Cognitive Behavioral Therapy: Escape From the Binds of Tight Methodology - See more at: http://www.psychiatrictimes.com/cog...vioral-therapy-escape-binds-tight-methodology
If you can't see the second part of this, go to: www.psychiatrictimes.com/printpdf/177446
For example:
1. The premise of CBT that negative cognitions are the cause of MDD is the only instance in all of medicine and psychiatry where a symptom of an illness is also construed to be the cause.
2. The statement that CBT clinical trials are “randomized and controlled” obfuscates that the studies are not double-blind (ie , neither subjects nor therapists in psychotherapy studies are blind to the type of treatment).
3. Symptoms in MDD include primary symptoms such as low mood, and negative cognitions as secondary reactions to these symptoms such as hopelessness and despair that may be easily assuaged by a psychotherapy. The person is then deemed a responder because “responder” is defined as a 50% improvement on a rating scale.
This point is about the outcome measures. Criticisms have also been made about the outcome measures used in ME/CFS CBT trials (questionnaires).
4. Patients’ response to psychotherapy can strongly differ depending on whether they have non-melancholic, melancholic, or psychotic MDD (Figure 2), and this can critically affect the results of a clinical trial.
Don't be put off by the graph - the piece is not mathematical.
(I can't remember where I became aware of this article so apologies for not acknowledging somebody here if somebody here mentioned it)