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CBT stands for "cognitive-behavioural psychotherapy". It is very often recommended in medcolegal reports. It is a form of ģtalking treatmentī which is currently popular because
- it is understandable in common sense terms (unlike psychoanalytic therapies)
- it has been shown in randomised controlled trials to work more effectively than placebo (dummy) treatments- and is therefor "evidence-based".
It consists of:
- a cognitive component (Latin cogito, I think), where the patient identifies and learns to modify unhelpful thought patterns, such as negative thinking, black and white thinking, etc.
- plus a behavioural component, where a patient sets themselves targets (e.g. an agoraphobic gradually learning to go out more).
CBT will typically consist of 6-12 1-hour sessions with a therapist, usually either a psychiatrist, psychologist or nurse (though any professional can train in CBT). CBT is the ģflavour of the monthī, so that there have even been suggestions of a mass programme of recruiting 10,000 therapists to tackle psychological problems on a population basis- though the sudden stringency in NHS funding may be the reason the programme has yet to get underway.. CBT: CURRENT PERSPECTIVES One hopes that CBT will not be wrongfully rejected if the great expectations placed upon it are- as seems only too possible- not fully substantiated in practice. It is probably the treatment of choice for mild cases of anxiety. But in complex cases, it is best seen as part of the treatment package, not the sole treatment offered. If used alone in complex cases, with physical, personal and social problems antedating the current episode of illness, large sustained effects are unlikely from the CBT alone. In everyday clinical practice, treatment effects of CBT are typically modest, ameliorating symptoms to some extent but making little difference to function. Multidisciplinary care is needed for these patients to progress. CBT AND REHABILITATION On its own, CBT may produce improvement in symptoms. However, symptomatic improvement may not necessarily be accompanied by improvement in function. Therefore, especially in the medicolegal scenting, there will be increasing reluctance to pay for CBT to be carried out in isolation. This will probably be positive, however, because CBT is ideally suited to be carried forward into graduated programmes of return to work (GRTWP). Those funding CBT programs in the future may therefore in the future insist that it be integrated into rehabilitation. |
