CBT vs Psychotherapy: Freud’s here to stay.

January 7, 2016 1:52 pm Published by

This month, The Guardian published an article written by Oliver Burkeman titled “Therapy Wars: The Revenge of Freud,” which discusses the effectiveness of CBT (cognitive behavioural therapy) compared to psychotherapy and how the latter has made its comeback following results from an in-depth study.

Noel Hargrave, Clinical Director at The Counselling Foundation said “As a charity that delivers both short and longer term psychodymanic therapy for the NHS and on a charitable basis, we welcome the results from London’s Tavistock showing the effectiveness of a longer- term psychoanalytic approach for depression and its longer lasting effect.

“There is now good evidence that enabling access to a range of therapeutic interventions is cost effective and good for patient choice. Whilst the NHS has been focussed on CBT as a preferred short term modality since the mid 1990’s, the commercial (employee assistance programmes) and charity sector have utilised a variety of approaches including humanistic and psychodymanic therapy over the same period and the evidence for their effectiveness is robust.

“Alternative approaches such as psychoanalytic and psychodymanic interventions could enable the NHS to draw on new resources and expertise for patients at a time when mental health services within the NHS are under pressure to meet increased demand and meet higher expectations from service users.”

We’ve taken out the best bits for our blog below but for the full article please click here https://www.theguardian.com/science/2016/jan/07/therapy-wars-revenge-of-freud-cognitive-behavioural-therapy

It opens “cheap and effective, CBT became the dominant form of therapy, consigning Freud to psychology’s dingy basement. But new studies have cast doubt on its supremacy – and shown dramatic results for psychoanalysis.”

It goes on “from all the different approaches – including humanistic therapy, interpersonal therapy, transpersonal therapy, transactional analysis and so on – it’s generally agreed that one emerged triumphant. Cognitive behavioural therapy, or CBT, is a down-to-earth technique focused not on the past but the present; not on mysterious inner drives, but on adjusting the unhelpful thought patterns that cause negative emotions.

“CBT has always had its critics, primarily on the left, because its cheapness – and its focus on getting people quickly back to productive work – makes it suspiciously attractive to cost-cutting politicians.

“Seek a therapy referral on the NHS today, and you’re much more likely to end up, not in anything resembling psychoanalysis, but in a short series of highly structured meetings with a CBT practitioner, or perhaps learning methods to interrupt your “catastrophising” thinking via a PowerPoint presentation, or online.

“CBT embodies a very specific view of painful emotions: that they’re primarily something to be eliminated, or failing that, made tolerable. A condition such as depression, then, is a bit like a cancerous tumour: sure, it might be useful to figure out where it came from – but it’s far more important to get rid of it. CBT doesn’t exactly claim that happiness is easy, but it does imply that it’s relatively simple: your distress is caused by your irrational beliefs, and it’s within your power to seize hold of those beliefs and change them.

“Psychoanalysts contend that things are much more complicated. For one thing, psychological pain needs first not to be eliminated, but understood. From this perspective, depression is less like a tumour and more like a stabbing pain in your abdomen: it’s telling you something, and you need to find out what.

A study published last May seemed to show CBT getting less and less effective, as a treatment for depression, over time. Examining scores of earlier experimental trials, two researchers from Norway concluded that its effect size – a technical measure of its usefulness – had fallen by half since 1977.”

“London’s Tavistock clinic published results in October from the first rigorous NHS study of long-term psychoanalysis as a treatment for chronic depression. For the most severely depressed, it concluded, 18 months of analysis worked far better – and with much longer-lasting effects – than “treatment as usual” on the NHS, which included some CBT. Swedish press that a multimillion pound scheme to reorient mental healthcare towards CBT had proved completely ineffective in meeting its goals.

“It may be time for psychologists and therapists to re-evaluate much of what they thought they knew about therapy: about what works, what doesn’t, and whether CBT has really consigned the cliche of the chin-stroking shrink – and with it, Freud’s picture of the human mind – to history. The impact of such a re-evaluation could be profound; eventually, it might even change how millions of people around the world are treated for psychological problems.


To find out about the counselling services we offer across Hertfordshire and Bedfordshire and how we can help you, please get in touch by calling your local centre.



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