![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by Snowie on May 19, 2000, at 17:01:26
There are many references on this and other BBSs to psychotherapy and cognitive behavioral therapy. Are there any differences between psychotherapy and CBT, and if so, what are they? Also, does anyone have a preference as to which works better for long-term anxiety and possible social phobia? I'm trying to figure out just where I belong in obtaining the best benefit from therapy, but I'm uncertain, and more than a little confused.
Also, it's a possibility that I may also suffer from ADD. Would therapy (either psychotherapy or CBT) help with that?
Thanks!
Snowie
Posted by boBB on May 19, 2000, at 19:02:16
In reply to Psychotherapy v. CBT, posted by Snowie on May 19, 2000, at 17:01:26
Psychotherapy is a broad term that refers to the use of psychological principals to treat behavioral or emotional problems. Psychoanalytic, cognitive and behavioral approaches all come under the umbrella of psychotherapy.
Cognitive therapies rely on an individual's logical abilities to overcome emotional difficulties.
Behavioral therapies focus on the environment outside an individual, and often involve goal setting, self monitoring, self evaluation and self reinforcement.
Well, that is what I can recite out of the few textbooks at my disposal. I am not really up on the plethora of popular methods in use today. Perhaps CBT refers to a hybrid of cognitive and behavioral therapies. The tradition in psychotherapy, it seems to me, has been for theorists and therapists to borrow from each other and to hybridize various approaches.
My survey is far from complete, but it seems to me behavioral approaches are more often used in settings where individuals are likely to be ordered by a court to participate in therapy, such as in cases of domestic violence, drunk driving or the use of illegal drugs. Cognitive therapies are most often offered to individuals working for large institutions, such as universities, where a large pool of insured lives provides sufficient capital to pay for prolonged talk therapy.
To continue with an overview of methods that might be hybridized into an individual therapists technique, there are also
• psychodynamic theories, ranging from traditional Freudian pschoanalysis, with its presumptions of oral, anal and phalic stages of development, which if thwarted, result in specific patterns of maladaptation in adult life; to Jungian anaylsis, which presumes broad archetypes shared by society in a collective unconscience, which can be interpreted as they reveal themselves in dreams, to Alderian methods, which presume that individuals strive for superiority in a social context, to Katherine Horneys suggestion of conflicting parts of an individual psyche.
• humanistic theories, which focus on the ability of individuals to control and change their circumstances.
Even in the cognitive camp, there are several methods, including transactional analysis, reality therapy, and rational-emotive therapy. Then there are some fringe ideas - I have know of county mental health counselors who offer hypnotherapy of the kind associated with past life regression and recall of repressed memories of abuse. A practice called direct therapy involved(s) basically locking down clients and assaulting them with accusations of their own complicity in their apparent disfunction.
IMHO, any or all of these methods have been tested in recent years by the contributions of "wet" psychology, which is the product of neurological research. The therapies available on the market tend to reflect the latest thinking of researchers and theorists along with the historic body of psychological theory. In some cases, theorists have revised their theories in light of neurological findings. In other cases, theorists have claimed vindication by neurological findings. It seems to me that the importance of early childhood development, and the indelibility of emotional drives have been in part validated by research, but I am not well versed in the materials, methods and interpretations that contribute to that vindication. At any rate, the idea of emotional indelibility is a primary underpinning of the "chemical imbalance" school of thought that is offered along with most pmed scrips.
There was a time, in the '60s, when the most common mild psychological disorder seemed to be "inferiority complexes." More recently, with a vast body of research demonstrating correlations between neurotransmitters, mood and behavior, the leading disorders have become depression and attention deficit disorders. In the past few weeks, the American Psychiatric Association has revised its criterea for diagnosis of ADD, recognizing the normal adolescent rambunctiousness is often misidentified as ADD. The prevelance of these disorders seems to correlate to the willingness of insurance companies to pay for treatments based on the diagnosis.
Apparently, medications are the treatment of choice and in many cases companies are refusing to pay for long term "talk therapy," of the sort that is likely to effectively sublimate emotional problems into socially constructive thought or behavior. Even less common are sociologists who rely on a broad body of psychological and neurological research to indicte society for the disorders it systematically imposes on individuals. Would-be sociologists with such lofty aspirations will likely find little employment or research funding in an academic community that is closely allied with industrial-capitalism.
In any case, your individual expectations and the expectations of your preferred social circle will likely determine what is considered "disorder." It might be luck of the draw that determines whether you will find a trained, working clinician willing to help you delve into internal factors that influence your dissatisfaction with your self. One counselor might tell you only medications can treat ADD because "it is a brain disease." Across the street, another therapist might say you have no deficit of attention but rather you are involved in situations that demand too much attention. If you believe that therapist, but still wonder why your attention span is less than that of your peers, you might meet another therapist across town who will delve into your childhood and explore the context of your emotional development. Perhaps in the process you might enjoy a cathartic experience that in deed seems to expand on your span of attention.
On the other hand, if you are a low income factory worker, with two children to support, you might ignore all of the medical advice and regularly purchase an aminergic agent such as methamphetamine that closely resembles the psychopharmaceutical offerings such as Ritalin often used to improve apparent deficits in the span of an individual's attention.
If you read all the way through this poorly edited post, I would seriously consider that your attention span is adequate when you are involved with a subject about which you are truly concerned. I would suggest that you look deep inside yourself to see what really matters to you and persue that interest at any cost.
Posted by Snowie on May 19, 2000, at 22:36:52
In reply to Re: Psychotherapy v. CBT, posted by boBB on May 19, 2000, at 19:02:16
Bobb, would you mind emailing me so we can go over your points with a fine tooth comb? Some of them I understand but others I'm having a problem with, although I feel you understand this much better than do I.
I'll explain it all in the email. If you like, you can just email your post here, and we can go from there.
I really appreciate it, and if you can help me understand, I will definitely owe you one.
Thanks.
Snowie
Posted by bob on May 19, 2000, at 23:46:45
In reply to Re: Psychotherapy v. CBT--to boBB, posted by Snowie on May 19, 2000, at 22:36:52
boBB, I'd say that text book describing what cognitive therapy is has a pretty poor grasp on the topic. If anything, the "type" of therapy relies more on the theory underneath it than what patients are supposed to be doing with it. And, quite frankly, few cognitive theories rely all that much on human thought being logical. Most of the time, we aren't, and logic and reason often have no sway over pathology.
Snowie, boBB makes some really good points about just how broad "psychotherapy" can be, although a lot of people tend to think of a psychodynamic, Freudian approach (I imagine) just due to cultural biases on the nature of therapy. My roommate, who is in the long process of becoming an analyst, would try to make a rather broad distinction between therapy and analysis, tho.
I can't say that I've been through any CBT (outside of being subjected to advertising), but it's based on the same theories I use in the psychological research I've done ... so I can at least fill you in a bit on the theoretical basis. Here's a little history lesson. Behaviorism, as a psychological theory, dominated American psychology from early in the 1900's till the 1960's. It tried to be very objective and scientific, and so ruled out any notion of mind -- you've got no objective, empirical means of directly measuring mind or thoughts, only their consequences. BF Skinner was the darling of behaviorism for a long, long time -- his version of it (including operant conditioning) is what most people think of, if they think of anything, when they hear "behaviorism". (Then there's classical conditioning -- Pavlov's dogs and all that -- which is quite different from operant conditioning.)
Anyway, when the 1960's came along, a couple of things happened. First, theories from Europe (Piaget for one, Vygotsky for another) started intruding on behaviorism's hegemony, due to the second thing -- a reaction against the "dehumanizing" nature of behaviorism. While operant conditioning works really well to explain the behavior of cockroaches, rats, and pidgeons living in mazes, it failed miserably at explaining things like language acquisition. Then there were those pesky emotions.
Of course, the Freudians, Jungians, Gestalt folk and others had been there all the time, but they got no respect from the research establishment because of behaviorism's seeming objectivity and more scientific nature.
All this opened the door for what's called the cognitive revolution -- the development and testing of psychological theories that do try to account for thinking and having a mind and memories, studied through indirect methods and inference.
One problem about behaviorism, tho ... well, as a professor of mine said, "You may disagree completely with Skinner's ideas, but you can't argue with his results." Operant conditioning just plain works in a lot of situations. Madison Avenue has made a killing off of it.
Anyway, some dyed-in-the-wool behaviorists who were also dissatisfied with ruling out thoughts started modifying behaviorism to account for cognitive processes. Albert Bandura is responsible for much of the foundation of this area of psychology -- his approach is more commonly known as social cognitive theory. One core element of SCT is the bidirectional relationships between the mind, our behaviors, and feedback from our environment. Another critical aspect of his work was pointing out that we act on our perceptions of reality, not on some objective measure of it. Self-efficacy is predicated upon that idea -- it refers to how good we *believe* we are at doing something, not how good we are compared to some external standard.
One very powerful concept that started off based more on behavioral/neurological science but quickly latched onto SCT is "learned helplessness". It's based on somewhat of an idea of a lack of resiliency in our efficacy judgments, so when facing a series of failures a learned helpless response is to ascribe the cause of the failure to internal, unchangeable flaws. This concept has been applied to just about every psychological pathology around, and you can probably find a paper with Bandura's name on it for each (he's quite a prolific writer). Other major theorists in social cognition have done considerable work on the social bases of personality and the relationship between our thoughts, our emotions, and our subsequent behaviors.
Anyway, to make a long story short, CBT often relies on operant conditioning techniques (because they work) but in the context of approaches to psychology that account for cognitive (thinking) and affective (feeling) processes. Due to the nature of SCT and operant conditioning, such approaches tend to focus on very specific behaviors and/or beliefs. As such, CBT can be a great approach to treating something like a phobia or social anxiety in specific circumstances. The more generalized and global a psychological issue, the more trouble CBT has with treating it.
Well, I'm a bit surprised that the folks out there who've had gone through some CBT haven't chimed in yet, but I imagine we'll be hearing from someone soon.
cheers,
bob
Posted by Sigolene on May 20, 2000, at 2:54:35
In reply to Psychotherapy v. CBT, posted by Snowie on May 19, 2000, at 17:01:26
Maybe I can tell you about my experience if it helps...
I nearly tried all the Bob's mentionned psychotherapy, and for me the one that most improved my life, was a psychoanalytical psychotherapy, once a week, during 2 years. I still have sometimes depression problem, but nothing compared with before the therapy. (before I was suicidal, I had important relations problems with people, I was unable to work...) I'm lucky my insurance paid this psychotheray.Cognitive and behavioural therapy had no long term effects on me. And I didn't feel like trying all my life to fight cognitively against my problem (i.e. to cope). Psychoanalytical therapy works on the causes, no the effects of the psychological difficultes, like depression for ex.
But the problem is to find the right therapist for a psychoanalytical therapy. Often they don't exactly know what psychoanalytical therapy is, so they argue that it's an old fashionned way of treating people, or they say it's not "scientific".
Good luck and sorry for my bad english, it's not my mother language.
Posted by Snowie on May 20, 2000, at 9:49:52
In reply to Re: Psychotherapy v. CBT, posted by bob on May 19, 2000, at 23:46:45
Thanks, Bob and BoBB. I've just started treatment with a psychologist who specializes in CBT. I found a good link below to a site that lists and discusses the different types of therapies available.
During my first appointment last Monday, he gave some literature to read and a relaxation tape. I presently take Xanax, which admittedly is no cure, but it allows me to have a functional life. He asked me how much Xanax I take per day (3 mg.), and he said that is a lot. (I disagree.) I also want to try Klonopin again in the future. (BTW, he's not certain as to what my disorder is, but a psychiatrist colleague of his talked with me for a little over an hour a few weeks ago, and that was his conclusion. I personally think I have social and general anxiety, an occasional panic attack, and perhaps ADD).
My big concern is that he seems to be anti-medication. It appears from things he said and from some of the literature he gave me that with CBT I should be able to eventually wean off medication. Unfortunately, I just don't see that happening anytime in the near future. I envisioned CBT working with medication, not as a replacement or substitute for it. Fortunately, I remember what my life was like before Xanax, and all the CBT in the world won't change that.
In sum, I'm not certain if CBT is the right form of therapy for me, particularly if withdrawal of anti-anxiety medication is the ultimate goal of CBT.
Snowie
http://www.psychcentral.com/therapy.htm
Posted by Cindy W on May 20, 2000, at 12:23:55
In reply to Re: Psychotherapy v. CBT, posted by Snowie on May 20, 2000, at 9:49:52
> Thanks, Bob and BoBB. I've just started treatment with a psychologist who specializes in CBT. I found a good link below to a site that lists and discusses the different types of therapies available.
>
> During my first appointment last Monday, he gave some literature to read and a relaxation tape. I presently take Xanax, which admittedly is no cure, but it allows me to have a functional life. He asked me how much Xanax I take per day (3 mg.), and he said that is a lot. (I disagree.) I also want to try Klonopin again in the future. (BTW, he's not certain as to what my disorder is, but a psychiatrist colleague of his talked with me for a little over an hour a few weeks ago, and that was his conclusion. I personally think I have social and general anxiety, an occasional panic attack, and perhaps ADD).
>
> My big concern is that he seems to be anti-medication. It appears from things he said and from some of the literature he gave me that with CBT I should be able to eventually wean off medication. Unfortunately, I just don't see that happening anytime in the near future. I envisioned CBT working with medication, not as a replacement or substitute for it. Fortunately, I remember what my life was like before Xanax, and all the CBT in the world won't change that.
>
> In sum, I'm not certain if CBT is the right form of therapy for me, particularly if withdrawal of anti-anxiety medication is the ultimate goal of CBT.
>
> Snowie
> http://www.psychcentral.com/therapy.htm
Snowie, I'm a cognitive behavior therapist (work with felons in a state prison), but am also in therapy myself. What I have found (having tried therapy before; this is only the second time I've ever been in therapy where I feel ready to really change) and what I've read from the literature is that it isn't the theoretical background or theories that matter; it's the relationship between the client and therapist, the support for making changes. Most therapists are very similar I think in their "therapeutic attitude/behavior" (warmth, concern, caring, compassion, empathy, etc.); I think the theoretical framework is more for the therapist's comfort than for the client's. CBT stresses changing irrational ideas that lead to depression, and I think focusing on this can really help. But it is the feeling of emotional support, for me, which makes the difference, when I'm in therapy. --Cindy W.
Posted by Noa on May 20, 2000, at 15:00:24
In reply to Re: Psychotherapy v. CBT, posted by Cindy W on May 20, 2000, at 12:23:55
Cindy makes an excellent point. I think there have been studies of the effectiveness of different psychotherapeutic orientations, that found that it is what is shared among the different approaches (the qualities Cindy mentioned) that are the most effective tools.
That being said, I am always very wary of anyone who is any kind of "purist", ie, they only do one kind of therapy. In my mind, the client's needs will guide the therapy, and the therapist will draw from his or her set of tools to help. I had a bit of a reaction reading your post about the CBT therapist being anti-med.
I think CBT is very in vogue right now, because it lends itself to a short-term model, which is, of course, favored by managed care. I am not knocking short term therapy or CBT. Sometimes it is exactly what the doctor ordered. But it is not necessarily a one-size-fits-all approach, especially if it is rigidly "pure" and rigidly short-term.
Posted by boBB on May 20, 2000, at 18:23:32
In reply to Re: Psychotherapy v. CBT, posted by Cindy W on May 20, 2000, at 12:23:55
An easy way of summarizing psychoanalytic, cognitive and behavioral approaches might be that:
• psychoanalysis deals with how you arrived at an emotional condition.
• cognitive therapy deals with what you think about an emotional condition.
• behavioral therapy deals with what you are going to do about an emotional condition.
Posted by boBB on May 20, 2000, at 22:34:40
In reply to Re: Psychotherapy v. CBT, posted by boBB on May 20, 2000, at 18:23:32
hey Snowie,
(this was a private e-mail, but I posted it here, unedited, since some people seem to enjoy reading my towering babble.)
You can call be bob with one "b" on each end. Its not my real name, and i have caused so much havoc with this psuedonym in various discussions, I am reluctant to go over to my real name when i have introduced myself as bob.Sorry.I read the URL you mentioned. That guy is probably better informed than I am about the subject matter, at least as far as him having advanced training in pscyhology. I don't even have a high school diploma, but I have a room full of things i have published. The ecletic approach to therapy seems pretty rational to me. Psychodynamic approaches seem so deterministic they soemtimes might as well be astrological forecasts. The popular methods don't account for cultural or individual differences, it seems. But still, deterministic psychodynamic theory seems take into acount the way brains seem to be built than do sugar sweet humanistic approaches that believe people can do anything they put their mind to. In some ways, we are slaves of our emotions, at least if you believe the neurologists.
Behaviorists say free your ass, your mind will follow. Cognitive theorists say free your mind, your ass will follow. Humanists say if your not free its all your own fault. Pro-med docs say their meds will make you free.
I still think we would find a lot of strict behavioral stuff practiced in publicly funded clinics and state hospitals. I talk to people coming out of there and they say if a person acts a certain way- violent, self-destructive, etc., "they will put you in (your state hospital name) and change your behavior." My hunch is, the more time a therapist has to spend with a client, the more they will wrangle with the client's cognitive relationship with their emotions.
There is another approach I here about that treats personal problems "phenomenologically." This seems much like what the guy called ecclectic, though I suspect there is a body of literature developing around the word phenomenological that is more specific than the ecclectic hybrids various therapists might put together. It seems to me, phenomenology expands on psychodynamic approaches to consider the whole range of phenomenon that can influence a person's life and emotional development. I tend to agree that there are influences from our childhood that determine who we are, the trouble comes in cataloguing those influences in such a way that fits all 6 billion humans alive today. And while traditional psychodynamic therapists might focus only on familial relationships, and others might focus only on our striving for superiority in a social context, maybe a phenomenological therapist would deal with the impact of poverty, or of wealth, perhaps hybridized with nutritional assesements, maybe some genetic understandings, and a consideration of the amount of early childhood training or lack there-of, and maybe some other things like adolescent experiences - I don't know - maybe if you were a farm kid and had to give up the farm, or your dad was a vietnam vet dealing with frustrations over losing a war, whatever - the whole phenomomenon of the clients life would have as much influence as would the therapists eclectic selection of theoretical approaches.
The trouble I see with pro-med therapists is that they have to agree with one of DSM's catagorical diagnoses, which are really subjective analyses, to fit the client into a legal catagory to which they can prescribe the correct med. That is why I keep harping on the correlation of Ritalin and other aminergins and illegal aminergins, such as Methamphetamine or Ecstacy. The drug seems to work for some people, but the ritual of obtaining the drug varies whether it is obtained legally or not. If it is obtained legally, then the client is often sold a set of assumptions about themselves that can easily become stereotypes that in turn develop their own limiting dynamic. People develop telling language, like "I am AADD" when in fact they are a person who was diagnosed as having AADD. The difference is that the stereotypical "I am" claims a set of assumptions, where as the "I am a person who was diagnosed..." accurately describes the relationship. This is important, I think, because the end result of therapy should be clear thinking, not stereotypes. I have made the most progress in life when I learned to describe things with the dispassionate accuracy of a journalist. I learned to distinguish between allegations of something and having actually witnessed something. I try not to say something happened if I did not see it happen.
This gets to the heart of what I see as the limits of therapy. Most of it deals with fixing the emotional status of the individual. Some of it involves (especially cognitive approaches, maybe) developing better understandings of how an individual percieves the world. But little of it deals with developing reforming behaviors in the individual, which is to say, therapy does not teach us that the world is broken and we can help fix it, it teaches us that we are broken and the world wants to make us normal. I disagree. At best, we are all broken together.
The other problem with therapy is that most therapists bring into the relationship their presumption of what is the best life, culturally. College, education and steady employment are pretty much presumed to be normal. In fact, those are just cultural choices. We might correctly believe, as I do, that most human industry - building skyscrapers, roads, cars, airplanes, is kind of sick - it is a product of humans dissatisfaction with who they are (hairless apes) and that in our sickness we are attempting to re-create the world in their image - a world that ran itself pretty well without our help. That is why I long for, but do not find, therapy for activists, for people like me who you (Snowie) called "net citizen scientists". I need help dealing with my lifelong frustration with the vanity of human endeavor. I don't need a well-paid college grad telling me my world view is the product of my brain disease. Too many people who I love, and who seem to me to be very healthy emotionally, agree with me and I have a duty to those people, and to all the non-human life on earth to be true to myself.
Well, that is a lot to say, heh? It's okay, I write fast and don't mind talking off the top of my head. Feel free to stay in touch and explore my perspective, even if you disagree. I don't even mind if you tell me about yourself and your point of view, if you feel safe doing that.
Later,
"bob"
Posted by Renee N on May 21, 2000, at 3:33:46
In reply to Re: Psychotherapy v. CBT, posted by boBB on May 20, 2000, at 18:23:32
> An easy way of summarizing psychoanalytic, cognitive and behavioral approaches might be that:
>
> • psychoanalysis deals with how you arrived at an emotional condition.
>
> • cognitive therapy deals with what you think about an emotional condition.
>
> • behavioral therapy deals with what you are going to do about an emotional condition.
Excellent explanation!!!
Posted by Noa on May 21, 2000, at 15:54:22
In reply to Re: Psychotherapy v. CBT, posted by boBB on May 20, 2000, at 18:23:32
> An easy way of summarizing psychoanalytic, cognitive and behavioral approaches might be that:
>
> • psychoanalysis deals with how you arrived at an emotional condition.
>
> • cognitive therapy deals with what you think about an emotional condition.
>
> • behavioral therapy deals with what you are going to do about an emotional condition.Not exactly, boBB, not exactly.
All 3 approaches would say they are about all three of these things, but have differing theories about that.
Cognitive therapy is not about what you think about an emotional condition. It is about how your thought patterns might be contributing to how you feel. It is about examining your long held and previously unexamined assumptions, your thought habits, essentially, and to analyze their effects on how you experience yourself in the world, and trying to learn to think differently, in order to effect a new way of experiencing yourself in the world.
More tomorrow....they are closing the library now.....
Posted by Noa on May 22, 2000, at 9:09:21
In reply to Re: Psychotherapy v. CBT, posted by Noa on May 21, 2000, at 15:54:22
More .....
As I mentioned, I think proponents of each of the three approaches you mentioned would argue that their approach accounts for how you arrived at your present problem, how you think about it, and what you might do about it.
With psychodynamic therapy, and I am painting here with a broad brush for all three approaches, the idea is that your early relationship experiences have shaped how you related to yourself and to others. By exploring your history, and by exploring the relationship between the client and therapist in the work of therapy, one can come to a better understanding of how essential emotional needs were or were not met early in life, and how you might be attempting to compensate for parts of your self that have not had needs met. It involves thinking, and in order to make real changes, it also involves behavior, ie, looking at patterns of behavior and trying to address the needs that led to developing unhealthy patterns, and then trying out new ways of behaving.
With the behavioral approach, the idea is that we learn from our environments, and develop patterns of feeling and behavior that become habitual. To unlearn them, one must examine them up close, looking at antecedents (what happens immediately prior to a behavior or feeling), and consequences (how we might be reinforcing our habitual patterns). Then, to change, one must deliberately alter the sequence of antecedent-behavior-consequence, often by breaking the links between them that have been so automatic, and often by substituting other things. A simple example is the common link bewteen coffee and cigarettes or between talking on the phone and cigarettes. Or between various kinds of stress and eating, smoking, drinking, whatever. It involves tuning into physical sensations, and not responding so automatically with one's typical behaviors, to the physical sensations, whether from hunger, fatigue, anxiety, etc., and trying more healthful responses.
In cognitive therapy, the idea is to examine all the previously automatic and unexamined thoughts that are the antecedents of feelings. We all walk around with automatic assumptions about ourselves, and have automatic thoughts in response to all kinds of experiences and stimuli. In cognitive therapy of depression, the idea is to look at all the negative, toxic, automatic thoughts, and try to challenge their validity, to look at how irrational many of them are, and how our feelings and sense of selves are based on those negative ways of thinking. The idea is to increase awareness of thoughts as they occur, and attempt to change the way one thinks to be both more reality based and more positive, in hopes that the feelings will follow.
CBT is essentially cognitive therapy but it makes use of behavioral techniques, as well. The idea is that not only has the person developed negative, self-defeating ways of thinking, but they have also developed self-defeating behavior patterns, as well, and that treatment calls for more than just examining our thoughts, that active attempts to change behaviors is helpful, too. This involves increasing awareness of thoughts, actions, feelings, and what is going on within the body, and focuses a lot on skill development---ie, learning more healthy ways of behaving and interacting with one's environment.
As I mentioned in an earlier post, I believe each of these approaches has something to offer most people, and I am always wary of therapy that is ardently purist in following one approach only.
I think it has been unfortunate that the cognitive school has been partially commandeered by the insurance world, because it has been offered as a short term model. I think that with some people who present with rather uncomplicated problems, short term cognitive therapy probably works really well. For many others, though, the therapy needs to be longer, in which case it is likely that the other qualities of therapy, as Cindy said earlier (eg the relationship with a caring therapist), are just as effective as the specific approach. Unfortunately, because managed care seems to have so much power to dictate what is good treatment these days, short term is usually all that is available. Interstingly, proponents of cognitive therapy acknowledge that the short term cognitive approach does not work for everyone, and that a modified approach, that recognizes the need for a more long term relationship with a therapist, is a better option for some people.
Posted by Annie on May 22, 2000, at 22:30:19
In reply to Psychotherapy v. CBT, posted by Snowie on May 19, 2000, at 17:01:26
Hi, I haven't read through all the messages to you, so if I am repeating something already said, oh well! I am in therapy right now with a person who specializes in Social Phobia. She is wonderful. I tried other therapists, none were really "into" the social phobia/anxiety thing and hence were no help at all. First find someone who specializes in the area you want to work on. Also we are currently trying EMDR on me and it is working wonders. A very interesting type of therapy, read up on it if you are interested. It has been particularily helpful to me since I had a very traumatic event in my life about 10 years ago which looks like it has been a major factor in my social anxiety.
> There are many references on this and other BBSs to psychotherapy and cognitive behavioral therapy. Are there any differences between psychotherapy and CBT, and if so, what are they? Also, does anyone have a preference as to which works better for long-term anxiety and possible social phobia? I'm trying to figure out just where I belong in obtaining the best benefit from therapy, but I'm uncertain, and more than a little confused.
>
> Also, it's a possibility that I may also suffer from ADD. Would therapy (either psychotherapy or CBT) help with that?
>
> Thanks!
>
> Snowie
This is the end of the thread.
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Dr. Bob is Robert Hsiung, MD,
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