Cognitive Behavioural Therapy
Effectiveness of CBT.
- Research support.A meta-analysis by Robinson et al found that CBT was superior to no treatment control groups. However, wen these control groups were subdivided into waiting list and placebo groups, CBT as not significantly more effective than the placebo condition at reducing depressive symptoms.
- Therapist competence. Therapist competence appears to explain a significant amount of the variation in CBT outcomes. Kuyken and Tsivrikos lend support to this claim, concluding that as much as 15% of the variance in outcome may be attributable to therapist competence.
- The Importance of Homework. Research suggests that clients' engagement with homework predicts their outcomes and that therapists who are able to improve clients engagement with homework have associated benefits in terms of outcomes (Bryant et al).
Appropriateness of CBT.
- Who is it suitable for? CBT has been successfully applied to many different client groups, including elderly populations, juveniles and depressed adolescents. The cognitive aspect of CBT has also been administered by computer and shown to be as effective as other forms of psychotherapy treatment (Selmi et al). A particular advantage of computer based and phone based psychotherapy is the relatively low level of drop out compared to face to face CBT.
- Who isn't it suitable for?CBT appears to be less suitable for people who have high levels of dysfunctional beliefs that are both rigid and resistant to change (Elkin et al). CBT also appears to be less suitable in situations where high levels of stress in the individual reflect realistic stressors in the person's life that the therapy cannot resolves (Simmons et al).
CBT in depressed Adolescents.
The fear that some antidepressant drugs might increase the risk of suicide, has lead researchers to explore the possibility that combining antidepressants with CBT might reduce this risk. The Treatments for Adolescents with Depression Study (March et al) enrolled 327 adolescents aged 12 to 17 who were diagnosed with major depression. They were randomly assigned to either and SSRI antidepressant alone, CBT alone, or the SSRI antidepressant combined with CBT. After 12 weeks, 62…