Increasing use of CBT suggests promise ahead

Cognitive Behavioral Therapy, or CBT, will be more widely used over the next five to ten years, as predicted by one of its developers. He is basing his projections in part on what has occurred in Britain and Scandinavia.

CBT is an amalgam of cognitive therapy and behavioral therapies able to help patients counter negative thoughts and behaviors underlying various illnesses. Science has demonstrated that it can pack quite a therapeutic wallop.

“There are more than 375 trials of cognitive-behavioral therapy in the research literature,” Donna Sudak, M.D., director of psychotherapy training at Friends’ Hospital in Philadelphia and a member of the APA Committee on Psychotherapy by Psychiatrists, told Psychiatric News. “There is very robust evidence of its efficacy in depression and in multiple anxiety disorders, particularly generalized anxiety disorder, obsessive-compulsive disorder, panic disorder, social phobia, and posttraumatic stress disorder.

“The nice thing about CBT is that you can use it in a 15-minute appointment, a 60-minute appointment, or an inpatient service.”

She also noted there are data to support its use as “an effective adjunctive treatment for bipolar disorder and schizophrenia – not by any means as the sole line of treatment, but in terms of increasing patients’ responses to medication. There is also good evidence of its efficacy in bulimia and as an adjunct in the treatment of a number of medical conditions – for example, chronic pain, chronic headache, and irritable bowel syndrome.”

H. Blair Simpson, M.D., Ph.D., an assistant professor of clinical psychiatry at Columbia University, said, “CBT techniques will be modified to make them even more effective than they are today. For example, virtual reality CBT treatments and computer-interactive CBT treatments are being developed. There is also interest in using medications that might enhance the effects of CBT itself. And what I anticipate, and what I hope, is that we’ll know more and more about the brain mechanisms that underlie how CBT actually works.”

Judith Beck, Ph.D., director of the Beck Institute for Cognitive Therapy and Research in Philadelphia and the daughter of Aaron Beck, M.D., the father of CBT, added, “I think that what is going to happen is that CBT is going to be applied more and more widely, for different diagnoses and for different populations. A huge amount of research in cognitive therapy is with medical patients who hav ea psychological component [to their illness]….And I think it will also be used more broadly not only in individual therapy, but also in group therapy.”

Finally, as Aaron Beck, M.D., university professor of psychiatry at the University of Pennsylvania and father of cognitive therapy, told Psychiatric News, “I think that CBT has been refined and perfected enough that the next stage is going to be dissemination. What I foresee is that it will be much more widely used by psychiatrists, who will probably integrate it into treatment of the severely mentally ill, and then by other professional groups, including psychologists, social workers, and nurses.”

He explained that his projections “are based on observations, not just on wish fulfillment. In Britain and the Scandinavian countries, CBT has become the dominant form of psychotherapy and has been endorsed by the national health services of those countries.”

© Copyright 2007 Insight Journal Online Magazine.

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