Talk:Cognitive behavioral therapy

Issues

I have several issues with this article. The earlier stuff is alright, but the latter stuff - not so much. The claim that schizophrenia is completely unhelpable through CBT is just... wrong. If someone is in a serious psychotic state, sure, a trip to the psych ward and a round of olanzapine or haloperidol would be the best course of action, no question, but in other instances, I simply disagree. My boyfriend works for early-intervention psychosis services as a Clinical Psychologist and finds CBT a very useful intervention. New understandings about schizophrenia tell us that the hallucinations are dissociated thoughts and experiences of the client, and are not only meaningful, but can also fit in to the CBT models (particularly the famous "hot cross bun" model). Both NICE and the British Psychological Society's Division of Clinical Psychology say that talking therapies like CBT are effective for many people, with the BPS itself ruling that the lack of provision of CBT for people with a diagnosis of psychosis or schizophrenia in the UK to be "scandalous". All of the above can be found in a summary of their report on psychosis and schizophrenia here: http://www.bps.org.uk/networks-and-communities/member-microsite/division-clinical-psychology/understanding-psychosis-and-schizophrenia. This isn't to take an antipsychiatric view per se, as it does recognise antipsychotic medication is often of help to people with a diagnosis of schizophrenia (the majority of my boyfriend's clients take olanzapine+fluoxetine, risperidone, or aripiprazole, and many found them useful), but the point is CBT is definitely of help here. Especially when combined with mindfulness, by the way, which has been found really effective ("Mindfulness for Psychosis", Chadwick, British Journal of Psychiatry, 2014).

Somewhat the same can be said for Bipolar Disorder. I suffer from this so I can weigh in somewhat more, but yeah, CBT is veeeery useful for bipolar folk. Most of us have a pretty serious trauma background, which leads to poor coping strategies and even worse emotional regulation, for which CBT for Trauma and an augmented form of CBT called "DBT" (Dialectical Behaviour Therapy) can really help with. But even without that, there's good evidence that CBT + Mindfulness in a therapy called "MBCT" (Mindfulness-Based Cognitive Therapy) can help with mood regulation as good as medication. Don't get me wrong, medication is usually profoundly useful for bipolar disorder, but the idea that lifelong medication is obligatory is not a great one, and often neglects that the side-effects of these medications is often horrendous (atypical antipsychotics are associated with gross weight gain, diabetes, narcolepsy, and tardive dyskinesia; lithium is associated with renal failure, hair loss, and hypothyroidism; and lamotrigine and other anticonvulsants are associated with "toxic epidermal necrolysis", which is as awful as it sounds). I'm currently unmedicated... mostly because I'm already choked with medication for other problems, but also because, so long as I stay off the alcohol and antidepressants, I don't get more than high-functioning hypomania, and the severe depression responds to cognitive behavioural therapy and mindfulness. And in the event things suddenly start getting really awful and out of control, well, there's always emergency Seroquel! But yes, all of the above can be pretty much backed up by the BPS's report on Bipolar Disorder here: http://www.bps.org.uk/system/files/Public%20files/cat-653.pdf.

Likewise, I'm not sure where the last bit comes from? It's true, CBT isn't perfect and can't solve everything nor work with everyone's thinking patterns, but it is useful to most, and thus the NHS has "IAPT" (Improving Access to Psychological Therapies), which expands CBT access tremendously. Likewise, the NHS also has its own "CAT" (Cognitive Analytical Therapy), which is basically CBT on 'roids to address certain issues with CBT.

I would basically rewrite the whole article, but before I take a real hatchet to it, I thought I'd raise this on the talk page. DarkFire (talk) 01:35, 14 July 2015 (UTC)

Disregard the user above

There is little evidence that CBT is effective for schizophrenia. Seriously. --Ibrahim Moizoos (talk) 18:02, 23 February 2018 (UTC)