Clinicians all know that CBT is considered the gold standard among insurance companies and licensing boards, but many clinicians are not big fans of CBT.
I hear therapists say that CBT is:
Not interesting or fun
Only about skill building
Completely focused on the present
I totally get it. The way CBT is presented often shows it as a very brief and very skills-focused type of therapy.
It seems like therapists don’t get to do what they best; practice therapy! People don’t become clinicians unless they value connection, they believe in healing, and they care about the process. If you were to believe the soundbites about CBT, it would seem like it’s a cookie-cutter structured model that anyone could do. That is 100% false, but I can understand why you might feel that way.
In reality, CBT is one of the richest practice modalities around.
The endless skills that you’ve heard about are real and relevant, but they are used individually and personally for each client. You don’t start the work prescribing skills, you start the work by getting to know the client.
The case formulation is the standard beginning to CBT treatment, and this process involves understanding how the client see themselves, others, and their world. In CBT, we cannot solve problems without knowing the person fully. We have to understand how they think, what they believe, and what drives their behavior. It is only when we have this understanding that we work on collaboratively helping them figure out how to resolve issues.
Collaborative is a key word here.
Real CBT involves a strong alliance and connection with the client.
Real CBT clinicians understand that change involves a therapeutic relationship and a deeper understanding of how each person views their situation. Yes, there is structure to the sessions, but this structure doesn’t make it less interesting, it makes it more focused, deeper and richer. Yes, the work is measurable, but accountability isn’t a bad thing. Therapists care about their work, and they want to do their best. I don’t think we’re scared of evaluations of success, I think we’re worried about our clients and making sure they are taken care of. CBT has amazing research, and this research is good. We want to show that therapy helps and makes a difference. We wouldn’t have committed our careers to this field if we felt otherwise.