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(Depression) "Psychotherapy [CBT] is Becoming Less Effective"
- Thread starter Dolphin
- Start date
Snow Leopard
Hibernating
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- 5,902
- Location
- South Australia
Studies are becoming less biased over 35 years. 
adreno
PR activist
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- 4,841
Probably right. There is a phenomenon known as winner’s curse, a tendency of finding large effect sizes in early studies that cannot later be replicated.Studies are becoming less biased over 35 years.
Snowdrop
Rebel without a biscuit
- Messages
- 2,933
Or, fewer people feel the need to tell a medical authority what they want to hear and are more truthfully reporting on the efficacy.
alex3619
Senior Member
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- 13,810
- Location
- Logan, Queensland, Australia
I think this has something to do with bias in small early studies, but this latest one controlled for that. The problem still persists.
I wrote this comment on this paper elsewhere:
Given that outcome measures are typically subjective, and CBT might well alter how many patients fill in questionnaires, this might be a shift back toward its true effectiveness rate (which might be worse than zero) as people see through the gloss and babble. I do think CBT can help some to some degree, but its overhyped, oversold, etc. Who those some are, and to what degree, is still not being properly studied. It may even be nobody.
Psychiatry will not advance as a science until objective measures are used. Even then entire methodological systems have to be abandoned, and psychiatry evolve to modern use of the scientific method. Until then much, if not most, of psychiatry, and probably all of psychogenic medicine, will remain dubious alternative medicine that has wormed its way into medical doctrine.
More and more patients and prospective patients are better and better informed. Psychiatry has not only lost its gloss, its becoming visibly more and more tarnished. Fixing this will require a shift of the basic paradigms used in psychiatric practice and research. It will require a shift from dogma to rational practice.
I wrote this comment on this paper elsewhere:
Given that outcome measures are typically subjective, and CBT might well alter how many patients fill in questionnaires, this might be a shift back toward its true effectiveness rate (which might be worse than zero) as people see through the gloss and babble. I do think CBT can help some to some degree, but its overhyped, oversold, etc. Who those some are, and to what degree, is still not being properly studied. It may even be nobody.
Psychiatry will not advance as a science until objective measures are used. Even then entire methodological systems have to be abandoned, and psychiatry evolve to modern use of the scientific method. Until then much, if not most, of psychiatry, and probably all of psychogenic medicine, will remain dubious alternative medicine that has wormed its way into medical doctrine.
More and more patients and prospective patients are better and better informed. Psychiatry has not only lost its gloss, its becoming visibly more and more tarnished. Fixing this will require a shift of the basic paradigms used in psychiatric practice and research. It will require a shift from dogma to rational practice.
There is an older thread on this article here:
http://forums.phoenixrising.me/index.php?threads/cbt-for-depression-losing-its-efficacy.38075/
http://forums.phoenixrising.me/index.php?threads/cbt-for-depression-losing-its-efficacy.38075/
out2lunch
Senior Member
- Messages
- 204
Before my endo problems were diagnosed, my depression (from undiagnosed fibro) was treated with CBT. The therapist was well meaning, but worthless for dealing with anything other than transient sadness like grief. Needless to say, my physical problems only worsened over time, which only resulted in guilty self-shaming for not "trying harder" to get better. Thank goodness a supervising psychiatrist with orthomolecular training intervened and sent me to an endocrinologist for diagnosing.
Physiological depression from a chemically induced metabolic imbalance -- you know, the stuff that effects us -- will never respond to talk-talk therapy. And thanks to the hyperfocused budget cutting monkeys in 21st century healthcare management, far too many patients will be tossed into the CBT Thunderdome for treatment, essentially abandoned for the sake of lower costs.
Immoral doesn't begin to describe it.
Physiological depression from a chemically induced metabolic imbalance -- you know, the stuff that effects us -- will never respond to talk-talk therapy. And thanks to the hyperfocused budget cutting monkeys in 21st century healthcare management, far too many patients will be tossed into the CBT Thunderdome for treatment, essentially abandoned for the sake of lower costs.
Immoral doesn't begin to describe it.