Jonathan I don’t know if you’re going to read this but you just saved my life. I am being cancelled by CBT and DBT psychologists In very unkind Waze. I am being told of the therapy I’ve done for 37 years was mistaken and relevant even though I know as a result of discussing this with clients that I have done extremely good work. Thank you so much for your presentation and your willingness to think critically and present facts. Thanks again
My experience was: My first therapist said that I was now successfully treated. One Week (!) later, I was sent to the second CBT Therapists and the BDI test showed the same results. I told them that the data showed that CBT did not work at all. They completely ignored my criticism.
You probably dont give a damn but does any of you know a way to get back into an instagram account?? I somehow forgot the password. I would appreciate any tips you can give me
@@dominiktristian3139 I've got like 4 accounts now and don't know how to log in to any of them. I kept getting logged out and unable to log back in. It's confusing.
They have it backwards. Thoughts don't create emotions. Emotions create thoughts. If cbt is so effective, why is the mental health crisis worse than ever?
@@psicologia_e_reflexao vc esta aqui tb? ta vendo os problemas q existem nesse tal psicologia baseada em evidencias? vc ta vendo? kkk. e tem mais se a maioria dos estudos comparativos foram feitos como o estudo apresentado no video, essa afirmação de q a tcc superior as praticas psicodinamicas, são falsas, ou é uma evidencia fraca, como vcs adoram falar.
@@psicologia_e_reflexao pare de espernea vc e sua turminha da PBE q se colocam em um olimpo...vou nem entra na questão epistemologica que é um problema pior ainda.
Its worth watching the IAPT CBT conference whereby the CBT therapists are asked to close their cases to increase their stats, due to so many cases remaining open. There has been another suicide in Dublin, the suicides are increasing at an alarming rate. In the UK people are being sent to see kids at colleges for help, that's what Cameron calls appropriate assistance. Cost cutting has cost a huge amount of lives. America has started Elijah's Journey, and Elijah's Journey in Israel are making a film about the suicide of their children in response to it. Who supported Angels Healing Trust when we tried to raise money for healing centres specifically for 'depressed and suicidal children', who cared in 2000?
It's a shame that such an important medical presentation was repeatedly interrupted by a broken sound system. I hope the conference organizers will pay closer attention to the sound and video quality in future meetings.
Psychodynamic psychotherapy is definitely much more effective; CBT is popular largely because it also happens to fit 3rd party reimbursement model with time limited therapy. CBT is also friendlier for data analysis and has the veneer of being more scientific. Evidence based practice particularly in psychotherapy is a way of branding "manualized" therapies since it is favored by insurance companies and people who feel psychotherapy could gain respect with CBT. CBT is very superficial as it lacks depth and connection with the patient.
not to mention that emotional disturbance is about feelings not "thoughts". I say CBT is a just sophisticated way of shaming the patient into reacting the way the therapist TELLS him to. If you are told your thoughts are inappropriate since a certain result ensues, the patient will THINK different thoughts and maybe a different result will ensue. If not the patient is not cooperating or not understanding the need to change the thoughts. BULLOCKS. More like bullying. Sometimes the right result will come out in spite of WHATEVER thoughts. Why doesn't that count?
But people do practice like this in the real world, avoiding presenting issues, neglecting their patients, and then they lie about it afterwards. They are never accountable.
CBT: yes I am not a robot! And it was completely awful. Did not take into consideration ME as a human being. I never went back. Instead I went to psychotherapy which allowed me to ask the questions I has always wanted to ask.
At 50 min: he cites study saying that benefit was inflated by 75%, but then turns this into the claim that the benefit received was only 1/4. But that would require an inflation of 300%. 75% inflation is not even double. Also, I think the study is "Does Publication Bias Inflate the Apparent Efficacy of Psychological Treatment for Major Depressive Disorder? " Or if not, this one is by the same group and is more recent (given pub date). But it seems to claim effect size increase drops by only 25% when unpublished studies are included. That is an inflation of only 33% (Reported effect size .52, total effect size .39). I would appreciate seeing some clarification of this point. It sounds very fishy to me but perhaps I don't understand what he is saying (For starters effect sizes I imagine can't be treated simply on a ratio scale, although that is how the original researcher does it also. But an effect size of .52 compared to .38 doesn't sound like only 1/4 the benefit received!)
I just started the video and I'd need to watch it through. However, are you positive that he was referring only to differences in treatment effect sizes as opposed to say, mean differences on various outcome measures ?
Cognitive therapies are barely effective and frequently coercive leading to deepening the pathology while superficially offering the patient verbal defensive arguments. In the end nothing is healed excepting the lightest symptoms which respond to many other therapies. These cognitive approaches are frequently the very opposite to how real healing and effective therapies work. Moreover the claims are just marketing and no comparisons were done to compare these cognitive so called approaches to deeper and affect based experiential approaches that effect better more lasting relief and even cures for some diagnoses. There are apparently political and other non scientific motives for the heavy marketing of cbt as a real therapy or more stunningly as the main "evidence based" therapy. This is pure fiction
Furthermore, in the second paper, he ridicules the 25% remission rate for the therapies. Yet, 25% remission for 16 week therapy is pretty great. Imagine if we were talking cancer here.
Except all the rest he says shows that 25 percent isn't that valid and if we do talk about cancer, then we should also precise that cancer will certainly come back within 2 years in most cases
Very interesting. It seems clear that the marketing for EBT is, ironically, I’m conflict with the evidence. I think that that’s clear to anyone who has looked into it, and this talk presents some good solid examples of the conflict. I do think that some of the math is off in places, and I’d be happier to have a stronger comparison, such as examples of how many people drop out of psychodynamic therapy, return for the same issue, shown improvement and are completely cured.
" MARKETING " CORPORRUPTION 24 / 7 DRUG ADS ( LICENSED MALPRACTICE ) " OBJECTS GET NO CARE COUNTED for PROFIT " ( SALES MASTER DEGREE ) FALL to FELONY CONTEMPT !!!
I feel like he is making some basic statistical mistakes. If the 1.2 point difference is indeed true, it is not the case (as he seems to argue) that this represents a 1.2 point difference for any one participant (indeed it would be very unlikely that any participant experienced a change of exactly 1.2 points as the mean is a statistical abstraction of data only). Instead it demonstrates the mean difference (between the control/experimental groups). The effect size is the important thing here, which he doesn't seem to mention. Also, the p-value (statistical significance) does not provide the probability that the data were due to chance, but the probability that the data (or more extreme data) would have been obtained if the null were true.
Also, his arguments about the psychodynamic students seem to be borderline mistruths: From the paper: The manualized treatments were provided by 11 MA-level clinicians (5 delivered PE and 6 TLDP) who received weekly group supervision. The PE-A therapists attended a 5-day training workshop conducted by E.F. and E.Y. The TLDP-A therapists attended a 2-day workshop conducted by L.R. Throughout the treatment, E.G.S. conducted weekly supervision meetings with the PE-A therapists, and L.R. conducted weekly supervision meetings with the TLDP-A therapists. All treatment sessions were videotaped and watched by supervisors to ensure treatment fidelity, and weekly verbal corrective feedback was provided to the therapists. Note that he refers to LR as a grad student in the video, but LR at that time had a PHD. He also states that CBT therapists received 10 days of training...they actually received 5 (according to the paper). Also, they were not forbidden to discuss the trauma. From the paper: "Therapists did not mention the traumatic event, and if the patient brought up details of the memory, they referred to the meaning of the event in the context of the central issue, without further encouragement to discuss the memory.
@@clydedale8108 Neither did I. But that last point that therapists’ dealings with traumatic events is disturbing. Ignoring suffering, bypassing negative emotions and replacing them with positive ones is just going to repress emotions.
Practice-based evidenced therapies is the alternative. Also, there are degrees of suffering and in many insight-oriented therapies, MEANING is derived from relating to suffering in a different way. Thus, meaning becomes the alternative to the American myth of happiness as the be all end all. The pursuit of happiness is such a shallow pursuit anyway...meaning, however, always comes with a little pain. It takes pain to grow. So one might liberate the very philosophical underpinning behind the purpose of life being to limit pain and gain pleasure to the purpose of life as a pursuit of growth and evolution, which requires both pain and pleasure, creation and destruction.
Minh Tran That's an interesting way to look at it, but PTSD or a severe anxiety disorder don't really lend themselves to growth, they are literally debilitating.
Well yes of course. One needs an ego before one can lose it; ego-strengthening is what a lot of these EBPs are about I think. However, it should be done simultaneously with more empowering approaches that allows the patients to glimpses at "the bigger picture" especially as most debilitating illness forces one to only see so small a view. I think I essentially agree with you though :)
Jonathan I don’t know if you’re going to read this but you just saved my life. I am being cancelled by CBT and DBT psychologists In very unkind Waze. I am being told of the therapy I’ve done for 37 years was mistaken and relevant even though I know as a result of discussing this with clients that I have done extremely good work. Thank you so much for your presentation and your willingness to think critically and present facts. Thanks again
My experience was: My first therapist said that I was now successfully treated. One Week (!) later, I was sent to the second CBT Therapists and the BDI test showed the same results. I told them that the data showed that CBT did not work at all. They completely ignored my criticism.
You probably dont give a damn but does any of you know a way to get back into an instagram account??
I somehow forgot the password. I would appreciate any tips you can give me
It sounds like a religious cult.
@@dominiktristian3139 I've got like 4 accounts now and don't know how to log in to any of them. I kept getting logged out and unable to log back in. It's confusing.
I have a strong suspicion that Judith or Tim Beck was working the sound at this conference
😅❤️
Thank you for your work Dr. Sheldon. I have always been very suspicious of CBT. Thank you for validating that.
the shed never disappoints. what an spokesman!
They have it backwards. Thoughts don't create emotions. Emotions create thoughts. If cbt is so effective, why is the mental health crisis worse than ever?
I don´t see them claiming that CBT is so effective. They say it is more effective than psychodinamic therapies.
@@psicologia_e_reflexao vc esta aqui tb? ta vendo os problemas q existem nesse tal psicologia baseada em evidencias? vc ta vendo? kkk. e tem mais se a maioria dos estudos comparativos foram feitos como o estudo apresentado no video, essa afirmação de q a tcc superior as praticas psicodinamicas, são falsas, ou é uma evidencia fraca, como vcs adoram falar.
@@ebony5076Sim. São problemas com os estudos de má qualidade, com a metodologia. Não com a proposta. Pare de espernear e aceite, caso seja psicólogo.
@@psicologia_e_reflexao pare de espernea vc e sua turminha da PBE q se colocam em um olimpo...vou nem entra na questão epistemologica que é um problema pior ainda.
It works both ways pal.
CBT looks cheaper and faster to insurance companies.
Its worth watching the IAPT CBT conference whereby the CBT therapists are asked to close their cases to increase their stats, due to so many cases remaining open. There has been another suicide in Dublin, the suicides are increasing at an alarming rate. In the UK people are being sent to see kids at colleges for help, that's what Cameron calls appropriate assistance. Cost cutting has cost a huge amount of lives. America has started Elijah's Journey, and Elijah's Journey in Israel are making a film about the suicide of their children in response to it. Who supported Angels Healing Trust when we tried to raise money for healing centres specifically for 'depressed and suicidal children', who cared in 2000?
It's a shame that such an important medical presentation was repeatedly interrupted by a broken sound system. I hope the conference organizers will pay closer attention to the sound and video quality in future meetings.
Psychodynamic psychotherapy is definitely much more effective; CBT is popular largely because it also happens to fit 3rd party reimbursement model with time limited therapy. CBT is also friendlier for data analysis and has the veneer of being more scientific. Evidence based practice particularly in psychotherapy is a way of branding "manualized" therapies since it is favored by insurance companies and people who feel psychotherapy could gain respect with CBT. CBT is very superficial as it lacks depth and connection with the patient.
not to mention that emotional disturbance is about feelings not "thoughts". I say CBT is a just sophisticated way of shaming the patient into reacting the way the therapist TELLS him to. If you are told your thoughts are inappropriate since a certain result ensues, the patient will THINK different thoughts and maybe a different result will ensue. If not the patient is not cooperating or not understanding the need to change the thoughts. BULLOCKS. More like bullying. Sometimes the right result will come out in spite of WHATEVER thoughts. Why doesn't that count?
But people do practice like this in the real world, avoiding presenting issues, neglecting their patients, and then they lie about it afterwards. They are never accountable.
CBT: yes I am not a robot! And it was completely awful. Did not take into consideration ME as a human being. I never went back. Instead I went to psychotherapy which allowed me to ask the questions I has always wanted to ask.
Beautifully presented.
Outstanding!
At 50 min: he cites study saying that benefit was inflated by 75%, but
then turns this into the claim that the benefit received was only 1/4.
But that would require an inflation of 300%. 75% inflation is not even
double.
Also, I think the study is "Does Publication Bias
Inflate the Apparent Efficacy of Psychological Treatment for Major
Depressive Disorder? " Or if not, this one is by the same group and is
more recent (given pub date). But it seems to claim effect size
increase drops by only 25% when unpublished studies are included. That
is an inflation of only 33% (Reported effect size .52, total effect
size .39).
I would appreciate seeing some clarification of
this point. It sounds very fishy to me but perhaps I don't understand
what he is saying (For starters effect sizes I imagine can't be treated
simply on a ratio scale, although that is how the original researcher
does it also. But an effect size of .52 compared to .38 doesn't sound
like only 1/4 the benefit received!)
Thank you!
I just started the video and I'd need to watch it through. However, are you positive that he was referring only to differences in treatment effect sizes as opposed to say, mean differences on various outcome measures ?
Outstanding analysis Mr Shedler!
Cognitive therapies are barely effective and frequently coercive leading to deepening the pathology while superficially offering the patient verbal defensive arguments. In the end nothing is healed excepting the lightest symptoms which respond to many other therapies.
These cognitive approaches are frequently the very opposite to how real healing and effective therapies work.
Moreover the claims are just marketing and no comparisons were done to compare these cognitive so called approaches to deeper and affect based experiential approaches that effect better more lasting relief and even cures for some diagnoses.
There are apparently political and other non scientific motives for the heavy marketing of cbt as a real therapy or more stunningly as the main "evidence based" therapy. This is pure fiction
spoken like a true Freud. You missed the cocaine and making up cases, but close enough
@@Blunderbussy Are you equating all psychodynamic therapy with only Freud? Big mistake.
You have no idea what you are talking about hahahahha. Do you know how to analyze if the methodology of the study is strong or weak?
Furthermore, in the second paper, he ridicules the 25% remission rate for the therapies. Yet, 25% remission for 16 week therapy is pretty great. Imagine if we were talking cancer here.
Except all the rest he says shows that 25 percent isn't that valid and if we do talk about cancer, then we should also precise that cancer will certainly come back within 2 years in most cases
Very interesting. It seems clear that the marketing for EBT is, ironically, I’m conflict with the evidence. I think that that’s clear to anyone who has looked into it, and this talk presents some good solid examples of the conflict.
I do think that some of the math is off in places, and I’d be happier to have a stronger comparison, such as examples of how many people drop out of psychodynamic therapy, return for the same issue, shown improvement and are completely cured.
" MARKETING "
CORPORRUPTION 24 / 7
DRUG ADS
( LICENSED MALPRACTICE )
" OBJECTS GET NO CARE
COUNTED for PROFIT "
( SALES MASTER
DEGREE )
FALL to FELONY
CONTEMPT !!!
I feel like he is making some basic statistical mistakes. If the 1.2 point difference is indeed true, it is not the case (as he seems to argue) that this represents a 1.2 point difference for any one participant (indeed it would be very unlikely that any participant experienced a change of exactly 1.2 points as the mean is a statistical abstraction of data only). Instead it demonstrates the mean difference (between the control/experimental groups). The effect size is the important thing here, which he doesn't seem to mention. Also, the p-value (statistical significance) does not provide the probability that the data were due to chance, but the probability that the data (or more extreme data) would have been obtained if the null were true.
nope, you are misunderstanding what he is saying
Thank you for saying that. This comment section is a great exemple of echo chamber
Also, his arguments about the psychodynamic students seem to be borderline mistruths: From the paper: The manualized treatments were provided by 11 MA-level clinicians (5 delivered PE and 6
TLDP) who received weekly group supervision. The PE-A therapists attended a 5-day training workshop conducted by E.F. and E.Y. The TLDP-A therapists attended a 2-day workshop conducted by L.R. Throughout the treatment, E.G.S. conducted weekly supervision meetings with the PE-A therapists, and L.R. conducted weekly supervision meetings with the TLDP-A
therapists. All treatment sessions were videotaped and watched by supervisors to ensure treatment fidelity, and weekly verbal corrective feedback was provided to the therapists.
Note that he refers to LR as a grad student in the video, but LR at that time had a PHD. He also states that CBT therapists received 10 days of training...they actually received 5 (according to the paper). Also, they were not forbidden to discuss the trauma. From the paper: "Therapists did not mention the traumatic event, and if the patient brought
up details of the memory, they referred to the meaning of the event in the context of the central issue, without further encouragement to discuss the memory.
Way too many letters and initialisms. I don't get it.
@@clydedale8108 Neither did I. But that last point that therapists’ dealings with traumatic events is disturbing. Ignoring suffering, bypassing negative emotions and replacing them with positive ones is just going to repress emotions.
7
Charleton
all i am hearing is a defense of psychodynamic therapy. I don't care about your little psychodynamic ego. Does therapy work?
So what's the alternative? Are mentally ill patients condemned to suffer?
Practice-based evidenced therapies is the alternative. Also, there are degrees of suffering and in many insight-oriented therapies, MEANING is derived from relating to suffering in a different way. Thus, meaning becomes the alternative to the American myth of happiness as the be all end all. The pursuit of happiness is such a shallow pursuit anyway...meaning, however, always comes with a little pain. It takes pain to grow. So one might liberate the very philosophical underpinning behind the purpose of life being to limit pain and gain pleasure to the purpose of life as a pursuit of growth and evolution, which requires both pain and pleasure, creation and destruction.
Minh Tran That's an interesting way to look at it, but PTSD or a severe anxiety disorder don't really lend themselves to growth, they are literally debilitating.
Well yes of course. One needs an ego before one can lose it; ego-strengthening is what a lot of these EBPs are about I think. However, it should be done simultaneously with more empowering approaches that allows the patients to glimpses at "the bigger picture" especially as most debilitating illness forces one to only see so small a view. I think I essentially agree with you though :)
Rubbish
We can tell which team you bat for🤣
You wish. It's the CBT myth that's rubbish. We all know this.