CBT - evaluation

• EFFECTIVENESS - evidence for effectiveness at treating serious psychological disorders

  Kuipers et al (97) > 60 people with medication resistant schizophrenia randomly allocated to either CBT and standard care, or standard care alone

  9 months later > 50% in CBT condition improved compared to 31%, also, 1 person in CBT got worse compared to 3 getting worse and 1 suicide

  CBT in conjunction with normal care - very effective for treating people with SZ especially when medication failed

  limits potential for suicide - effective at improving SZ and preventing serious consequences
• EFFECTIVENESS - not effective when input - realistic stressor

  CBT assumes - cause of mental disorders = faulty/maladaptive thought processes and aims to help patients challenge these to treat disorder

  Simons - sometimes cause of depression/anxiety are genuine negative life events

  CBT works on basis that the person processing events in a dysfunctionally negative way

  However - may not be possible to think about realistically bad situations in a more optimistic way

  CBT only effective in situations where the problem is the result of irrational thoughts to a not so serious event
• EFFECTIVENESS - effectiveness partly due to how good the therapist is

  Kuyken and Tsivrikos (2009) - claimed - up to 15% of the variation in the success of CBT - due to therapist competence (how good they are - at their job, ability to plan/structure sessions, understand needs and build relationships)

  difficult to simply claim that CBT is/isn't effective > rather, success partly due to individual differences e.g. relationship
• ETHICAL - viewed as unethical (a)

  blames them for the way they think, feel/behave

  CBT - essentially blaming client for mental illness as the cause of their disorder and because of the way they think > may place blame on client for their disorder

  blame put on them even when there may be situational factors that contribute to their disorder that are out of their control

  putting full responsibility for themselves on shoulders of someone who already may be emotionally fragile > cause psychological harm and seen as unethical
• ETHICAL - viewed as unethical (b)

  who decides what is an irrational though

  a 'normal' therapist may judge client's thoughts to be irrational and decide they must be changed

  However - Alloy and Abrahamson identified 'sadder but wiser' effect

  depressed people may see things in a more realistic way, whereas normal people may distort things in a positive way

  ethical concern - may damage client's self esteem (psychological harm) to have their thoughts criticised/judged by another person
• ETHICAL - can empower the individual

  assumes cause of mental disorder is faulty thinking and client chooses to think that way so can use their free will to choose to think another way

  works to give client power + skills to control thoughts and give control over mental disorder

  participants encouraged to realise that while they can do little about life stressors > can change the way they process life events and therefore change behaviour/emotions

  seen as positive thing as - can prevent feelings of helplessness during difficult times
• ETHICAL - avoids chemical straightjacket that drugs impose

  drug treatment - criticised = chemical straightjacket > suggests drug - way of controlling behaviour and mental state through altering biological processes

  CBT gives person control over thoughts rather than taking drugs that control mind and body

  acknowledges role of free will and encourage participants to take control of and change thoughts

  CBT - ethical method of modifying schizophrenia and more ethical than antipsychotics