Is Cognitive Behavioral Therapy an Empirically-Supported Treatment?

The concept of an evidence-based practice in therapy refers to interventions backed by rigorous scientific research. While no study can definitively prove that a therapy works for all individuals, empirical studies indicate that certain therapies can be effective for a significant proportion of the population. This article explores whether Cognitive Behavioral Therapy (CBT) can be considered an Empirically-Supported Treatment (EST).

Understanding Statistical Significance in Therapy Studies

No single study can conclusively state that a therapy works. Studies typically show that the chance of a therapy working for some people is 95% or higher. This means that the therapy only needs to achieve a mathematically noticeable difference in a group of usually 30 or more subjects to be statistically significant. The caveat is that a study may also suggest that the therapy may work for around 50-50% of the population, indicating that it isn't significantly better than a placebo or random chance.

This is best illustrated by an extreme case where a study with a large enough sample size could show a 51% versus 49% difference in a population, indicating statistically significant findings, yet the therapy is only marginally better than a coin flip. This highlights the importance of considering the entire range of outcomes rather than just one extreme.

The Difference Between CBT and Evidence-Based Practice

Thinking about CBT as an Empirically-Supported Treatment (EST) rather than an Evidence-Based Practice (EBP) may be more accurate. EST refers to treatments that have a relatively high likelihood of success based on empirical studies. In contrast, EBP typically involves a more structured, five-step process:

Asking a clinical question Gathering relevant data and other evidence Critically evaluating the findings Implementing an intervention informed by the critical appraisal process Evaluating observed results

While much of the CBT framework naturally aligns with these steps, CBT itself is not a stand-alone EBP. However, the approach used in CBT is evidence-based, meaning that it is supported by empirical research showing that it can help people achieve desired outcomes.

CBT as an Empirically-Supported Treatment

CBT has a solid body of research supporting its use in treating various mental illnesses, including depression, anxiety, and even substance use or psychosis. It has repeatedly demonstrated significant effects, often on a wide spectrum of diagnoses. The approach is grounded in a robust evidence base and is widely recommended by mental health professionals.

For instance, numerous meta-analyses and randomized controlled trials have shown that CBT is effective in reducing symptoms of anxiety and depression. It can be tailored to address specific issues and often involves techniques such as cognitive restructuring, behavioral experiments, and mindfulness practices.

When considering mental health treatment, it is crucial to seek out therapies that have shown effectiveness through empirical research. Just as you might prefer treatment for a venomous spider bite or flea medication for your dog from a reputable source with a proven track record, it makes sense to trust a treatment that has demonstrated success in research studies.

Conclusion

While CBT is not a standalone Evidence-Based Practice, its approach is evidence-based and has been shown to be an Empirically-Supported Treatment. This means that for a wide range of mental health needs, CBT can be a reliable and effective choice. Whether you are seeking treatment for yourself or someone you care about, knowing that the therapy has a solid empirical foundation can provide a level of confidence that it will be beneficial.

As a mental health administrator and former psychology student, I believe in the power of CBT and its ability to make a difference in people's lives. However, it's important to stay informed and consider the broader context of empirical evidence when choosing a therapy.

Further Reading and References

For those interested in delving deeper into the research supporting CBT, consider the following resources:

“Cognitive Behavioral Therapy for Psychological Disorders: A Review of Meta-Analyses” by Nathan and Gorman (2002) “Evidence-Based Practice in Psychology: State of the Science” by McKinley et al. (2015)