CBT for Depression Losing it's Efficacy.

[barbc56]

Did it really ever work, especially in the long term?

The last sentence below is rather a mystery. It's as if they are saying this trend is a negative. The article also states "and now for the bad news". Why are they all so apologetic?

I may be reading way too much into this and have to admit I haven't read the whole study which may put this in context.

Hopefully, this means the science is finally catching up to the reality.

In the initial phase of the cognitive era, CBT was frequently portrayed as the gold standard for the treatment of many disorders. In recent times, however, an increasing number of studies ... have not found this method to be superior to other techniques. Coupled with the increasing availability of such information to the public, including the Internet, it is not inconceivable that patients’ hope and faith in the efficacy of CBT has decreased somewhat, in recent decades. Moreover, whether widespread knowledge of the present meta-analysis results might worsen the situation, remains an open question

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http://digest.bps.org.uk/2015/06/is-cbt-for-depression-losing-its.html
Barb

 

[A.B.]

If the problem is only a lack of motivation, then a motivational technique can be helpful. That a motivational technique fails to cure an actual disease shouldn't come as surprise (there do seem to be some therapists who genuinely believe in mind over matter faith healing though).

 

[barbc56]

Absolutely, As I have said many times and will repeat it here, if it was simply a matter of motivation, I would have been well a long time ago.

Sometimes we do need a gentle push, but then who doesn't whether sick or well?

Barb

 

[Effi]

Moreover, whether widespread knowledge of the present meta-analysis results might worsen the situation, remains an open question

This sounds like the widespread idea (amongst certain medical professionals) that patients should never ever consult the internet. Patients should stay ignorant, as knowledge might negatively influence recovery

 

[Kyla]

This commenter got it exactly right:

This doesn't suprise me, unfortunately. It always seems to be that new therapies are hailed as the panacea when they are first formulated, but lose power gradually. I don't think it's loss of placebo effect, because research shows that placebos work even when people are told by their doctor that they are worthless placebos.

I think there are three explanations. First, the publication bias effect. This is notorious for making treatments seem better than they are. Second, better research design, as people challenge previous findings more robustly. Third, [prepares to duck] fashion. I know we are supposed to be professionals and above all that. But when a therapy is in vogue people are keen to learn about it and, having done so, show how good it is. This tends to favour cherry picking among research studies and is an example of the confirmation bias effect.

The fundamental problem is that new treatments are not evaluated using strict enough methodology and large enough samples in the first place. This is the fault of researchers, but also journal editors who often publish stuff that really shouldn't see the light of day. And, as we now know, they often don't publish negative results that should. It is also the fault of influential advisers who push their pet projects to policy makers without a proper scientifc basis.

There will now be a prolonged intermission as those who have based reputations and careers on poor evidence refuse to accept better. There are salaries and published books and manuals to protect, after all. Think of the money!

 

[A.B.]

This commenter got it exactly right:

Except for the comment about placebos. I'm not aware of any way to test psychotherapy in a double blinded placebo controlled study. I therefore interpret the comment as wishful thinking about psychotherapy being better than a placebo.