Editorials

Talk that works: the rise of cognitive behaviour therapy

BMJ 1996; 313 doi: https://doi.org/10.1136/bmj.313.7071.1501 (Published 14 December 1996) Cite this as: BMJ 1996;313:1501
  1. Gavin Andrews
  1. Professor of psychiatry University of New South Wales at St Vincent's Hospital, Darlinghurst, Sydney, NSW 2010, Australia

    The effective ones are as good as drugs

    Some people who are troubled seek referral to a counsellor or psychotherapist. “It helps me to get things in perspective,” they say, “It really works.”1 Are such “treatments” specific—that is, do they produce improvement faster than could be expected from natural recovery or from talking through problems with a supportive friend? Judging by advertisements in the local press, a wide range of therapies is now on offer, from plain psychotherapy to exotic varieties like “astrological archetypal counselling.” While people can spend their own money on whatever they wish, just what psychotherapeutic procedures should responsible doctors prescribe for their troubled patients, once they have made the appropriate diagnosis?

    Cochrane popularised the use of the randomised placebo controlled trial as the preferred means of deciding which treatments were specifically effective for which disorders, and governments and other funders of health care now require data from a series of such trials before deciding which new drugs they will license and subsidise. Searching the mental health literature, and setting a threshold for effectiveness, our group has recently completed reviewing those disorders in which a specific psychotherapy exceeded that threshold, and …

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