MHM Magazine

CBT does not consider the patients past – The approach to the past in CBT is different from other therapeutic modalities. In CBT the past is part of the conceptualisation of the difficulties the patient is experiencing. Helping patients change core beliefs and schemas provides patients an opportunity to redefine problematic aspects of the past differently. CBT is about thinking positively – CBT is not about changing negative thinking into positive thinking but rather about wise, flexible, and logical thinking strategies that empower patients by helping them to understand the way they are making sense of the world they are living in, identifying the way in which their current way of thinking (beliefs) are unhelpful and how to behave differently within the context they are struggling in and respond differently to their needs. CBT as an evidence-based approach CBT’s evidence-base has been ex- amined extensively. More than 2000 papers investigated the effectivity of CBT for different disorders (https:// beckinstitute.org/cbt-resources/re- sources-for- professionals-and-stu- dents/research-corner/). Hofman et al. (2012) in a compre- hensive review of 269 meta-ana- lytic studies examined the efficacy of CBT for a variety of problems, including substance use disorder, psychotic disorders, depression and dysthymia, bipolar disorder, anxiety disorders, somatoform disorders, eating disorders, insomnia, person- ality disorders, anger and aggres- sion, criminal behaviours, general stress, distress due to general med- ical conditions, chronic pain and fa- tigue, distress related to pregnancy complications and female hormonal conditions. Additional meta-analytic reviews examined the efficacy of CBT for various problems in chil- dren and elderly adults. They found that CBT was used in a wide range of problems and that the evidence base for CBT was very strong. David et al. (2018) state that CBT is the most researched form of psychotherapy, no other form of psychotherapy has been shown to be systematically superior to CBT, the CBT theory and mechanisms of change are the most researched and in line with modern theory of human mind and behaviour. David et al. (2018) concluded that CBT is effective, and that CBT is an evolv- ing field and is committed to an ev- idence-based approach to research in the field. CBT due to its clear research support is the first choice in inter- national guidelines for psychoso- cial treatments, including the UK’s National Institute of Health and Care Excellence (NICE) and the American Psychological Association (APA). CBT’s efficacy was investigated across different criteria, such as population and context, and was shown to continue to be effective regardless. CBT is also cross-cultur- al, as it focuses on the client’s own world view and values, and ongo- ing research is being done in Asia, South America and Africa in view of adapting the approach to factors such as ethnicity, religion, culture and language. A relatively new way to assist therapists and clients in conjunc- tion with in-person CBT is I-CBT (internet-delivered CBT). Digital CBT increases access to mental care and has benefits where stigma, financial constraints, location, and time restrictions play a role. Ac- cording to a study done in the USA I-CBT is cost-effective and provides access to therapy, although does not replace a trained CBT therapist. Some online platforms and possible limitations are listed on the Forbes Health website. Evidence-based therapy is safe and ethical; works faster; is cost-effec- tive and treats a wide variety of disorders in different settings. However, the efficacy of CBT is reliant on various factors, such as embedded therapist training (includ- ing therapeutic relationship), client participation, personalized interven- tions, fidelity measures, to name a few. The empirical evidence for CBT raises a strong argument why CBT should be more widely accessible. More information on what CBT is – theoretical foundations, areas of application and evidence base for each model – is available at www.cbtasa.co.za . References available on request. EDITORIAL 2 | MENTAL HEALTH MATTERS | 2024 | Issue 3 MHM