Joint Statement Issued by Professors Mick Cooper and Robert Elliott (both Unicersity of Strathclyde), William B.Styles (Miami Uniiversity) and Art Bohart (Saybrook Graduate School)

CBT superiority is a myth

The government, the public and even many health officials have been sold a version of the scientific evidence that is not based in fact, but is instead based on a logical error. This is how it works: 1) More academic researchers subscribe to a CBT approach than any other. 2) These researchers get more research grants and publish more studies on the effectiveness of CBT. 3) This greater number of studies is used to imply that CBT is more effective.

This is a classic example of the logical fallacy known as ‘argument from ignorance’, i.e. the absence of evidence is taken as evidence of absence.

Although CBT advocates rarely make this claim so boldly, their continual emphasis on the amount of evidence is misunderstood by the public, other health care workers, and government officials, a misunderstanding that they allow to stand without correction. The result is a widespread belief that no one takes responsibility for; in other words, a myth.

Research points to three facts

This situation has direct negative consequences for other well-developed psychotherapies, such as person-centred and psychodynamic, which have smaller evidence bases than CBT. These approaches are themselves supported by substantial, although smaller, bodies of research. The accumulated scientific evidence clearly points to three facts: 1) People show large changes over the course of psychotherapy, changes that are generally maintained after the end of therapy. 2) People who get therapy show substantially more change than people who don’t get therapy, regardless of the type of therapy they get. 3) When established therapies are compared to one another in scientifically valid studies, the most common result is that both therapies are equally effective. A case in point is person centred and related therapies (PCTs): in a meta analysis of more than 80 studies, to be presented by Robert Elliott and Beth Freire at the Norwich conference, PCTs were shown to be as effective as other forms of psychotherapy, including CBT.

In view of these and other data, it is scientifically irresponsible to continue to imply and act as though CBTs are more effective, as has been done in justifying the expenditure of £173m to train CBT therapists throughout England. Such claims harm the public by restricting patient choice and discourage some psychologically distressed people from seeking treatment.

We urge our CBT colleagues and government officials to refrain from acting on this harmful myth and to broaden the scope of the Improving Access to Psychological Treatments (IAPT) project to include other effective forms of psychotherapy and counselling.

Issued at the Conference of the World Association for Person-Centered Psychotherapies and Counseling held at the University of East Anglia, UK, from 6-10 July 2008.

Feeling Low?

Breathe in. Create a snapshot; visualise
the faces of those people who have said
Chin up, it could be worse. Include in shot
the Cheer up! It might never happen lot,

those who know exactly what you need and,
of course, the pull yourself together team.
Bring into frame the smiling kindly crew
who mention people far worse off than you.

Zoom out to show all heads impaled on spikes
(a little way outside the city walls).
Add crows to peck at eyes – should people doubt
the depth and darkness of your mood. Now smile.

Breathe out.

Emma Purshouse 2011

You might also choose to see a counsellor!

Emma is a very good friend and obviously a very talented poet.

He is quoted as saying, ‘Now, I know, as soon as I use words like behaviour and moral people will say what gives politicians the right to lecture us? Of course we’re not perfect. But politicians shying away from speaking the truth about behaviour, about morality has actually helped to cause the social problems we see around us. We have been too unwilling for too long to talk about what is right and what is wrong …. and sometimes there are just human reasons. We’re not perfect beings ourselves and we don’t want to look like hypocrites’. “The greed and thuggery we saw during the riots did not come out of nowhere,” he said. “There are deep problems in our society that have been growing for a long time: a decline in responsibility, a rise in selfishness, a growing sense that individual rights come before anything else.”

Tony Blair said the riots were primarily caused by a minority of disaffected and alienated young people who were outside the social mainstream and who constituted “an absolutely specific problem that requires deeply specific solutions”. He added, the rioting was mainly caused by “a group of young, alienated, disaffected youth who are outside the social mainstream and who live in a culture at odds with any canons of proper behaviour”. He said that his government developed specific policies to deal with these people and that they required intervention “literally family by family and at an early stage, even before any criminality had occurred”.

Yet is there much difference between these riotous activities and the following?

Almost all the glass of the lights and 468 windows of Peckwater Quad Christ Church were smashed, along with the blinds and doors of the building.

Police arrested all 17 of the members of the ‘gang’ for wrecking the cellar of a 15th Century pub by smashing more than a dozen bottles of wine into its walls.

After damage to a country house the perpetrators received an Anti-Social Behaviour Contract from the Thames Valley Police.

The ‘gang’ walked through Oxford when one threw a plant pot through the window of a restaurant. The burglar alarm was activated and police descended with sniffer dogs. Six of the group were collared and spent the night at Cowley police station before being released without charge.

The ‘gang’ enjoyed a famously explosive dinner at the White Hart near Oxford in 2005. “All the food and plates had been thrown everywhere and they were jumping on top of each other on the table like kids in a playground,” recalled the pub’s landlord Ian Rogers.

On one occasion the ‘gang’ hired a string band to play at a garden party and ended up smashing up all the instruments, including a Stradivarius.

This brand of self-destruction led to headlines worldwide, and was even reported in the New York Times, which described students as being guilty of committing an orgie (sic) of destruction that went into the early hours of the morning.

However, these are not the activities of a gang of the suburbs of London or any other large city in the UK but they are those of the Bullingdon Club. A club comprised of selected students of Oxford University. Young men who have enjoyed a privileged upbringing and expensive education (around 60% are ex-Eton scholars – the rest went to really posh public schools), they are largely solid high-achievers who see this kind of thing as a ‘social networking experience’. The cost of buying the Club’s uniform, at around £2,000-£3,000, clearly indicates the members are extremely wealthy.

The reasons given for the causes of the riots – social deprivation, financial hardship, poor education etc – do not apply to members of the Bullingdon Club. So what is the explanation? Mr Cameron, one of four people who escaped a night in the Cowley police cells after the ‘plant pot incident’, has refused to comment, saying merely: “Like many people, I did things when I was young that I should not have done, and that I regret.”

Clearly riotous behaviour is not restricted by social class and therefore the investigations into the August riots perhaps needs to consider the activities of the Bullingdon Club to gain a more complete picture of what motivates young people, in particular, to behave in an anti-social manner.

Punishment itself is no deterrent. Some say ‘prison works’ but does it? Certainly not if once incarcerated little or nothing is done to rehabilitate the inmates. If the United States were to execute one person on death row each and every day the gruesome task would take ten years to complete, yet crime figures remain high. Merely punishing people does not solve the problem. The criminals themselves may not fully understand their true motives for doing their crime, so they are likely to repeat it. It is not in society’s interest to allow the status quo to continue. Investment is needed in the provision of appropriate facilities and education to meet the needs of those who, at the moment, are unable or unwilling, for whatever reason, to help them. To do that, understanding is needed as to why such events happen.

Think of this on a personal level. We, ourselves, may be repeating an action or behaviour which isn’t in our own best interest. We will continue to do so until we have a realisation about how damaging it is to continue. In which case we may turn to someone with the expertise to help us come to the understanding we need and assist us to resolve the issue.

Like us society needs to realise there are aspects of its behaviour which are not in its own best interest.