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IS CBT a POS?

14/6/2020

2 Comments

 
This is a hot topic for me, because it's a trap I fall into - criticising and rejecting something when I don't understand it.

Here are some lines I found in a book about therapy, and I think they would be quite agreeable to most psychologists:

"The therapist should take the stance that any feelings the (person) has may appropriately be discussed during the session. That is, all feelings are acceptable."

"(The aspiring therapist) must be, first, a good psychotherapist. He must possess necessary characteristics such as the capacity to respond to the patient in the atmosphere of a human relationship - with concern, acceptance, and sympathy."

"It is important to keep in mind that the techniques detailed in this book are intended to be applied in a tactful, therapeutic, and human manner by a fallible person - the therapist."

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I've been hearing lots of trainees say "I use ACT because I don't like CBT". I think part of why they feel free to say this to me is because I am a giant ACT/CBS nerd and will sprout out about it at the slightest encouragement (also I like to think I am an approachable supervisor...).  When I ask them why, they usually say that CBT is clunky and impersonal.

And I'll be the first to admit that I also thought this when I was a provisional psychologist.  "I want to be an ACT therapist," I chirped. This probably mortified my supervisor at the time, though she was a very tactful woman, and simply said, "I think you should attend some CBT training to help you meet your competencies."

Those quotes above? They are from Cognitive Therapy of Depression, written by Beck and co in 1979. 

I don't think there is a problem with CBT as an approach in itself. I think it has an image problem.  Over time, for whatever reason, maybe an over-adherence to technique without an understanding of the therapy's tenets, theory and history, has led to CBT getting a bad rep.  Also, supervisors (myself included) must give off the vibe that it is ok to reject an approach offhandedly.

In ten-twenty years time, ACT will probably have the same image problem.  "I can't believe that they told people to just defuse from their thoughts!  Like, thoughts are nothing?!"  "ACT is so clunky!" ACT is not the answer to CBT.  CBT is not the problem.  CBT is worth learning and using as a tool to support our clients.
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