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Unread September 22nd, 2005, 10:08 PM
James Pretzer James Pretzer is offline
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Join Date: Jun 2004
Posts: 283
Default Re: the downside to CT

Obviously, I think the benefits of CT outweigh the downsides (or I'd be doing another form of therapy) but there are some drawbacks worth considering:

Drawbacks for the therapist:
  • A number of critics have argued that CT demands too much of the therapist. One is expected to develop an individualized conceptualization of the client, use this conceptualization to guide a strategic approach to intervention, and use a wide range of intervention techniques skillfully. The critics say a simpler approach is needed. (My experience is that the vast majority of therapists can master CT with good training. We've been training theraapists in CT since 1984 and my sense it that about 95% end up doing decent CT after our 69.5 hour intensive training program. Many are really good by the end of the program, some have considerable room for improvement.)
  • A related criticism is the complaint that it takes too much time and expense to train therapists in CT. Again, the critics argue that a simpler treatment approach is needed (I agree that it takes a fair amount of training for the average mental health professional to master CT. The Academy requires 40 hours of didactics, reading 5 books, and 10 hours of supervision - or is it 20?-. I'd say that's a minimum.)
  • Cognitive Therapy can be hard work for the therapist. It isn't easy to develop a conceptualization, intervene strategically, use a range of techniques, and simultaneously maintaing a good therapeutic relationship.
  • If you're in practice and use an effective short-term therapy, you have to keep generating new referrals because clients actually finish therapy.

Drawbacks for the client:
  • CT is hard work. To get results, the client needs to follow through on homework assignments between sessions and needs to work persistently to make changes.
  • CT can be difficult. It often requires the client to face their fears, be honest with themselves, face memories and experiences they've been avoiding, etc. It isn't always fun.
  • It may not be easy to find a competent cognitive therapist. The client may need to drive a ways, see someone who isn't a provider for their insurance company, or pay to see someone who's in private practice.
  • In CT the client doesn't get to just vent to a sympathetic listener who makes them feel better for the moment, they are expected to take responsibility for making changes even when this means tolerating short-term discomfort and distress.

These are my initial thoughts. What other drawbacks to others see for therapist or client?
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