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The future is CBT

The future is CBT. CBT to remain dominant amongst psychotherapies Value of empiricism shared by society CBT follows the data – we adapt Develop, evaluate and re-brand interventions Imagery rescripting from Gestalt Role of pharmacotherapy?. Philosophical basis of CBT. Form

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The future is CBT

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  1. The future is CBT • CBT to remain dominant amongst psychotherapies • Value of empiricism shared by society • CBT follows the data – we adapt • Develop, evaluate and re-brand interventions • Imagery rescripting from Gestalt Role of pharmacotherapy?

  2. Philosophical basis of CBT • Form • Content & Process • Cognitive restructure • Two alternative theories & Behavioural Experiments to gain Knowlege • Act on data and understanding • Function • Pragmatism • Process • Mindfulness/distancing • Acceptance • Act on values

  3. 2050, NICE guidelines • RCTs and meta-analyses will not guide us on type of CBT • Danger of “Prizes for all” Dodo verdict unless RCTs are on chronic & severe • Disorders like depression are heterogenous • Complex interventions that overlap - even Behavioral Activation is complex! 1. Beck Activity Scheduling 2. Hopko / Richards 3. Martell 4. FAP enhanced BA 5. ACT

  4. No team will win beliefs/values • Beliefs and values are like two sides of coin • Will CBT 2050 be data driven and value driven? Alternative understanding of the problem + Use behavioural experiment to support alternative + Defuse beliefs from the self + Act on values

  5. Back to basics • Mediational Studies to determine process Difficult to conduct Power greater than RCTs Measure process or outcome Still need to determine which intervention • Single case series Uncommon submitted and published Scientist Practitioner – Ethics, Statistical support, Job plan?

  6. What will happen • Format briefer more cost-effective cCBT more sophisticated (Avatars in home) Stepped care studies on failures of low intensity • Stigma less mental disorder • User rating adherence - fidelity • Euthanasia/ suicide easier • BABCP strong – not split • Prevention (parenting and early intervention) • DSM/ ICD diagnosis – sub-typing of form or trans-diagnostic processes?

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