Hacker News new | ask | show | jobs
by cam_l 2095 days ago
Seriously?! I never claimed it is junk science.. didn't even allude to it. I certainly wasn't casting doubt on research figures where they have been replicated and proven.

Truth is, some CBT studies have repeatedly passed replication and others yet have failed. CBT studies in lots of areas where it is used have shown relatively low efficacy, but close to alternative options. Even across anxiety disorders, where is it most effective, it is with an average-ish 70-80% success, and often only a few points different with alternative options. Meta studies have shown it to be ineffective within certain sub-cohorts, even in general areas where it is shown to be effective. Lots of CBT studies are performed differently or with different cohorts to how or with whom they are instituted in practice.

None of this means it is junk science, it just means you have to be very careful to understand the precise limitations of the science. You cannot separate the outcomes you like from the replication issue, you have to test it all. You also cannot generalise the very real successes of CBT across areas where they have not been shown to be effective, or shown to be ineffective. It is worth keeping these things in mind.

This information is almost never shown to clients. Clients are told 'CBT works', with the implication (or outright claim) that if it doesn't work for you it is your fault. It is popular with clients and it is popular with the profession, because it sets expectations early, it is cheap, it is targeted, and it works for the majority of people with the majority of issues people seek counselling for (ie. anxiety and depression). If this doesn't work for you, and this is all your counsellor offers, they are doing a massive disservice.