“Researchers have found that CBT is roughly half as effective in treating depression as it used to be.”
Psychologists and other mental health clinicians love cognitive behavioral therapy (CBT). It’s the no-nonsense, quick and relatively cheap approach to mental distress – with none of that Freudian stuff, plenty of scientific research, and insurance pays for it. However, recently published meta-analysis in the journal Psychology Bulletin examined 70 studies between 1977 and 2014. Results suggested CBT has become less effective overtime. “Researchers Johnsen and Friborg concluded that CBT is roughly half as effective in treating depression as it used to be.”
So what’s going on?
- As any therapy grows more popular, the proportion of inexperienced or incompetent therapists grows bigger.
- Placebo effect. Early publicity around CBT made it seem a miracle cure, so maybe it functioned like one for a while. These days, by contrast, the chances are you know someone who’s tried CBT and didn’t work. Our expectations have become more realistic, so effectiveness has fallen, too. Johnsen and Friborg worry that their own paper will make matters worse by further lowering people’s expectations.
When it comes to talk therapy, what does it even mean to speak of the placebo effect? If you believe that CBT, or any therapy, is likely to work, and it does, who’s to say if your beliefs were really the cause, rather than the therapy? Beliefs are an integral part of the process, not a rival explanation. The line between what you think is going on and what is going on starts to blur. Truly convincing yourself that a psychological intervention is working and by definition it’s working.
- Perhaps every era needs a practice it can believe in as a miracle cure – Freudian psychoanalysis in the 1930s, CBT in the 1990s, mindfulness meditation today – until research gradually reveals it to be as flawed as everything else.
To close, be mindful that the old techniques weren’t completely wrong; they’d just outlived their usefulness. If the secret of happiness is hard to find, maybe that’s because the answer keeps changing.
Share your thoughts.
Johnsen, T. J., & Friborg, O. (2015, May 11). The Effects of Cognitive Behavioral Therapy as an Anti-Depressive Treatment is Falling: A Meta-Analysis. Psychological Bulletin. Online publication. http://dx.doi.org/10.1037/bul0000015
Illustration: Thomas Pullin for the Guardian