Sunday, July 12, 2015

Cognitive Behavior Therapy - is becoming less effective

The Guardian  Everybody loves cognitive behavioural therapy. It’s the no-nonsense, quick and relatively cheap approach to mental suffering – with none of that Freudian bollocks, and plenty of scientific backing. So it was unsettling to learn, from a paper in the journal Psychological Bulletin, that it seems to be getting less effective over time. After analysing 70 studies conducted between 1977 and 2014, researchers Tom Johnsen and Oddgeir Friborg concluded that CBT is roughly half as effective in treating depression as it used to be.

What’s going on? One theory is that, as any therapy grows more popular, the proportion of inexperienced or incompetent therapists grows bigger. But the paper raises a more intriguing idea: the placebo effect. The early publicity around CBT made it seem a miracle cure, so maybe it functioned like one for a while. These days, by contrast, the chances are you know someone who’s tried CBT and didn’t miraculously become perfectly happy for ever. Our expectations have become more realistic, so effectiveness has fallen, too. Johnsen and Friborg worry that their own paper will make matters worse by further lowering people’s expectations.

All this highlights something even stranger, though: when it comes to talk therapy, what does it even mean to speak of the placebo effect? With pills, it’s straightforward: if I swallow a sugar tablet, believing it to be an antidepressant, and my depression lifts, then there’s a good chance the placebo effect is at work. But if I believe that CBT, or any therapy, is likely to work, and it does, who’s to say if my beliefs were really the cause, rather than the therapy? Beliefs are an integral part of the process, not a rival explanation. The line between what I think is going on and what is going on starts to blur. Truly convince yourself that a psychological intervention is working and by definition it’s working.

Perhaps every era needs a practice it can believe in as a miracle cure – Freudian psychoanalysis in the 1930s, CBT in the 1990s, mindfulness meditation today – until research gradually reveals it to be as flawed as everything else. [...]
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Mindfulness Is Just As Effective As Cognitive Behavioral Therapy In Treating Anxiety, Depression 

Medical Daily   According to a new study out of Lund University in Sweden, mindfulness can be just as effective as your typical therapist who practices cognitive behavioral therapy (CBT), which necessitates focusing on negative thoughts and having a discussion, as well as running experiments, on them.  

The study, led by Professor Jan Sundquist, was held at 16 primary health care centers in southern Sweden. The researchers trained two mindfulness instructors at each health care center during a six-day training course. Participants of the study, who suffered from depression, anxiety, or severe stress, were gathered into groups of 10 for structured group mindfulness treatment. The patients also received a private training program, and were asked to record their exercises and thoughts in a journal. For eight weeks, all 215 of them went through mindfulness therapy, then answered questions about their depression and anxiety. The researchers found that self-reported symptoms of depression and anxiety had decreased during the treatment period.

“The study’s results indicate that group mindfulness treatment, conducted by certified instructors in primary health care, is as effective a treatment method as individual CBT for treating depression and anxiety,” Sundquist said in a press release. “This means that group mindfulness treatment should be considered as an alternative to individual psychotherapy, especially at primary health care centers that can’t offer everyone individual therapy.”

The notion of mindfulness dates back to ancient Buddhism, and is an essential part of the religion. It involves accepting the present moment and focusing on the sensations, feelings, and thoughts that are happening right now. Being able to reduce the extraneous "noise" from anxiety, worrying, and fear can help people focus on and live in the moment, and also allow them to lessen unnecessary stress. [...]

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