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CBT is a scam and a waste of money

Discussion in 'General ME/CFS News' started by cigana, Nov 15, 2014.

  1. cigana

    cigana Senior Member

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  2. Sidereal

    Sidereal Senior Member

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    In other words, the government should fund my brand of quackery instead of my rival's brand of quackery.

    The alternative he's pushing for sounds even more awful to me.
     
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  3. SilverbladeTE

    SilverbladeTE Senior Member

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    Somewhere near Glasgow, Scotland
    Although I've never been officially diagnosed, pretty damn sure I've got PTSD, not surprising really
    As little kid, terrified, hoping lock Mum put on my door will keep the "monster" out and he smashed it down, twice, took the door right off the hinges once.....
    yer at school and an actual psychopathic lad who was at the same school pulls a knife on you demanding yer pocket money or he'll stab you (first time I ever "banjoed" someone, smashed his nose flat, years later he got 8 years in jail for incredibly brutal attempted murder of a pal of mine)
    etc etc

    only things that every helped that were chilling, sitting by a river with my dog and/or fishing rod or the wandering over the hills or along the rivers, or painting, stuff like that.
     
  4. chipmunk1

    chipmunk1 Senior Member

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    Psychodynamic therapy is based on psychoanalysis. In my opinion psychoanalysis is one the biggest scams in healthcare and medicine that has ever existed and also one of the longest running and most successful. It is also a more profitable scam than CBT as it can cost tens of thousands.

    Does that mean a bit of "positive thinking" will not cure me? Who would have thought that?
     
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  5. cigana

    cigana Senior Member

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    Very good point :(
     
  6. adreno

    adreno PR activist

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    I'd take CBT over psychodynamics (freudianism). Here is an excerpt of psychoanalytic theory:

    Most of psychoanalytic therapy revolves around the person's handling of the Oedipus complex, the problems "rooted in childhood", as the unconscious conflicts created during this childhood phase is "perpetuated" in later relationships. It is insane nonsense.
     
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  7. justy

    justy Donate Advocate Demonstrate

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    I think the point is - and a good one I think - that CBT in Britain has been sold to the NHS and government as a cure all for all mental health problems. Many people with mental health problems or problems resulting from abuse etc are offered 6 - 12 sessions fo CBT by a 'trained practitioner' (not a therapist) and told this will cure them.

    CBT is a blunt instrument for this kind of work with distressed people and many organisations that promote therapy and counselling etc have been critical for some time of the govt stance on rolling it out as the cure all.

    cant post mpre for now...
     
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  8. alex3619

    alex3619 Senior Member

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    I agree about Freudian psychoanalysis. Its a scam. I am deeply suspicious that most psychotherapy is a scam, if not all of it. Yet I am also aware there are many types of psychotherapy.

    One of the reasons I think its mostly a scam is that success rates tend to be similar across modalities. It seems to me that just having someone who cares, who can help a patient sort out some troubles, is what makes the difference. The psychoanalytic mumbo-jumbo is just a layer on top of that, a justification, and that is the part that is a scam.

    CBT has been over-hyped. It is used highly inappropriately, and even misleadingly, on ME and CFS. Yet I would not want to say that no patient has ever been helped. What I would like to see is evidence of the impact of regular counseling. I suspect the knowledge that someone cares and you can go to them is what makes the difference. The choice of which babble goes on top of that varies from therapist to therapist.

    This is not science. It can be academic, but promoted as science it becomes pseudoscience. So its right up there with many forms of alternative medicine. Not science, some may be helped, but any successes may not be why the theory says they happened.

    When it comes down to it the process whereby much of psychoanalysis is promoted is identical to that used in much of quackery. Someone finds a therapy that seems to work on some patients. They promote it, treat more patients. A few more patients improve. Bingo, this is a good therapy.

    The success rate in all of psychiatry is appalling. Psychoanalysis is not scientifically based. The evidence base for its success is poor. The standards for what can be achieved are very very low.

    The evidence I see is that a lot of this is indeed useful for improving quality of life in subgroups of patients. This is very different from being touted as curative, though still important.

    I think a huge driving force behind CBT is economic. Its being promoted as a cheap fix. As a result it gets research funding priority, due to the economic and political imperatives. So it gets more and larger studies, often RCTs. Yet they are not double blinded, do not have a placebo control, and the outcome measures are typically subjective.

    Politicians love cheap fixes.

    My own experience with CBT, classic CBT not from the Wessely School, is that it was mildly helpful in helping me cope, but that all of it was things I was figuring out on my own, or had already figured out. (I was into esoteric philosophy and even interested in Buddhism as a philosophy back then.)

    The real scan though is that the medical profession has been sold that all of this should be part of medicine. I think we need to change the story ... its alternative medicine, not scientific, and should be treated as such.
     
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  9. CFS_for_19_years

    CFS_for_19_years Hoarder of biscuits

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    I'm pondering this: If you've got a support group set up for a specific life event such as divorce, grief, or adult survivor of abuse (as examples) and a therapist moderates the group (guides the discussion and brings up topics), will that group of people be better off than a group getting together without a therapist?

    Women have been getting together for ages to dish about their problems. Seems all one needs are some good friends to keep you sane.

    Anyway, just a thought.
     
  10. A.B.

    A.B. Senior Member

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    One can define quackery as knowingly selling a patient a cure that doesn't work.

    One thing all psychotherapies have in common is that they avoid seriously checking whether a treatment actually works or not. The standards of evidence are so low, even a treatment that doesn't work can appear to work. Even a sugar pill can make people give better answers on a questionnaire for a while if the patient believes in it.

    I suspect that they suspect it doesn't really work, but they don't want to find out because they would be without a job. Science becomes a ritual for the purpose of advertising, not a tool for solving problems and advancing knowledge.

    And some psychotherapies are probably an outright scam where the practitioner knows that it won't help, but finds it all too easy to take advantage of desperate patients.
     
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  11. worldbackwards

    worldbackwards A unique snowflake

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    What's interesting about the way CBT is used in the UK is that the cheap fix is getting ever cheaper, with increasing 'evidence' that computer-based CBT courses are effective for anxiety and depression. Surely the only really beneficial thing about talking therapy is the patient can believe that they're talking to someone who cares? I can't imagine that anyone with depression is going to feel any better if they feel that their condition is so irrelevant to their doctor that their treatment can be outsourced to a computer.
     
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  12. Hell...Hath...No...Fury..

    Hell...Hath...No...Fury.. Senior Member

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    I've never done it but have heard from people who have which is enough to make me know that it's a pile of...
    I don't take well to being patronised, blamed and spoken to like I'm an idiot. Most of us already know the ideas that they're pushing and have been able to figure that out for ourselves over the years. I think the whole process of the therapy would make me react in a way that would have me leaving the 'therapy' labelled as mentally unstable in which I wasn't before I went in :confused:

    It's great to see an article highlighting the inadequacies of CBT, it would have held more weight without the ulterior motive to advertise his own 'therapy' in the process o_O

    For someone who's often biggest energy drain is physically talking, I can't think of a more inappropriate treatment for me personally,:bang-head: but this small point doesn't matter to the pushers.

    I often worry that one day CBT will be scrapped though because it will most probably be replaced by something even more unhelpful and potentially dangerous for us :nervous:
     
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  13. alex3619

    alex3619 Senior Member

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    I think most quack therapies are from believers, people who think they actually work. That is a huge part of the problem. Yet when objective outcome measures are used no major success can be shown.
     
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  14. chipmunk1

    chipmunk1 Senior Member

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    computer-based CBT is THE biggest and also the dumbest scam of recent times. It's a shame that such low quality healthcare is even considered in the UK. and we know why they do it: $$$

    Then in 10 years they will whine that they have so many people on disability that cost so much money. Referring people to a computer program instead of providing healthcare or counseling will turn out be very costly over a longer period of time.

    How would "computer therapy" work? It often said that the single biggest factor in therapy is the relation with the therapist not the type of therapy itself.

    Computer therapist:

    You lost your job. How do you react:

    a) Cheer up
    b) I am a failure

    You answer: b

    Computer therapist: Wrong answer. Please try again.

    You answer: a

    Computer therapist: Correct. We are making a lot of progress.

    I think CBT may be replaced by mindfulness based therapies as they seem to become more and more popular.

    I can't see why they would be more dangerous but maybe they manage to make something horrible out of it.
     
    Last edited: Nov 15, 2014
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  15. justy

    justy Donate Advocate Demonstrate

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    I was talking to my husband about this over lunch today - he is a psychotherapeutic counsellor and uses all modalities in his work with adults and young people, including elements of CBT and Psychodynamics and others such as person centred and humanist techniques etc

    He says that studies have shown over and over again that the most important factor affecting outcomes for the client/patient is their relationship with their therapist. This is termed the working alliance and involves specialist training for the therapist in important skills such as empathy, listening, mirroring, feedback and extreme sensitivity to the needs of their clients.

    CBT on its own, as delivered by the NHS and govt projects removes the step of having a specialist skilled worker and thinks training someone to deliver it after a two week course, with no respect being paid to the working alliance is going to help cure people of anxiety, depression or drug abuse.

    Many people in our society have been traumatised and abused by parents, relatives, the system, illness, a death etc. and those people deserve and are often helped by a highly skilled listening ear who will spend the time - as much time as it needs to listen, tease apart and support the issue's that the client brings.

    Therapy done correctly can be enormously supportive, and for people suffering form trauma, loss or any other issues that we as humans have to withstand and hopefully helps people to find the inner resources to cope better with life. I really don't think that therapy, counselling or psychotherapy are scams. Done correctly they help vulnerable people to find strength to carry on and make what good they can of their lives.

    For the record I believe any type of therapy CBT, person centred counselling, mickel therapy, gestalt etc. are all completely pointless for people with a physical illness unless as my own experience has been it is to support the client to cope with the feelings that arise from being in that situation.

    Rogers, who was the father of humanist therapy said that counselling wasn't about making people feel better, it was about helping people to feel better.
     
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  16. adreno

    adreno PR activist

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    I have to agree with justy that therapy are not scams. A scam is knowingly taking someone for a ride, just to get their money. I believe the vast majority of practitioners care about their patients, and believe in the therapy they're doing. Whether the therapy is effective or not is irrelevant in this context. It might become a scam in a governmental context, if legislators knowingly push modalities that they know are not working, though.

    As you say, the practitioner matters more than the technique used. More specifically, as justy points out, it is the relationship (rapport) between the therapist and client that is important. Does this mean that the theoretical framework (modality) is unimportant? I don't think so. What it means is that a theoretical framework is not enough, and being an effective therapist is damn difficult, and much more than just knowing theory.

    Good therapy is an art, it's not a science. It is not about telling people what to do or how to feel. It is about helping people to find their own way, to increase understanding, but hopefully also to increase possibilities of action. It is about helping people to become aware of their resources. And I am not saying that only a trained therapist can do this. There are people out there that just through their personality and experience can help tremendously.
     
    Last edited: Nov 15, 2014
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  17. Snowdrop

    Snowdrop Rebel without a biscuit

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    It is sad to hear of those experiences Silverblade. For some of us the world has not been a safe place as children.

    In my opinion, psychotherapy is not in general helpful whether it be psychodynamic or CBT. The reason I think this is because if you take 100 children and give them all the same scary set of experiences you will find that there is a whole spectrum of responses to how they deal with those exact same experiences. I believe this is because we all have different set points to how we respond to stimuli (in this case scary/personal assault stimuli). Now most children will react the same to an event as threatening as personal assault. The issue is one of how much and how long. Do they recover (I mean biologically). We process it mentally but the interaction was indeed physiological. We need to intervene by healing the biochemical pathways. Not eradicating obviously but calming those that are very sensitive.

    As adults, talking to us about how we are safe now and what tools we have available are not really the point. But people want to improve and will make every effort to find meaning in the therapy. People who provide therapy while wanting to help don't seem to understand that they are essentially trying to reprogram biology (even if they pay lip service to this).

    This would be more suitably be accomplished by researching and applying biological interventions. But psychotherapy has taken hold because it pre-dates other more modern understanding of how we interact with our environment.

    This is a long topic and I'm probably as clear as mud. Plus, I know, I do go on about this. :rolleyes:
     
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  18. alex3619

    alex3619 Senior Member

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    Most psychotherapists know that therapy is problematic. They know the theories are unproven, and many disproved. They know that most patients do not respond as they should according to theory. They often, and this is particularly true of many doctors, have the view that they need to present a positive tone. So they tell the patient something reassuring. I think this is a mistake, as if they are wrong they break trust with the patient.

    Not being honest is a scam. Its overselling the point, presenting something as its not, so that their services will be used, and they make money from that. Yet in psychotherapy this is usually acceptable, and its probably the norm., though whether its the norm is hard to judge as nobody has properly studied this that I know of.

    Just as some doctors deal with ME on the merits, I am sure that many therapists deal honestly with patients. It just does not happen often enough in the therapist community.

    I fully agree that an intelligent experienced counselor is more important than a given theory. Honesty is vital in my view. An honest therapist will not misrepresent things, and so will have a good chance of establishing a trust based relationship. I would rather talk with an honest experienced counselor than someone pushing a whacky dodgy psychodynamic theory.

    Psychoanalysis is worse than CBT. It used to dominate psychotherapy. Historians have now identified at least several counterfactual, and arguably fraudulent, claims by Freud himself. He misrepresented cases.

    Now the psychology behind what many therapists do and what a career scam artist do is probably very different. That is an area I prefer not to go into much, as it involves making judgements about mental states, and that is not an unproblematic thing to do.
     
  19. alex3619

    alex3619 Senior Member

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    This is the basis for my comment about experienced honest counselors. Does the therapy modality really matter if the therapist is really trying to help?
     
  20. adreno

    adreno PR activist

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    Most therapists know that therapy is not easy and that there are no quick fixes. I guess there are therapists out there who claim they can "cure" just about anything with therapy, and this is of course problematic.

    However, the problems go deeper than you suggest. If someone is to promote (or test) a modality as a "cure" or treatment for something, that something must first be diagnosed. This brings us to the diagnostic systems used by psychiatry (DSM) with diagnoses such as MDD, OCD, ODD and what have you. But these diagnoses are already problematic and unscientific, as they are clinically (subjectively) assigned. There are no objective biomarkers to validate these diagnoses. Does narcisistic personality disorder exist? Does oppositional defiant disorder?

    So really, as long as we have no scientific diagnoses, any talk about testing or proving therapy scientifically against these disorders, is in fact meaningless.

    Nevertheless, if we assume there is such a thing as MDD, then how do you go about diagnosing it? How can you (objectively) tell if a patient is depressed? And how can you (objectively) tell how depressed they are? If you can't measure this, it is impossible to measure the effects of any intervention, be it therapy or drugs.
     
    Last edited: Nov 15, 2014
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