[cupcake-unicorn]

Gave you an upvote. CBT has done so much damage and really is a step backwards for those with trauma. It's ridiculous how all the knowledge we have about trauma still hasn't hit the mainstream psychiatric institution yet and 9 out of 10 times with the average provider it comes down to "Have you tried CBT?" versus trauma informed treatments that actually work (somatic therapy, IFS, EMDR, ketamine/psychedelics, stellate ganglion block, etc)

The irony is you may not believe you're really traumatized if you've been spent 10 years in standard CBT being gaslit about your "cognitive distortions" and wondering why it's not working...

[throwaway684936]

CBT is very neurotypical-centric. Hate it.

CBT by itself is inappropriately prescribed as a comprehensive treatment plan for ADHD-related insomnia when there's little evidence for its efficacy compared to CBT for other insomnias.

And don't get me started on CBT and autism.

[SpodGaju]

Agree! CBT is a way for the neurodivergent or the Neurodifferent to fit into a world that we had no hand in designing.

[cupcake-unicorn]

I saw a great quote on Reddit recently about psych wards being "conversion camps for the neurodivergent"! That really stood with me.

[sonofhans]

Yes, exactly. CBT can easily be retraumatizing for CPTSD survivors. It’s so common for it to fall into symptom whack-a-mole rather than understanding the true arising of the disorder and a useful path to healing.

[novok]

CBT and meds are insurance friendly. Even if therapists don't like it, they're basically forced into it by the system, otherwise payments are more likely to get clawed back in an audit by the insurance company. And why does insurance like CBT and meds? CBT is time boxed in many ways and 'evidence based'. Psychoanalysis and other therapy types are effectively not, and insurance already doesn't like paying for mental health as it is. Meds are relatively cheap compared to therapy also.

It's also related to why it's pretty hard to find therapists that take insurance in some places.

[taurath]

Evidence based but yet wholly ineffectual for so many. The medical model of mental health treatment is designed to treat symptoms not heal causes very often. That the causes are varied and treatments don’t scale as easy as a pharmaceutical manufacturing line doesn’t mean it’s not one of the more important pursuits medicine is trying to tackle. Hoping the current medical generation will continue to move away from the “chemical imbalance” theory of the past, of which there are far far too many practitioners out there holding onto ineffective treatments.

CBT still costs a LOT of money and time, so there is an incentive towards finding more effective treatments, but managing symptoms is in some ways more preferable because the medical system needs people to be “sick” or else a treatment might be seen by puritanical society as somehow indulgent or hedonistic. What if a “cure” involves taking significant time away from work to work through trauma? They might be better and more productive in the end than a stopgap treatment, but society can’t necessarily tolerate the idea.

[depr]

"Where Is the Evidence for “Evidence-Based” Therapy?" is a pretty interesting paper on "evidence based" therapy.