"I was merely illustrating that CBT has been proven effective and efficient and this effectiveness has endeared it to the quantitatively-minded managed care culture" No argument here, at least for a good number of diagnoses (I use a great deal of CBT in my practice). One thing I like about it is the (relative) measurability. When I'm supervising interns, I always start with the premise that psychotherapy should lead to measurable improvement. I concur that too many "go their own way", what I was referring to earlier as their "instincts". Sometimes, I find "instinct" to be a sort of code word for "whatever seems right at the time." If that "instinct" does not lead to measurable improvement, who is being served? I believe every psychotherapist has an ethical responsibility to keep up on current literature and research in the field (proven techniques, "best practices", etc.) There should be more than just "instinct". As far as psychotherapy being a "science", well...I think the evidence is mixed. The core problem, as I see it, relates to confounding variables. Human experience, both internal and external, is so subtle and complex. Family history, culture, biology, gender, resources, etc. etc. all interrelate in ways we cannot possibly control. What works for one depressed client may have no effect on another, or even make them worse. This, plus the understandable restrictions on human experimentation, make a truly "pure" scientific approach very challenging. All of this, of course, ignores what many of us know, which is that the relationship itself, regardless of content, can be very healing. Many of the greats in our field have spoken to this. Unfortunately, there's no box for that on an insurance form...
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