Wednesday, November 02, 2016

Review: Cognitive Behavioral Therapy (Great Courses)

The subtitle to the Great Courses's video series for Cognitive Behavioral Therapy is "Techniques for Retraining Your Brain." That sounded so exciting that I checked it out from the library. The instructor, Professor Jason M. Satterfield, is affiliated with UCSF, so comes with great credentials.

The target audience for this course isn't clear. Is it for the person looking to become a therapist? Is it for a patient looking to see which type of therapy suits him or her best? Is it for someone looking to acquire new habits? That's completely unclear. As a result I spent the first couple of episodes kinda confused, but then got into it.

The idea behind cognitive behavioral therapy (CBT) is that traditional therapy is open-ended, doesn't have any hard end-points, and all too focused on digging deep into the human psyche without providing any relief from the symptoms the patient is suffering from. That's great for producing a continuous stream of revenue from a few patients, but if your goal is to help as many people as possible, it's unsatisfying.

CBT differs from this in having completely different goals:

  • Specific treatment of symptoms and behaviors that the patient would like to change
  • Providing tools for the patient to use, so that when he/she leaves therapy, he/she can continue to use those tools to prevent relapse or help himself/herself.
  • Specific end point in mind. Since the goal is self-sufficiency and self-treatment, once those symptoms are relieved, the patient gets off the therapy, with only occasional checkups.
The tools CBT provide are very secular and focused:
  • Capture a thought diary, so that triggering situations can be analyzed and dissected at a distance.
  • Note that thoughts are opinions, and strength of emotion doesn't necessarily mean that the opinions are true.
  • Attack those opinions using three approaches: (1) experiment with behavioral changes to prove those opinions false (2) stand from a distance to see if you can reinterpret the same events in a different way (3) make a prediction of whether you'll enjoy a new activity, and then re-evaluating that activity after you've done it to show that what you rated as being unenjoyable turned out to be good
Throughout the videos, the course examines 3 patients struggling with different behavioral issues: one of severe shyness, one with managing anger, and one with depression. We watch each of them deal with their problems, run experiments with changing behavior, and reflecting and evaluating the results of their experiments. Throughout the program, the patients are treated with respect, sympathy, and encouraged to solve their problems through a toolbox. There's no hocus-pocus involved. Some of the exercises involved:
  • Muscle relaxation (progressive relaxation of muscle)
  • A mindfulness based approach of meditation --- including talking to yourself. This seemed very new-agey to me, but hey, if it works, it works.
Throughout the entire course, Dr. Satterfield provides pointers to further books, studies and results. Don't expect to be super impressed by the numbers. A success rate of 30% in treatment is considered good as far as psychotherapy is concerned. If you think about it, that makes sense. Think about trying to change a habit, like eating less calories so you can lose weight. Lots of people try, but very few manage to do so. Illnesses like depression, a hair-trigger temper, or severe shyness would be even harder.

Nevertheless, it's an interesting no-nonsense approach that I'd never even heard of before. It's well worth checking out, especially if (like me), your former impression of psychotherapy is Freudian mumbo-jumbo.

Post a Comment