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Unread November 5th, 2006, 01:48 AM
John Simon John Simon is offline
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Join Date: Aug 2004
Posts: 45
Default Re: CBT with Borderline Personality Disorder

What an interesting discussion!

Actually, from my understanding after reading Wampold's book where they did meta analysis of the research, diagnosis has little to do with favorable outcomes. There is normally a huge variance in diagnoses given a set of symptoms and yet people get better. In other words, therapists normally can not agree on a diagnosis and yet the clients are still able to get better so something else must be going on.

The research does show that allegiance to a model does help outcomes as long a the client is not in disagreement with the model. It seems that if a therapist believes that they will be helpful because of their theory then they are often helpful, which is hopeful. However, if the client disagrees with the premises of the model then outcomes will normally be very bad unless the therapist changes their interventions.

I look at the gold bar differently. 50 years of research has shown that therapy models are all about the same in terms of effectiveness. The fact that DBT or some cog/beh model has been "validated" only states the obvious. All therapy works in general so it is not surprising that co/beh therapy works also. It is like one team showing up at a game while the other team has already forfeited and then the first team says that they are empirically the best team. Notice that many therapy styles have not tried to validate themselves in the same way. The ones that have have been proven to be about equal to all of the other models. In the cases where one model is shown to be superior, they never are able to eliminate the allegiance factor that you detailed in your response. In other words, you will never see Salvador Minuchen vs. Albert Ellis. You will only see some researcher who believes in cog/beh vs. some local agency etc. This is not a fair comparison.

John
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