CBT underused, undervalued

CBT is not only helpful for patients dealing with anxiety, depression, or lifetime personality styles and behaviors that cause them some form of distress in everyday living. A study soon to be published in the Journal of Behavior Therapy and Experimental Psychiatry suggests that CBT also might prove beneficial for negative symptoms in outpatients with disorders on the schizophrenia spectrum.

After 20 sessions of CBT over a 6-month period, the investigators found that patients reported a decrease in the number of dysfunctional beliefs about their own "cognitive abilities, performance, emotional experience, and social exclusion" (J. Behav. Ther. Exp. Psychiatry 2013;44:300-6). This was a small study (n = 21), and as the investigators noted, randomized controlled trials are needed. Still, this study is a reminder that focusing on problem resolution in a few highly focused sessions also can help patients with serious mental illness.

Those findings notwithstanding, CBT is certainly no panacea for numerous psychotic disorders. But in light of its superb track record of resolving many emotional problems, I believe that it should be used more as a mainstay of treatment and that anyone coming out of a mental health training program – whether psychiatrists, psychologists, mental health social workers, or psychiatric nurse practitioners – should be just as adept at using CBT as they are in using psychodynamic psychotherapy or medication management.

Dr. London is a psychiatrist affiliated with the New York University Langone Medical Center. He has no conflicts of interest to disclose.