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For example, one study  determined CBT to be superior to other treatments in treating anxiety and depression. However, researchers  responding directly to that study conducted a re-analysis and found no evidence of CBT being superior to other bona fide treatments, and conducted an analysis of thirteen other CBT clinical trials and determined that they failed to provide evidence of CBT superiority. In cases where CBT has been reported to be statistically better than other psychological interventions in terms of primary outcome measures, effect sizes were small and suggested that those differences were clinically meaningless and insignificant.
Moreover, on secondary outcomes i. A major criticism has been that clinical studies of CBT efficacy or any psychotherapy are not double-blind i.
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They may be single-blinded, i. The patient is an active participant in correcting negative distorted thoughts, thus quite aware of the treatment group they are in. The importance of double-blinding was shown in a meta-analysis that examined the effectiveness of CBT when placebo control and blindedness were factored in. This study concluded that CBT is no better than non-specific control interventions in the treatment of schizophrenia and does not reduce relapse rates; treatment effects are small in treatment studies of MDD, and it is not an effective treatment strategy for prevention of relapse in bipolar disorder.
For MDD, the authors note that the pooled effect size was very low. Nevertheless, the methodological processes used to select the studies in the previously mentioned meta-analysis and the worth of its findings have been called into question. Additionally, a meta-analysis revealed that the positive effects of CBT on depression have been declining since The overall results showed two different declines in effect sizes : 1 an overall decline between and , and 2 a steeper decline between and Additional sub-analysis revealed that CBT studies where therapists in the test group were instructed to adhere to the Beck CBT manual had a steeper decline in effect sizes since than studies where therapists in the test group were instructed to use CBT without a manual.
The authors reported that they were unsure why the effects were declining but did list inadequate therapist training, failure to adhere to a manual, lack of therapist experience, and patients' hope and faith in its efficacy waning as potential reasons. The authors did mention that the current study was limited to depressive disorders only.
Furthermore, other researchers  write that CBT studies have high drop-out rates compared to other treatments.
Psychosocial treatment in schizophrenia
At times, the CBT drop-out rates can be more than five times higher than other treatments groups. Those treated with CBT have a high chance of dropping out of therapy before completion and reverting to their anorexia behaviors. Other researchers  conducting an analysis of treatments for youths who self-injure found similar drop-out rates in CBT and DBT groups.
In this study, the researchers analyzed several clinical trials that measured the efficacy of CBT administered to youths who self-injure. The researchers concluded that none of them were found to be efficacious . The methods employed in CBT research have not been the only criticisms; some individuals have called its theory and therapy into question. Slife and Williams  write that one of the hidden assumptions in CBT is that of determinism , or the absence of free will. They argue that CBT holds that external stimuli from the environment enter the mind, causing different thoughts that cause emotional states: nowhere in CBT theory is agency, or free will, accounted for.
Another criticism of CBT theory, especially as applied to major depressive disorder MDD , is that it confounds the symptoms of the disorder with its causes.
CBT is generally seen as having very low if any side effects. The writer and group analyst Farhad Dalal questions the socio-political assumptions behind the introduction of CBT, connecting the rise of CBT with 'the parallel rise of neoliberalism , with its focus on marketization, efficiency, quantification and managerialism '. Psychotherapist and professor Andrew Samuels stated that this constitutes "a coup, a power play by a community that has suddenly found itself on the brink of corralling an enormous amount of money Everyone has been seduced by CBT's apparent cheapness.
The NICE also recommends offering CBT to people suffering from schizophrenia, as well as those at risk of suffering from a psychotic episode. From Wikipedia, the free encyclopedia. For the peer-reviewed journal, see Cognitive Behaviour Therapy journal. The diagram depicts how emotions, thoughts, and behaviors all influence each other.
The triangle in the middle represents CBT's tenet that all humans' core beliefs can be summed up in three categories: self, others, future. Main article: Cognitive behavioral treatment of eating disorders. Main article: Cognitive emotional behavioral therapy.
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