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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by fires on January 15, 2008, at 11:42:30
Full article: http://tinyurl.com/2ndubk
ScienceDaily (Jan. 15, 2008) Psychotherapies such as cognitive behaviour therapy (CBT) are under-regulated in the UK and should be subject to the same standards of evidence as drugs, assert two experts in psychological medicine. They say the largely unrecognized potential for serious adverse effects resulting from talking therapies means rules should be tightened, particularly in light of the UK Government's recent £150m investment in psychotherapy services for depression and anxiety, which will result in many more therapists practising in the UK.
Posted by Racer on January 15, 2008, at 15:36:27
In reply to Finally! adverse effects of CBT, posted by fires on January 15, 2008, at 11:42:30
Hm...
I'm in favor of psychotherapy, because I know that it's been a big part of any recovery I can claim, but I agree that there should be studies, I agree regulators would do well to view it with the same seriousness as they do drugs, and I happen to have experienced adverse effects from CBT...
Something about all this makes me nervous, though. I can't quite put my finger on it...
Maybe it's because I think therapy is so useful, and that there is a place for CBT in the treatment of depression -- even if it wasn't a good choice for me -- or maybe it's as simple as my fear that individual chemistry with a therapist is so much more important than the specific therapeutic model chosen? Dunno -- I just know that I felt a strong wave of anxiety when I read this...
(Then again, I just restarted Wellbutrin today -- could just be medication effects...)
Thanks for posting this -- it's certainly food for thought.
Posted by fires on January 15, 2008, at 17:17:42
In reply to Re: Finally! adverse effects of CBT, posted by Racer on January 15, 2008, at 15:36:27
I've always been skeptical of CBT, especially after I had some -- about 21 years ago.
Does Dep cause cognitive distortions? Yes. Do cognitive distortions cause Dep? I don't think so. Maybe mild dep or the blues, but not Dep.
Proof for my argument is the fact that patients with Dep are in no condition to have CBT, or any other type of therapy.
Patients and Ts are quick to blame meds and pdocs for poor patient outcomes, but do they ever look in the mirror? I don't think so.
Also, 20 some years ago when I had CBT, CBTers tended to look down on med patients as lazy, weak willed, etc.., because they wanted the "quick med fix". How harmful was/is that to patients who forgo CBT?
Posted by Phillipa on January 15, 2008, at 22:48:10
In reply to Re: Finally! adverse effects of CBT » Racer, posted by fires on January 15, 2008, at 17:17:42
What kind of therphy do you recommend? I'm older too. Phillipa
Posted by obsidian on January 15, 2008, at 22:56:04
In reply to Finally! adverse effects of CBT, posted by fires on January 15, 2008, at 11:42:30
Posted by obsidian on January 15, 2008, at 22:57:52
In reply to down with CBT!!! (nm), posted by obsidian on January 15, 2008, at 22:56:04
Posted by caraher on January 15, 2008, at 23:12:42
In reply to Finally! adverse effects of CBT, posted by fires on January 15, 2008, at 11:42:30
Putting down people on meds is a bad idea, regardless of your philosophy of therapy.
It seems like the article doesn't have anything terribly negative to say about CBT per se relative to other therapies. It seems more concerned that its effectiveness be scientifically validated and that its practitioners be well-trained.
I think they single out CBT because it's by far the dominant form of therapy in the UK. Their recommendations would apply equally to any other therapeutic approach.
Posted by Deputy Dinah on January 16, 2008, at 9:29:54
In reply to down with CBT!!! (nm), posted by obsidian on January 15, 2008, at 22:56:04
To those who find CBT helpful.
It's ok to talk about forms of therapy in terms of your own experiences and preferences. But Dr. Bob's new rules on generalization would tend to reinforce the old rules about being respectful in general.
Dinah, acting as deputy to Dr. Bob
Posted by Dinah on January 16, 2008, at 9:35:11
In reply to Re: Finally! adverse effects of CBT, posted by caraher on January 15, 2008, at 23:12:42
I think you're probably right as to the reasons for the focus of the study
I always get the feeling that scientific measurement of therapy outcomes is difficult. In an article I was reading, it said even medication results and the ability to tolerate side effects was greatly influenced by the patient's relationship with the prescriber. I'd imagine with therapy it would be hard to tease out the provider and the therapy.
Then there are the subcategories of measurement. I *think* I read that DBT shows really good results with modifying behavior, but less good results with clients actually feeling less distressed? I could be wrong about that...
Posted by fires on January 16, 2008, at 14:55:26
In reply to Re: Finally! adverse effects of CBT » caraher, posted by Dinah on January 16, 2008, at 9:35:11
My beliefs, most of which are supported by science:
1) I think that there are too many cases in which a person with Depression doesn't know who's prescribing their medication, yet responds well. Also, the placebo effect is of very short duration, contrary to common beliefs.
2) Many Depressed patients don't believe that meds can help, either because they are too ill, or because they are anti-med. They still tend to respond if the med is the one for them. Relapse when the med is stopped is common.
3) I had about a ten second discussion with my neurologist recently during which we agreed that patients with true Depression are borderline catatonic (of course not in the typical use of the term, but figuratively). Most people whom claim to be, and/or are diagnosed with MDD are really dysthymic or just plain sad.It's really unfortunate that MDD has been given such a bizarre and inaccurate label.
For example, people will say that a movie is depressing. Sorry, try using sad, scary, etc... but movies can't be depressing. Movies aren't bipolarizing, etc...
Posted by Dr. Bob on January 16, 2008, at 21:16:09
In reply to Re: Finally! adverse effects of CBT » Dinah, posted by fires on January 16, 2008, at 14:55:26
> Most people whom claim to be, and/or are diagnosed with MDD are really dysthymic or just plain sad.
Please don't exaggerate or overgeneralize.
But please don't take this personally, either, this doesn't mean I don't like you or think you're a bad person.
I encourage anyone who has questions about this or about posting policies in general, or is interested in alternative ways of expressing themselves, to see the FAQ:
http://www.dr-bob.org/babble/faq.html#civil
http://www.dr-bob.org/babble/faq.html#enforceFollow-ups regarding these issues should be redirected to Psycho-Babble Administration. They, as well as replies to the above post, should of course themselves be civil.
Thanks,
Bob
This is the end of the thread.
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