ in short time windows but outstrip medication long-term. See the TADS study. There is also a much lower risk of suicide with CBT in the short- and long-term when compared to placebo and drug treatment. Also, CBT doesn't tend to have the fun side effects of weight gain, sexual dysfunction, and needing to be on it forever.
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Your arguments are unconvincing. Sure, CBT outperforms at follow-up (i.e., after treatment discontinuation), but CBT and ADM/placebos generally do not yield different outcomes at end of treatment. Thus, there is good reason to believe that taking a placebo over the long-term would result in the same outcome as long-term CBT.

I agree that CBT doesn't have the side effects that meds do, but we're talking specifically about outcome. There is little evidence that drop-out rates are different across CBT and ADM conditions, and so in this context, I think its an irrelevant point. Moreover, placebo doesn't have the side effects of ADM, and yet will yield equivalent depression reduction.

I disagree with the idea that CBT outperforms in reducing suicide risk. This seems to be a very specific interpretation of the literature- sure you can find a handful of studies or a meta-anlaysis that suggest this, but these are outweighed by the mountain of "Dodo" data.
 
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Considering the ample evidence that suggests CBT leads to lower rates of depression relapse (Kennard 2008; Vittengl et al 2007; Stangier et al 2013, etc) over medication and placebo, feel free to be unconvinced. Whether or not you choose to accept data is your right. If you see patients though, I feel bad for the advice of "just go home, it will probably go away eventually, although, you'll be more likely to relapse and kill yourself than if we actually did something useful." Not too mention that there are many reviews and critiques that call the Dodo bird hypothesis into serious question. But, buzzword away.
 
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McClinas said:
Your arguments are unconvincing. Sure, CBT outperforms at follow-up (i.e., after treatment discontinuation), but CBT and ADM/placebos generally do not yield different outcomes at end of treatment.
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I am not a strong supporter of CBT, that is to say I slightly support it; however, on face value alone, I think it is ridiculous for you to say there is no empirical outcome support for the use of CBT.

McClinas said:
Thus, there is good reason to believe that taking a placebo over the long-term would result in the same outcome as long-term CBT.
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No, there isn't.
 
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These are straw man arguments. At no point did I suggest that there is "no empirical outcome support for the use of CBT." Moreover, with regard to WiseNeuro's comment, taking a placebo is not equivalent to saying "just go home, it will probably go away eventually."

Clearly, you are not a wise consumer of outcome research. The fact is that CBT is clearly effective. ADM is clearly effective. AND placebo is clearly effective. Placebo does not mean that clients will spontaneous remit (i.e., "go home, it will go away eventually"). The fact is that placebo is much more effective than doing nothing.

In addition, to say that outcomes are not different across CBT, ADM, and placebo is not to say that CBT and ADM are ineffective. These treatments are highly effective (relative to time/waitlist control), but not for the reason that people think they are. That is, placebo seems to be driving most of (if not all) of their effects.

It is disappointing, and frankly kinda shocking, that two professionals equate placebo with "do nothing."

And no, I'm not a therapist. I'm a psychotherapy outcome researcher.
 
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WisNeuro said:
Considering the ample evidence that suggests CBT leads to lower rates of depression relapse (Kennard 2008; Vittengl et al 2007; Stangier et al 2013, etc) over medication and placebo, feel free to be unconvinced. Whether or not you choose to accept data is your right. If you see patients though, I feel bad for the advice of "just go home, it will probably go away eventually, although, you'll be more likely to relapse and kill yourself than if we actually did something useful." Not too mention that there are many reviews and critiques that call the Dodo bird hypothesis into serious question. But, buzzword away.
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PsychBiker said:
I am not a strong supporter of CBT, that is to say I slightly support it; however, on face value alone, I think it is ridiculous for you to say there is no empirical outcome support for the use of CBT.
No, there isn't.
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These are straw man arguments. At no point did I suggest that there is "no empirical outcome support for the use of CBT." Moreover, with regard to WiseNeuro's comment, taking a placebo is not equivalent to saying "just go home, it will probably go away eventually."

Clearly, you are not a wise consumer of outcome research. The fact is that CBT is clearly effective. ADM is clearly effective. AND placebo is clearly effective. Placebo does not mean that clients will spontaneous remit (i.e., "go home, it will go away eventually"). The fact is that placebo is much more effective than doing nothing.

In addition, to say that outcomes are not different across CBT, ADM, and placebo is not to say that CBT and ADM are ineffective. These treatments are highly effective (relative to time/waitlist control), but not for the reason that people think they are. That is, placebo seems to be driving most of (if not all) of their effects.

It is disappointing, and frankly kinda shocking, that two professionals equate placebo with "do nothing."

And no, I'm not a therapist. I'm a psychotherapy outcome researcher.
 
First off, its a stretch to call me a professional. Beyond that, I did not mean to infer placebo literally equates to "do nothing." In my world as a clinician, if my treatment is as good as a placebo, then I might as well go for a jog with my client; at least they will get some physical exercise. My point was, that your conclusions are ridiculous.

Lets have fun with identifying fallacies!

What fallacies can you find:

"I think your opinions are rubbish as you are not a therapist. All you have is a bunch of "data" involving self-reports and observations instead of any real experience and exposure with patients you have been seeing for years. Your 'outcome researcher' numbers mean nothing to me compared to what I have seen work. All my patients have been cured, what about yours?"

You get one :owle:per each correct fallacy identification!
 
You have yet to actually show any data about the equivalency of placebo in long-term outcomes. You've only cited a very small meta-analysis that has mostly 8 week outcomes. While we're throwing around logical fallacy buzzwords, throw around ad hominems all you want, they won't help your argument.
 
WisNeuro said:
You have yet to actually show any data about the equivalency of placebo in long-term outcomes. You've only cited a very small meta-analysis that has mostly 8 week outcomes. While we're throwing around logical fallacy buzzwords, throw around ad hominems all you want, they won't help your argument.
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WisNeuro-

Your first argument conflated placebo with "do nothing." I think you realize that was a mistake.

Your latest argument has conflated long-term outcomes with follow-up outcomes.

While receiving treatment (short-term or long-term), there is generally no difference between CBT, ADM, and placebo (again, we're talking about treating most forms of depression- mild and moderate).

CBT outperforms ADM and placebo at follow-up (i.e., after an extended period of no treatment).
 
In the research literature long-term outcomes and follow-up are somewhat synonymous. Not too many lifetime long studies out there. About 2 years follow-up is as good as they generally get. And, your last line was the only argument I was trying to make. As far as the data we have, up to a few years follow-up, CBT is effective above and beyond placebo and meds (if they have been discontinued) for a variety of outcome variables.
 
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