How helpful is CBT, really?

We have been discussing the approach of Dr. David Burns, renowned member of the Beck team which developed Cognitive Therapy in the 1980’s, best-selling author of the evergreen “Feeling Good: The New Mood Therapy” and many other fine books on CBT.


The Feeling Good Handbook (Plume)

If there is any criticism I have about Burns’s work, it is not so much about his work as his personality. He has (or had) this relentless, sunny optimism which even in the beginning I intuited overstated the case for CBT.

The people who have been helped by CBT-REBT don’t really care about the studies and stats on efficacy, as well they shouldn’t, they are happy to feel better and live more rewarding lives. Still, even the most favorable studies talk abut CBT-REBT being helpful in only about 60%-80% . Even on the high end, those numbers suck! And the low end may very well be a lot less than 60%. Would you get into a car if you knew that there was a 20%-40% chance it was gong to crash? Would you have surgery if you knew there was a 20%-40% chance you would end up dead or disabled? More important is insight into the subset of those who were helped. Why did it work for them? How many do we have to disregard because they had reached a stage of “readiness” and would have improved no matter what they did? Are there any unifying factors that researchers have identified? Maybe this has been well-researched, but I have not heard about hose studies. We know that there are no silver bullets, and in a perfect world, people who are suffering could be readily matched with the kind of therapy or treatment that will be most helpful.

I am a booster and life-long fan of this stuff, and a fan of Dr. Burns. His books as well as Dr. Ellis’s “saved my bacon,” and over the years have positively influenced my life in so many ways. Yet the best I have gotten is better tools for managing depression and anxiety. That is hardly chopped liver, and I remain grateful, but it is a long way from the sunny testimonials Burns serves up in his books.


Khon Kaen, Thailand

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Originally posted 2014-10-01 20:41:19.

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