Talk:Cognitive behavioral therapy/Archive 2

A mess
For such an important and well-studied topic, this article is a mess. Please review WP:MEDRS, WP:MEDMOS and Wikipedia Signpost/2008-06-30/Dispatches on how to locate secondary high quality recent reviews. There is no excuse for the random selection of primary studies used to source text throughout this article when so many high quality secondary reviews are available, nor for the severe out-of-date text in such an important topic. It appears that no one is tending to this article, and editors are using it to promote their favorite primary research, advertize products, and yet the article never covers the most important territory or most recent secondary reviews. Worse, there is no clear explanation here of what CBT is, how it is employed, and how and why it works. I intended to get farther along on cleaning up here, but this article is much too big of a wreck to be addressed in one setting. Consistency and throughness in citations can be accomplished by plugging a PubMed identifier number into this template generator. Sandy Georgia  (Talk) 18:00, 18 April 2012 (UTC)

Expansion and cleanup
I've done extensive cleanup to remove primary sources, reflect WP:MEDRS and reorganize repetitive material. The aritcle remains underdeveloped with resepct to areas where secondary reviews have a lot to say (eg, OCD), and with respect to a good description of CBT, and I didn't try to fix the History section.

Does anyone who has access to the sources know why this simple statement requires five sources?"In 1937 Abraham Low developed cognitive training techniques for patient aftercare following psychiatric hospitalization." Sandy Georgia (Talk) 22:17, 18 April 2012 (UTC)


 * Not sure - we have one by the author himself and two profiles/case studies. A Review Article'd be nice here. I'll read a bit more later. Recovery Inc had morphed more into self-help much to Low's chagrin by 1952 (read that in the Wechsler article just now) Casliber (talk · contribs) 22:16, 21 April 2012 (UTC)


 * I removed most of what was there when I made this post, and merged a couple of sentences, so my query above is outdated. Sandy Georgia (Talk) 23:15, 21 April 2012 (UTC)

Sources for a rewrite
There are thousands of secondary reviews, compliant with WP:MEDRS, of CBT listed on PubMed; here is a small sample of those reviews that are freely available, recent, and can be used for the complete rewrite needed here.



Here are some that are not freely available, but may be useful if someone can get hold of them:

There are many many more where those came from: this article is seriously outdated, in need of expansion, and in a state of disrepair. Sandy Georgia (Talk) 18:41, 18 April 2012 (UTC)


 * I can do some work on the Schizophrenia and Psychosis part when I have more free time after my finals. I literally just wrote at 20-page paper on CBT for Schizophrenia and read a bunch of studies as well as a treatment manual by Beck. I'll see what I can do. Ayzmo (talk) 04:11, 21 April 2012 (UTC)
 * Thanks ! Please make sure to stick to secondary sources such as those listed above-- I had to remove all manner of primary sources, uncited text, and original research here.  With the exception of the "History" section, it no longer has primary sources and OR, but the writing is still incomplete and rough.  There is plenty of information about CBT in general, and wrt specific conditions, and dealing with the history of CBT in the recent high quality sources above, that there is no need for this article to have relied so heavily on primary sources or outdated sources.   Sandy Georgia  (Talk) 11:08, 21 April 2012 (UTC)

More reviews
Just combined you list of PubMed CBT Review list to tthe Reviews from my private CBT collection to create a new Cognitive Behaviour Therapy (CBT) Review collection it may help dolfrog (talk) 12:28, 21 April 2012 (UTC)
 * Dolfrog, I have never learned how to link to a saved PMID search-- they go away when I try to link. How did you do that ?  Could you please explain here or on my talk?  Sandy Georgia  (Talk) 14:17, 21 April 2012 (UTC)
 * The first step is to create a PubMed account, and when you carry out a search you can save the results to either a new or exisitng research paper collection. For a single research paper example you select the "Send to" menu option top right, and choose "collections" and from there you can add the paper to one of your existing research paper collections or start a new collection. For the results of a search you select the articles you want (tick box on left side) and again select the "Send to" option as before, and that will add all the selected articles to your chosen collection. Next choose "My NCBI" select "Manage Collections" at trhe bottom of the collections box, which then brinks up all of yoyr PubMed Research paper collections, and from the "Settings/Sharing" column slect the "private" option which takes you to your collections admin page, select "Public" (Middle of page) and save, you select "Edit settings" from top menu, which takes you back top collection admin page which will now include a URLyou can post anywhere to you research paper collection. I hope this explains all dolfrog (talk) 10:31, 22 April 2012 (UTC)
 * Thank you so much ... I've used the "Send to" function, but didn't realize that by having an account, one could save lists. Would you mind reposting this to the talk page at Wikipedia Signpost/2008-06-30/Dispatches, so I'll know where to find it for relinking in the future ?  Thanks again !  Sandy Georgia  (Talk) 16:01, 22 April 2012 (UTC)

I'm surprised no-one has invoked Cochrane yet....aaargh, 111 to wade through! Casliber (talk · contribs) 18:29, 21 April 2012 (UTC)


 * Which begs the question on whether we add this as a concluding summary, and if we do do we need the other one. Casliber (talk · contribs) 18:38, 21 April 2012 (UTC)


 * Holy cow, there's so much secondary info easily accessible, and this is such an important topic-- this really should be an FA, or at least a GA. On schizophrenia, I defer to your judgment.  If we all want to work to really fix this mess up, the area I'm most equipped to help with is TS/OCD.  Sandy Georgia  (Talk) 19:24, 21 April 2012 (UTC)

French tertiary source and chart

 * Psychotherapy: Three approaches evaluated

The only tertiary source I could find is by INSERM. We are currently having a discussion about it's validity elsewhere on this discussion page but I also made a chart reflecting it. Specifically for CBT it used 31 meta-reviews and 19 control trials.

The basis for chart in the study be seen here

CartoonDiablo (talk) 18:21, 20 June 2012 (UTC)

French survey table
I reverted this because it isn't possible to constitute the hole field of reserch in effevtivness in only one table mirroring only one govermental survey. I read WP:MEDRS but I didn't found the point which approve this precede. If you only pick one survey in a field of hundreds of studys, metastudys, reviews & surveys and think this is NPOV I'm sure this gonna be a long discussion. WSC ® 04:59, 20 June 2012 (UTC)


 * CartoonDiablo re-added it because he/she said it is a MEDRS reliable source and the removal was 'POV'. I think CartoonDiablo needs to read MEDRS again. According to google scholar this source only has 3 citations, and it's actually 8 years old, not 6. It isn't POV to remove a source because it isn't high quality - that's what MEDRS tells us to do! --sciencewatcher (talk) 19:41, 20 June 2012 (UTC)


 * First of all my mistake, the study is actually a tertiary source because it reviews numerous secondary sources (which are themselves reviews of literally hundreds of effectiveness studies) to get its result. Specifically for CBT it used 31 meta-reviews and 19 control trials. That means it is the highest possible standard as a medical study.
 * And secondly there is no standard per MEDRS for how often a study needs to be cited (or have any citations at all) to be a reliable source.


 * This material has also been removed from the psychoanalysis article on the same baseless grounds. As far as things go, I urge Widescreen either to find another tertiary source that comes with different conclusions so as to show that it's disputed or I'll reinstate the material. CartoonDiablo (talk) 18:04, 20 June 2012 (UTC)


 * Just because it's a tertiary source doesn't automatically make it the 'highest possible standard'. Citations are one of the tools we use to determine the quality of a source, and this study only has 3 citations. Generally if it is a high quality secondary or tertiary source it should have hundreds of citations after 8 years. --sciencewatcher (talk) 19:41, 20 June 2012 (UTC)


 * Not to be obtuse but I don't see number of citations as any kind of requirement per MEDRS (although I could just be missing it) and if it's not I don't see why it should be used. That aside, Widescreen's reason is certainly not valid given that it's a tertiary source with 30+ meta-studies (secondary sources) for CBT alone.
 * As to the low number of citations, (which I agree is a general concern) an explanation could be that it's a foreign study which doesn't have any of the therapies (CBT included) listed in either the abstract or title making it difficult to search for if someone didn't already know what the study was about. My general feeling is it's the best reliable source (excluding any yet to be found tertiary sources) and would stand up to any expert evaluation.


 * The other thing I want to mention about it is its methodology which, unlike other secondary or primary studies, deals specifically with diseases which helps to eliminate discrepancies for rare diseases like schizophrenia. That is, in other studies it uses a sample of patients and judges it on the effectiveness of the treatment based on the sample, but if only a small number of the sample have rare and difficult to treat illnesses (as statistically it would) then the outcomes would still look rather good. But this is of course a side issue. CartoonDiablo (talk) 21:28, 20 June 2012 (UTC)
 * +1 to sciencewatcher. What about the traditional evidence grade classification? Not that I'am agree with it. I for meta study, II for RCT etc.? besides this is rather a pub health survey than real psychotherapy research. Additional, thers much more to say about the effectivness of Psychotherapie than that. WSC ® 22:36, 20 June 2012 (UTC)


 * From what I got from that comment, it's not just "a pub health survey;" the study conducted 19 of it's own trials in addition to 31 meta-studies (that is, each meta-study is based on hundreds of other studies). The study effectively looked at the data of thousands if not tens of thousands of people' there's no way it can just be explained away. CartoonDiablo (talk) 22:47, 20 June 2012 (UTC)


 * Psychotherapy research is an complicate and wide field. You can't discribe this field with only one single study. Thats nonserious. Apart from this, in other meta or meta meta studys CBT reaches significant effects in much more disorders than the french survey suggest. Why don't you refer to this studys if you want to spread your cognitiv pov? The NCBI got a lot of sources. Check it out! WSC ® 23:05, 20 June 2012 (UTC)


 * I'll explain this a third time, this "one single study" is a review of literally hundreds if not thousands of "single studies" (by virtue of reviewing secondary studies) in addition to its own independent trials, making it a tertiary source.


 * Given a lack of a valid reason to exclude it as well as the non-reason for few citations (the closest MEDRS policy being: "an older primary source that is seminal, replicated, and often-cited in reviews can be mentioned in the main text in a context established by reviews." which has nothing to do with number of citations for tertiary sources) I'm reinstating the content. CartoonDiablo (talk) 23:17, 20 June 2012 (UTC)


 * I think you might need to read WP:SCHOLARSHIP. Number of citations is one of the main ways we determine which sources to include in wikipedia. --sciencewatcher (talk) 23:52, 20 June 2012 (UTC)
 * First, this presents only the view of the authors of what is needed to proof a therapy as effective. The most experts have other standards. Second, when they include thousends and thousends of studys, why can they only testify the effectivity of twelve special disorders? Disorders in very special terms, like "acute phase, with medical drugs" or "hospitalised on antidepressants". What do they mean with psychoanalysis? psychoanalysis in long term psychotherapy with about 100 sessions in a hospitalised setting? You don't know what kind of conditions the study apply. So you can't display them without any comments about the parameter of the study desinge. -- WSC ® 04:52, 21 June 2012 (UTC)


 * There are two problems here 1. the quality and relevance of the study. 2. the presentation in table format. I think it may make sense to include the French survey, but not in a way that gives it undue weight. The checklist table format gives an enormous amount of prominence to the result of this survey which I don't think its quality merits. That format also glosses over all possible caeveats and study design issues and presnts its results as undisputabkle fact - it even uses the word "proven" which is obviously much too strong for something like this. If the French survey is to be included it should be in prose format and alongside other similar surveys. The table checklist is simply unacceptable.·ʍaunus·snunɐw· 14:23, 21 June 2012 (UTC)


 * My bad but yeah, I think given the circumstances it's still a valid source. To Widescreen, the study addresses all those questions in it.
 * To Maunus, I don't think it constitutes Undue weight because it's the single largest review of psychological effectiveness that exists. The study uses 31 meta-studies and 19 of it's own trials (meaning hundreds if not thousands of individual studies) for CBT alone, there is no weight to undue it.
 * As I've said numerous times, the study looks at all those questions right in it making claims of poor scholarship for missing "possible caeveats" absurd. As towards presenting the findings as "undisputabkle fact" it does no such thing; "proven" is one category along with "presumed" (but not proven) and having no effect. There's nothing wrong with the notion that using dozens of meta-studies on effectiveness on different diseases would result in some treatments being "proven" to be effective, while others "presumed" or having no effect. CartoonDiablo (talk) 14:49, 21 June 2012 (UTC)

A word on citations
 * After reviewing it based on the Google Scholar Citation Counter the study actually has about 1548 citations in 58 publications. The problem seems to be no one is mentioning the study by its title. However a refined search leads to higher results.


 * Just for reference, the study was part of a much broader government health report making it difficult to isolate the citation of that one psychotherapy study. It's also the only INSERM study done on psychotherapy. The chance of a study mentioning "psychotherapy" "efficacy" and "INSERM" outside that context is virtually non-existent. Even narrower searches including phrases like "psychoanalysis" net hundreds of citations. The lowest I've gotten is 587 citations.


 * The point being, there is no citation problem, just as sciencewatcher pointed out as a criteria, the study does in fact have hundreds of (if not more than a thousand) citations but it's not cited it as "Psychotherapy—Three approaches evaluated." CartoonDiablo (talk) 16:26, 21 June 2012 (UTC)
 * That does seem to suggest that including the study is merited. But not necessarily in the table form you propose.·ʍaunus·snunɐw· 16:38, 21 June 2012 (UTC)


 * Why not? The study (to my knowledge) is the largest evaluation of psychotheraputic effectiveness that exists, each technique's effectiveness is based on dozens of meta-studies and it's widely cited. The only reason that I can think of for the chart not being used is if another large tertiary source of therapeutic outcomes put the study's findings in question. Thus far, it is the most authoritative study by orders of magnitude, not being able to have a chart based on it is absurd.


 * Let me just say that I've seen medical charts based on much less, using this chart seems like a no-brainer. CartoonDiablo (talk) 19:57, 21 June 2012 (UTC)
 * I took a look at the Study here. I don't know if this is the full text but it seems to be. The authors forgott to define criterias which studys were included. The authors also forgott to cite the studys they have chosen. So I found they forgott, for example a meta study compars cbt vs. short term pp. This one The results: equally effective methods. And we are talking about short term pp <30 sessions. I know a study about shizophrenia with significant better effects of pp vs. medication. Why don't they include this study? Don't get me wrong. Maybe the authors got good reasons to ignore this little study. Or what about these little RCT Anxiety Disorder? What I try to say is, there are much more studys to analyse than this sruvey suggest. Why Psychodynamic studys of all this weren't included you can't learn from it. -- WSC ® 21:10, 21 June 2012 (UTC)
 * Addition: I try to find the cites of the french study. I even search with the french title. But I din't found more than 4 cites of it. 58 cites not at all. A psychoanalytical meta analysis, not included in the french survey, reaches 305 cites at this time. But you can't evaluate a study not only by the amount of cites they reach. Maybe the cites are critical and deny the results of the study? See Impact factor. It's indispensable to set the study in relations to others. Otherwise the mention of only one single study is highly selectiv. (excuse my bad english) -- WSC ® 07:52, 22 June 2012 (UTC)


 * Sorry but that response was a complete waste of time. As I've said:


 * Those studies are either not about specific diseases or are not secondary or (more obviously) were made after the 2004 study; and especially, none of them are tertiary sources. For instance the study you used of schizophrenia is a primary source. And yes the French study did list its sources including Foa and Meadows, 1997 and Maxfield et al. 2002.


 * The reason you can only find 4 citations is because few people cite it as "Trois approches evaluees" or "Psychotherapy—Three approaches evaluated" for the reasons I already mentioned. It has well over a thousand citations.


 * Since no one has addressed the actual questions that is, how this study would violate Undue Weight etc. I have no choice but to go into Dispute resolution. CartoonDiablo (talk) 22:00, 23 June 2012 (UTC)
 * And what exactly do you think dispute resolution is? It is not a magical way of getting it your way, it is just getting more people to chip in their opinions to reach a consensus. Consensus works through willingness to compromise and to consider other peoples arguments, you haven't exactly been doing this here, rather you have just maintained that your table must be included as is. If you adopt a "my way or the highway" approach someone is going to end up on the highway, and given the fact that not a single person has agreed with you this far it is likely to be you. If you want to do something useful you should start and rFc on this talkpage to attract more editors, so that we can find out whether to include the french study more prominently and if so how. And then you would do well in perhaps modifying your proposal for inclusion to something that takes into account other users concerns.·ʍaunus·snunɐw· 22:07, 23 June 2012 (UTC)


 * Certainly not, and I've said numerous times (here, here and here) if someone can find another tertiary source that puts this study into question, then I would be for excluding it. As it stands, everyone is excluding the largest study on this subject as well as the only tertiary source.


 * The other reasons don't withstand any kind of scrutiny and at worst look like obstruction. I don't think asking for evidence that puts the largest study on the subject into question is unreasonable. CartoonDiablo (talk) 22:46, 23 June 2012 (UTC)
 * The study is not being excluded - it is included right now. Your table is being excluded because it gives too much weight to the study relative to other studies and relative to the topic as a whole.·ʍaunus·snunɐw· 23:01, 23 June 2012 (UTC)


 * My bad, replace what I said with chart. Where is the other tertiary source(s) that would make the chart undue weight? CartoonDiablo (talk) 23:06, 23 June 2012 (UTC)

Ok, Diablo, you say, for example, "were made after the 2004". Is it imaginable for you, it's unserious to cite only one ten year old study as only fact, when you now know there were subsequent efforts with additionally results? Or is your only intention to increase the importance of this little study? -- WSC ® 11:59, 24 June 2012 (UTC)

No limits to effectiveness of CBT?
Everything I read about CBT extols its virtues but I can find little comment here on whether it's effectiveness is limited and under what circumstances. Yet I do remember reading isolated articles to that effect in the past.

Yes, the article lists a number of psychological problems that CBT is successful with but this is a sales approach. A scientific approach would be to lay out those areas where success has been achieved (and to what degree) and those where it has not.

Is CBT less effective for some people than for others? Does success may vary according to such factors as education level, or age or gender?

The article would appear to be more balanced if such questions were granted a separate section and were at least posed, even if (in the current atmosphere of wild enthusiasm for CBT) they haven't been answered yet.

As with all Wikipedia articles, I admire the care and work that has already gone into preparing what is here. Thanks --174.7.29.185 (talk) 16:12, 16 July 2012 (UTC)

Pavlov's theory was not "behaviorist"
"It was during the period 1950 to 1970 that behavioral therapy became widely utilized by researchers in the United States, the United Kingdom, and South Africa, who were inspired by the behaviorist learning theory of Ivan Pavlov, John B. Watson, and Clark L. Hull".

Pavlov's theory can by no means be labeled as behaviorist. Although Watson based his theory (Behaviorism) on Pavlov's research, Pavlov himself was not a behaviorist. — Preceding unsigned comment added by 186.109.165.103 (talk) 05:54, 6 August 2012 (UTC)

Page is incredibly biased in favour of CBT
There needs to be a lot more balance, and space for divergent opinions about and critique of for article to be considered valid. — Preceding unsigned comment added by 217.39.15.150 (talk) 16:42, 23 August 2012 (UTC)


 * While I agree with your sentiment that we should have criticism of CBT, you need to be aware that all references and edits must satisfy WP:MEDRS and WP:WEIGHT. A news article is unacceptable here. As a starting point I would suggest that you [1] read through the full-text of all the reviews used in the article to see if we are accurately reflecting the contents of the major reviews regarding the effectiveness of CBT and make sure we are not omitting any important caveats, then [2] do a search on google scholar for other articles that look critically at the effectiveness of CBT and see if we are missing anything important (but bear in mind WP:WEIGHT and WP:MEDRS - you can't just include any old criticism in the article). --sciencewatcher (talk) 17:28, 23 August 2012 (UTC)

They’re should be much more critiquing of CBT particularly the INSERM meta-analysis which is allowed to go entirely unchallenged here and I don’t see how the opinions of Oliver James can be termed 'any old criticism'??? I haven’t the time to spend researching scholarly articles but at least adding the Oliver James ( a well known psychologist, journalist, author, commentator) quote at least adds some balance. Also to state without caveat that CBT simply *is* an effective for the treatment implies that it is incontrovertibly so. This does not keep with wiki standards of impartiality. — Preceding unsigned comment added by 109.144.219.191 (talk) 23:34, 23 August 2012 (UTC)


 * I agree. This is a pretty poor article overall. Malleus Fatuorum 22:46, 30 August 2012 (UTC)


 * Ditto. I'm unimpressed with the unqualified use of "effective". The world deserves an FA on this topic. --Anthonyhcole (talk) 08:02, 1 September 2012 (UTC)

POV-Warning
The table about the effectivness of psychotherapy is POV. My arguments are listed here. The tabel ﻿must be removed. I insist, to set one of these POV-warning boxes into the article, till these table is erased. -- WSC ® 18:11, 30 August 2012 (UTC)
 * That's a conclusion, not an argument. Please share your argument. I&#39;m StillStanding (24/7) (talk) 21:02, 30 August 2012 (UTC)
 * My arguments listed, as I wrote, here. It's easy. Turn your cursor on the blue fonts, and klick your left mouse-button (apple useres the middel mouse button). -- WSC ® 21:59, 30 August 2012 (UTC)
 * I saw that. I'm no more convinced than CartoonDiablo was. As he pointed out, this is a large tertiary source, hence highly reliable. I&#39;m StillStanding (24/7) (talk) 22:35, 30 August 2012 (UTC)
 * A large tertiary source, like houndreds of others. You also think: I read one table in one source and now I'm a expert of psychotherapy reserch? It's not as simple as you think. Do you also think: Without knowing the hole field of psychotherapy research, you can make usefull alteretions? If you really do, it's not possible to conviece you. -- WSC ® 22:58, 30 August 2012 (UTC)
 * I looked through the previous discussion, and I agree with Noleander's comment that we should just have a text summary rather than the large table. I'm not entirely convinced that this study does have thousands of citations. If you perform that google scholar search that CartoonDiablo gives, most of the results are nothing to do with the study, and the ones that do mention the study call it a 'poorly designed and questionable study', so I'm concerned that we are giving a questionable study from 2003 with few citations too much weight. --sciencewatcher (talk) 16:23, 31 August 2012 (UTC)
 * ACK. And it's not only the study. You can't build a chapter about a hole research aerea with houndreds and thousends of studies, meta studies, reviews and summaries by know only one pure publication. Thats nonserious and got nothing to do with an enzyklopedic work. -- WSC ® 19:30, 31 August 2012 (UTC)
 * To Sciencewatcher, the only source that called it a "poorly designed and questionable study" was the International Journal of Psychoanalysis, which is a rather dubious source considering that it was cited thousands of times. The point is it's the largest study in the article, there are no other tertiary sources so far as I can tell and I don't see why it the chart shouldn't be used.
 * Unless someone can find a good reason for why 100+ meta studies would not suffice to create a chart (as apparently Widescreen and sciencewatcher are implying) there is no reason to exclude it. CartoonDiablo (talk) 06:20, 1 September 2012 (UTC)
 * The bigger the better? CartoonDiablo were do you know they use 100 meta studies? They doesn't list the studies they use as basis for they results! If you want to be pooterish, it's not even a studie. It's a rewiew. But there are much more studies, overlooks and reviews. With different results. I show you. -- WSC ® 08:24, 1 September 2012 (UTC)
 * First of all yes it does list its sources and results and unless you (Widescreen) personally are a reliable source that can dismiss 111 meta studies done by a government panel then there is no argument. CartoonDiablo (talk) 20:09, 1 September 2012 (UTC)
 * Your answer shows that you are not able to etimate the quality of scientific releases. Notably the fact it's a govermantal survey, don't create doubt at you. Thats why I always call it a survey, means not an scientific release but a helth policy survey. Thats perhaps the reason your study recieves so much critic? But that doesn't mean we can't use this superficial survey as source. But only in relation to other studies which have a better quality. But your study may not be the only study cited in the article, by ignore all the others. Thats POV. And POV is prohibited here. -- WSC ® 10:39, 2 September 2012 (UTC)
 * I'd like to see other editors opinion on this. I don't think it's useful Widescreen and CartoonDiablo just arguing over this. --sciencewatcher (talk) 15:23, 2 September 2012 (UTC)
 * Other input would be helpful but I honestly don't even see an argument. Widescreen is simply asserting that it's not reliable which isn't an argument unless he himself happened to be an RS. CartoonDiablo (talk) 02:09, 3 September 2012 (UTC)
 * 1. What means RS? 2. I never say the study isn't totaly unreliable. It recieved a lot of criticism from other scientiffic authors Thats a good advice. My main argument is still: You can't write about psychotherapy research by citing only ONE table taken form ONE single, study, because there are a lot more overviews like that. The study CD trys to push in the article is minor relevant. Trying to describe the hole field of psychotherapy research even in only one treatment is a gigant task. You are wrong when you say, you can do good enzyclopedic work, when you use only one source, by ignoring all others. Do you really think thats quality work in wikipedia? -- WSC ® 05:44, 3 September 2012 (UTC)

I chimed in earlier in support of CartoonDiablo. I just don't see what Widescreen's reasoning is, other than an arbitrary rejection of a rather good meta-study. I&#39;m StillStanding (24/7) (talk) 02:24, 3 September 2012 (UTC)
 * Yeah, I think the case is obvious here, the issue also remains in the psychoanalysis article. For now I'll put into the research section since the study was not meant as a critique of any kind and, if anything, redeems psychoanalysis' claim to help with personality disorders. CartoonDiablo (talk) 05:59, 3 September 2012 (UTC)
 * Regarding citations: if you do a search for the French title of the article on google scholar it gives 10 pages of results (click here). I think that is the most accurate reflection of the citations for the study, so it looks like it does have a good number of citations after all. The only question is whether it's taking up too much space in the article. One question I would ask is: does it agree with the other major reviews? If so then I don't think there is a problem with it. --sciencewatcher (talk) 15:32, 3 September 2012 (UTC)
 * Sry Sciencewatcher. Google-Scholar includes a citatiation counter. Under the Studie, you can see the link: "Cited by 4". That means Scholar found 4 other scientific releases which cited the study you was searching for. But you found the study not once but triple! Unter the fist hit at scholar you see two futher hits. In front of it is the word [CITATION]. It ment the same study but another release. All in all we have 8 citatiations. For example a review releases 1994 has above 2100 citatiations. These are importend studies. Not this french survey. 10 or 8 citatiations are ridiculous in this embatted field. -- WSC ® 15:47, 3 September 2012 (UTC)
 * The one thing I'd suggest is seeing if we can make the chart smaller on screen, without cutting anything. I&#39;m StillStanding (24/7) (talk) 15:50, 3 September 2012 (UTC)
 * The chart is POV. We don't reduce the POV by making it smaller. -- WSC ® 15:53, 3 September 2012 (UTC)

The content is neutral, but the size is a bit much. I&#39;m StillStanding (24/7) (talk) 16:26, 3 September 2012 (UTC) Oh, really?! What makes you belive this? Your expertise of psychotherapy research? -- WSC ® 16:35, 3 September 2012 (UTC)


 * To Widescreen, that's not how the argument works. The study's validity is based on the fact that it's 111 meta-studies collected by a reliable source and abides by WP:MEDRS. Your assertion that it's POV or not a RS is based on your opinion.
 * To StillStanding, I'll see what I can do with the formatting. CartoonDiablo (talk) 18:08, 3 September 2012 (UTC)


 * Widescreen, I'm aware of the '4 citations' that google scholar shows - it was me who first pointed that out after all. However google scholar isn't always correct in counting citations. I think the problem here is that the article is shown as an english transation, while all the citations are in French. --sciencewatcher (talk) 18:09, 3 September 2012 (UTC)
 * You are right! But ther's a different between 8 or 10 citatiations and the above 1000 CartoonDiabolo asserted. It's also a different to other releases which recieved really above 1000 citatiations. My point is still the same. You can't describe the field of psychotherapy research by only one govermental survey. That's nonserious and non-enzyclopedical. That's why the survey have to be erased. -- WSC ® 18:51, 3 September 2012 (UTC)
 * No, it's not '10' citations, it's 10 pages of results (144 in total). Probably not all of those are proper citations, but even 100 is pretty respectable. --sciencewatcher (talk) 21:05, 3 September 2012 (UTC)
 * Hm? Strictly thats not correct. The Scholar searches the full text at the name of the release. The citatiation been counted by the software. But I checked the mentioned citatiations counted by scholar, and I found one source doesn't even really cites the survey! Thats remarkeble. I also think it's a problem on the french translation. But you can't count only the resuls presented by scholar. Beginning from result page 1 on you can't proove if it's really a citatiation or a dead hit. At ScienceDirect I found 63 citatiations. Thats makes the survey generally mentionable in my eyes. Of course in relation to others. -- WSC ® 21:57, 3 September 2012 (UTC)

A offer for real
After the table was erased, I thought maybe I can help you to phrase a chapter about the evaluation of efficacy of cbt. I can help you to find sources or classify them. I got a lot of knowledge about this special research area. If you want? -- WSC ® 18:11, 4 September 2012 (UTC)

Text passage
Evaluation of effectiveness

According to a 2004 French government study conducted by INSERM, Cognitive behavioral therapy was the most effective therapy as compared to psychoanalysis and family or couples therapy.

The study used meta-analysis of over a hundred secondary studies to find some level of effectiveness that was either "proven" or "presumed" to exist. Of the treatments CBT was found to be presumed or proven effective at treating schizophrenia, depression, bipolar disorder, panic disorder, post-traumatic stress, anxiety disorders, bulimia, anorexia, personality disorders and alcohol dependency.

I just underlined all wrong statments. -- WSC ® 05:06, 5 September 2012 (UTC)
 * Widescreen, please stop edit-warring. I&#39;m StillStanding (24/7) (talk) 00:46, 6 September 2012 (UTC)
 * Also I'm working on an image as agreed per the discussion. If you remove either the image or text here or on the psychoanalysis article it will be considered edit-warring. CartoonDiablo (talk) 00:58, 6 September 2012 (UTC)
 * Nearly every statement you add last, was wrong. So I reverted it by quality management. -- WSC ® 04:45, 6 September 2012 (UTC)
 * You reverted against consensus and got reverted. I&#39;m StillStanding (24/7) (talk) 04:47, 6 September 2012 (UTC)
 * No, I didn't. see: -- WSC ® 04:49, 6 September 2012 (UTC)

With all due respect, I've been to WP:DRM so I know a few things about it. First, it's not binding. Second, it doesn't replace consensus. Third, it's often completely worthless. I suggest you try WP:RFC, with the options being: Try that. But until then, leave that part of the article alone. I&#39;m StillStanding (24/7) (talk) 04:59, 6 September 2012 (UTC)
 * 1) No chart.
 * 2) Chart.
 * 3) Small chart.
 * 4) Prose.
 * The table were POV but the prose is POV as POV can. The consensus dint't say: You can type anything you want. The alterations have to be confirm with our rules. -- WSC ® 05:18, 6 September 2012 (UTC)
 * The consensus was that an image be made in its place and this is blatantly edit waring as well as a violation of 3RR. CartoonDiablo (talk) 05:59, 6 September 2012 (UTC)
 * Widescreen, stop edit warring. The prose seems to be a good summary of the study to me. If you have objections you need to explain exactly what your objections are. --sciencewatcher (talk) 13:50, 6 September 2012 (UTC)

I'm sorry about that, but I hadn't much time. What's wrong with the passage?
 * 1) The heading. It's called "Evaluation of effectiveness". In fact it's about 1 single study or survey. The "Evaluation of effectiveness" would contain about 10 to 20 important studies. If anybody have the leisure for an detailed description it would contain about 50 stuies. A good heading would be. "INSERM efficancy survey" or "French govermental survey".
 * 2) The sentence: "Cognitive behavioral therapy was the most effective therapy as compared to psychoanalysis and family or couples therapy." Thats not true. If you want to describe a short approach it's rather: "The survey found that CBT is more effective as psa and ft in specific disorders and specific treatment conditions." (by ignoring about 70 studies in 2004)
 * 3) "The study used meta-analysis of over a hundred secondary studies" This sentence doesn't have a source. The french survey got such a bad quality, they doesn't list the studies they choose for there review or even cited them. I know some meta-analysis contains only 8 or 10 single rtc's. What makes the author sure, that the survey evaluated over a houndred secondary studies? Further, the study also use rct's if no meta-analysis was found. Or, I wouldn't to rule out that possibilitie, I didn't found a list or citatiation of the used studies. But meanwhile I've read the study (compulsorily) in parts. Thats the reason why the statement "of over a hundred secondary studies" is completeley imaginary. (there are a much more quality lecks)
 * 4) "secondary studies" This term is wrong if you ask me. I know, en:wp calls meta-analyses AND peer-reviewed articles Secondary_source (without a source!). But in de:wp you can read somthing different. In de:wp you can read secondary sources are overviews which based on so called primary sources. I saw how the anglophone Wikipedia works, just in this article here, an I trust the german more...
 * 5) "to find some level of effectiveness" A bit fussy, but these are no "levels" of effectiveness but a statement if the treatment is proven (effective) or presumed (effectiv). Levels of efficacy are more differentiated. But, just as I said, a bit fussy if you see the other serious shortcomings of the text.
 * 6) "Of the treatments CBT was found to be presumed or proven effective at treating schizophrenia, depression, bipolar disorder, panic disorder, post-traumatic stress, anxiety disorders, bulimia, anorexia, personality disorders and alcohol dependency." The main fault on this sentence is that he doesn't term the exact conditions of the treatment which was evaluated. E.g. "Schizophrenia (acute phase) with medical drugs" or "Depression, hospitalised on antidepressants" and so on.

But the important thing is, you have to expain the reader, that this single study does't explain the hole field of psychotherapy research. And why, in gods name, we choose this study for our articles.

Don't get me wrong. I know CBT got much more assured efficacys. But guys like CD doesn't know, becuse they only know ONE singel Study. -- WSC ® 17:39, 6 September 2012 (UTC)


 * This was literally all settled in the dispute resolution. The agreement was to turn it into prose and to have an image of the former chart. CartoonDiablo (talk) 20:31, 6 September 2012 (UTC)
 * Maybe its settled in the dispute resolution. But it's not settled in the source. Are you afraid answering my points? -- WSC ® 10:46, 8 September 2012 (UTC)
 * Your "points" have been answered ad nauseum in the dispute resolution, this talk page and your talk page, (and mind you, by the other participants in the dispute resolution) none of which are true. If your argument is based on things that are blatantly false then there is no argument. It's why your the only person whose putting up POV tags when there is no POV dispute. CartoonDiablo (talk) 15:46, 8 September 2012 (UTC)
 * No, they weren't answered. Because you mainly talked nonsense. -- WSC ® 23:27, 8 September 2012 (UTC)
 * Ok this is getting ridiculous, you've just been banned for edit waring and now you're basically edit waring without discussing again. CartoonDiablo (talk) 01:33, 9 September 2012 (UTC)

Widescreen, these were answered. Please stop edit-warring. I&#39;m StillStanding (24/7) (talk) 01:38, 9 September 2012 (UTC)
 * For reference here is the latest discussion. CartoonDiablo (talk) 01:52, 9 September 2012 (UTC)

Widescreen edit waring (again)
See latest discussion here. CartoonDiablo (talk) 23:37, 9 September 2012 (UTC)
 * He reverted again. I&#39;m StillStanding (24/7) (talk) 00:06, 10 September 2012 (UTC)
 * What a luck you both banterers didn't edit waring -- WSC ® 00:33, 10 September 2012 (UTC)
 * I won't exceed 2RR, even in such blatant cases of drive-by tagging as this. I&#39;m StillStanding (24/7) (talk) 06:32, 10 September 2012 (UTC)

French survey third round
The Textpassage is still deficient. After CartoonDiablo add some more studies the heading is no longer fallacious. But the rest of my criticism is still current:


 * 1) The sentence: "Cognitive behavioral therapy was the most effective therapy as compared to psychoanalysis and family or couples therapy." Thats not true. If you want to describe a short approach it's rather: "The survey found that CBT is more effective as psa and ft in specific disorders and specific treatment conditions." (by ignoring about 70 studies in 2004)
 * 2) "The study used meta-analysis of over a hundred secondary studies" This sentence doesn't have a source. The french survey got such a bad quality, they doesn't list the studies they choose for there review or even cited them. I know some meta-analysis contains only 8 or 10 single rtc's. What makes the author sure, that the survey evaluated over a houndred secondary studies? Further, the study also use rct's if no meta-analysis was found. Or, I wouldn't to rule out that possibilitie, I didn't found a list or citatiation of the used studies. But meanwhile I've read the study (compulsorily) in parts. Thats the reason why the statement "of over a hundred secondary studies" is completeley imaginary. (there are a much more quality lecks)
 * 3) "secondary studies" This term is wrong if you ask me. I know, en:wp calls meta-analyses AND peer-reviewed articles Secondary_source (without a source!). But in de:wp you can read somthing different. In de:wp you can read secondary sources are overviews which based on so called primary sources. I saw how the anglophone Wikipedia works, just in this article here, an I trust the german more...
 * 4) "to find some level of effectiveness" A bit fussy, but these are no "levels" of effectiveness but a statement if the treatment is proven (effective) or presumed (effectiv). Levels of efficacy are more differentiated. But, just as I said, a bit fussy if you see the other serious shortcomings of the text.
 * 5) "Of the treatments CBT was found to be presumed or proven effective at treating schizophrenia, depression, bipolar disorder, panic disorder, post-traumatic stress, anxiety disorders, bulimia, anorexia, personality disorders and alcohol dependency." The main fault on this sentence is that he doesn't term the exact conditions of the treatment which was evaluated. E.g. "Schizophrenia (acute phase) with medical drugs" or "Depression, hospitalised on antidepressants" and so on.

There was been add a picture what replaces the table just been removed. You can't take Picture of the table seriously. This Picture of the table can't be found at the source so he was homemade by the user. The question is: Why was this special Table selected? I know much better studies wich also have tables and beeing much more cited by other scientists than this special survey was. I claim that this table was selected and refused by a picture shows the same as the table, to overstate the efficacy of CBT. The results of psychotherapy research as not as simple the table/picture suggest. If you wan't a pretty good chapter about the efficacy you have to give futher explanations. -- WSC ® 17:15, 17 September 2012 (UTC)


 * In support of Widescreen here (but not the edit warring) the evidence for CBT has been disputed to my knowledge in the UK and publishing that table gives a misleading impression. Its cherry picking evidence to support a proposition.Snowded  TALK 03:23, 18 September 2012 (UTC)
 * Care to explain how 100+ secondary reviews is cherry picking data? CartoonDiablo (talk) 03:49, 18 September 2012 (UTC)
 * I'm not sure from that comment how much you understand about research in this area. There is for example a dispute about the validity of self-reported results in the general evidence base for CBT which has gained momentum in the last five years.  A lot of new work has been done since 2004 that would throw those claims into dispute.  At the moment you are giving prominence to a one country study in a controversial area that is itself 8 years old.  That is cherry picking as the table gives a false impression of CBT's position in the pantheon of methods.  I can understand an advocate pushing it, but we have to be balanced here.  Snowded  TALK 04:08, 18 September 2012 (UTC)
 * Also having reviewed the material and links I can't see that you established a consensus to include the table.  If you did please show me where otherwise it should be removed.  Snowded  TALK 04:24, 18 September 2012 (UTC)
 * If you exclude Widescreen -- and you should -- then there's a consensus. I&#39;m StillStanding (24/7) (talk) 07:07, 18 September 2012 (UTC)
 * It's good to see, another expert of psychotherapy research (p.r.) is connected to this discussion. The frech survey is high selectiv and biased. The survey evalueted the field of efficacy with large restriction. For example, it evaluates only studies and meta-studies which exemine special disorders like schizophrenia or Depression (hospitalised). Thats o.k. but not the state of the art in p.r. A lot of efficacy-studies are examine larger defined disorder groups these for example or this one. The french survey doesn't reveal which kind of studies they included in there examniations. Because other releases in this area show that there a lot more studies with other results. So you can't claime this survey as only significant. Futher, of course there are a lot of releases since 2004. So the survey doesn't represent the latest results. Thats why the survey is overstated at the article.
 * Not least the table, self-provided by CatoonDiablo, now added as picture, is a invalid shortcut of the study. Never showes the results of p.r. Not even in 2004. -- WSC ® 07:54, 18 September 2012 (UTC)
 * I'm getting evidence from some colleagues and also establishing if the picture should be there. Please don't edit war in the meantime, and best to keep contributions short and specific.  We can't question the french source, we can only report if it is questioned by other experts.  So lets keep this calm and within the rules and we will get the article back on track Snowded  TALK 08:46, 18 September 2012 (UTC)
 * You are right when you say, we can't report ur own critic. But I haven't done that. We as enzyclopedic authors have to select sources for our articles. Especially in a research field with houndreds of releases. My proposal was to have a look at the citatiations. Some think thats a quite good way to decide what the resonance of an scientiffic releas was. Fist CartoonDiablo talked about a thousends of citatiation. I found only one citatiation in Google-Scholar. But that wasn't right ther are much more, but the scholar seems to have problems with the french translation. So Scirus found about 40 citatiations. But any meta-analysis released in a famous magazine have over 100 citatiations. over 200 is not rarely. So we as authors can say, this survey is minor. But you are right, we can't report our own citic in articles. -- WSC ® 17:28, 18 September 2012 (UTC)
 * I think the dispute resolution was prematurely closed, I'm trying to get it re-opened and address the various points raised. CartoonDiablo (talk) 14:52, 18 September 2012 (UTC)
 * But in the meantime you do not have consensus for insertion of the diagram. The majority opinion was that text was enough.  Per WP:BRD you were bold, you were reverted discuss.  Until you have agreement it goes.  Deleting now Snowded  TALK 20:40, 18 September 2012 (UTC)
 * The prose is still lousy. -- WSC ® 20:55, 18 September 2012 (UTC)
 * DRN has been re-opened, if someone can put the material back in while its being discussed I'd be appreciated. CartoonDiablo (talk) 02:55, 20 September 2012 (UTC)
 * Disputed material is only put back if a consensus is reached to do so. Please read up on process Snowded  TALK 03:17, 20 September 2012 (UTC)
 * The previous consensus was about the table, not the image. I'd suggest you self-revert since now it's technically an edit war bordering on 3RR. CartoonDiablo (talk) 03:52, 20 September 2012 (UTC)
 * Oh please, the image contains the same material and it is referenced. See the comment on your talk page.  You do not have consensus for its insertion.  Also the editors at DRP also talked about the image so you plain wrong in your assertion there.  I quote "That said, the inclusion of the table either as wikitable or as image results in improper weight on this meta-analysis, which itself contains quite a bit of errata" Snowded  TALK 03:59, 20 September 2012 (UTC)
 * What the material was is irrelevant, every dispute was about the presentation of the data. And there was no consensus for the image in the second dispute (which is what we're discussing now) ie that was the opinion of some editors regarding the image, the consensus was for removing the table.
 * But more importantly, none of this changes 3RR. CartoonDiablo (talk) 04:08, 20 September 2012 (UTC)
 * See summary quotations on your talk page. The clear consensus was for using text not a table (and an image of a table is a table and that was also specifically rejected).  Fully agree that nothing changes 3rr and if you continue to edit war until you have consensus on your side then you will end up at that notice board.  Oh and the material is not irrelevant.  Yes the prior dispute was about the image/table.  The next task (and you may choose to make it a dispute) is to balance that text to reflect the overall position, not that of CBT advocates in a controversial area Snowded  TALK 04:21, 20 September 2012 (UTC)

Ok, I don't know what's going on at arbcom? I intend to change the text in all articles like I described it above. Any oppositions? -- WSC ® 11:15, 2 October 2012 (UTC)
 * Complete opposition per all prior discussions. The disputed text is not in the articles, its still awaiting Arbcom decisions and you really don't want to start an edit war. Be patient.  Propose the exact change you want on the talk page and allow other editors to commentate.  If and only if they agree should an edit be made <font color="#801818" face="Papyrus">Snowded  <font color="#708090" face="Baskerville">TALK 12:15, 2 October 2012 (UTC)
 * O.K. I wait for the arbcom decision. -- WSC ® 13:29, 2 October 2012 (UTC)

French survey, fourth round
After the arbcom closed the case, it's necessary to change the wrong text about the survey first.

My next proposal is to use textbooks about efficacy, CBT or Clinical Psychology/Psychiatry which includes a OVERLOOK about the hole field of psychotherapy research. That should be a tertiery source, as cartoonDiabolo requires in the beginning of discussion. I hope, CartoonDiablo will accept this proposal. I think CartoonDiabolos overstating of this single study is caused in a keen to overstate the meaning of CBT. A paradigm in psychology which was foundet by Noam Chomsky the user state he's a fan of. But it's not impossible to have a serious collaboration in spite of that fact. The efficacy of CBT is well evaluated and it's possible to go back to many high-quality sources. It doesn't hurt that there are multiple textbook sources too. The more we have the more we can talk about a real NPOV. -- WSC ® 09:02, 6 October 2012 (UTC)


 * Its being restored so its not closed yet. However I think it would be good if you drafted something along the lines you suggest above and post it here.  I think we also need to reference the sources that challenge the way in which 'evidence' has been used to validate CBT in the UK (the one I know about) and the general controversies with the talking therapies in general.  <font color="#801818" face="Papyrus">Snowded  <font color="#708090" face="Baskerville">TALK 09:12, 6 October 2012 (UTC)
 * Sry, I don't suggested something along the lines, I'm able to read the source and classify it in the field of psychotherapy research. The source dosn't mention the choosen studys and list or cited them. Nobody is able to tell me which studys were selectet and how many. Futher it's cleare the study only sum up if the treatment is proven or not. They don't make a statement which one is more effactiv, for example. But these are all issues in psychotherapy research, you can find in any undergraduate textbook. So it's necessary to classify the survey in the hole field. That was not the aim of CartoonDiablos lousy contributions.


 * CartoonDiabolo itself worded the "prose" of the study in the article. With only one source: the study itself. Now I criticised that by an argumentation based on the study.


 * Please read the conclusion by the authors of this study itself: Some citations:
 * "The objective of this report is to assist decision-making in public health. It is based on the results of controlled trials conducted in the clinical population that are appropriate for this purpose, and without ignoring the methodological limits of such an exercise that are discussed at the beginning of the review."
 * "The major criterion used to evaluate the efficacy of therapies is improvement in clinical symptoms."
 * Sorry, but I don't understand what you awaiting from me? My citic is based on facts taken from the study itself, CartoonDiabolo ignored or doesn't understand (by assuming AGF). What exactly is your critcism an my improvement suggestions?
 * Sry for my aggressiveness, but I'm stressed out of this discussion and still not amused of my 1 Week block. But for first I insist of change the text about the french survey as interim arrangement. Than I'll be game for a futher discussion. -- WSC ® 13:33, 6 October 2012 (UTC)
 * -- WSC ® 12:10, 6 October 2012 (UTC)

The chapter 'Evaluation of effectiveness' - seek for reliable sources
Now we shoud search for reliabel sources to have a foundation. Because of the abundance of reliable sources it's necessary to compile selection criterias. My suggestions: 1. Overviews about which we can classify as tertiary sources. That means a overview about the field of studies and meta-studies. 2. High citatiations on google-scholar or other datatbases. 3. The period of publishing to exclude older releases. I would suggest not oder than five years? That means not older than 2007 or 2008. Since this time, a lot of studies were published.


 * 1) Embraced in scholar but without a citation count. Only the single chapters are embraced.
 * 2) published 2010; cited about 500 times

As access to the issue. -- WSC ® 08:21, 14 October 2012 (UTC)

Strange sentence
In the section "Specific applications" there's this sentence:

"In the case of metastatic breast cancer, a Cochrane Review published in 2008 maintained that the current body of evidence is not sufficient to rule out the possibility that psychological interventions may cause harm to women with this advanced neoplasm."

I find this sentence extremely complicated. What does it even mean? Does it mean that CBT is good for breast cancer victims or that it's not? A case study has shown that the current body of knowledge is not sufficient to rule out something? To me, that sentence has too many negatives in it. It may be that I'm not a native English speaker but I've read the sentence five times and I still don't understand if the study indicated that CBT helps breast cancer patients or is dangerous. Also, what is meant by psychological interventions? Is CBT a psychological intervention, or is it more like traumas, to which CBT is supposed to help? If it means that psychological treatment in general hurts people with breast cancer, what has that got to do with CBT? — Preceding unsigned comment added by 83.233.151.155 (talk) 21:23, 13 February 2013 (UTC)


 * I agree, the sentence could be worded better. As I understand it, there is a possibility that CBT can actually harm (rather than help) women with advanced breast cancer; more work is needed to be certain. This is an important point, as the beneficial effects of a treatment tend to be overstated - for more information, see publication bias. Norman21 (talk) 16:53, 21 February 2013 (UTC)

Subconscious Mind
Denial of the subconscious mind was a strong belief among CBT believers, though as they catch up to the neurological research done in the last few decades that makes this claim more and more laughable I see it being brought up less. It would be nice if this article had some coverage of that, it's a major part of their evolving philosophy, and there are still today CBT centric grad students coming out with a conviction that the subconscious mind either doesn't exist as the mainstream thinks it does, or has no affect on a person's behavior. — Preceding unsigned comment added by 184.57.57.220 (talk) 12:59, 3 September 2013 (UTC)

Criticisms section edits
__NOINDEX__ — Preceding unsigned comment added by JzG (talk • contribs) 00:00, 22 January 2014 (UTC)

Section on meta analyses of CBT for schizophrenia states "Several meta-analyses have shown CBT to be effective in schizophrenia,[34][56]" - only the Wykes et al is a meta analysis - the other paper is not and should be removed or replaced — Preceding unsigned comment added by 147.197.160.194 (talk) 17:51, 22 July 2014 (UTC)

Defining Cognitive distortions
I feel like readers need to get a better understanding of what cognitive distortions is rather than just stating it, it should be described/defined a little bit more of what cognitive distortions really is. --Patel Zeel (talk) 05:02, 7 December 2014 (UTC)
 *  Reply - I completely agree. It's one of the many things I plan on fixing on this page the next couple of weeks. See my comments above directly yours on the talk page. But, I completely agree with you. Especially since labeling thoughts as "cognitive distortions" is highly controversial in our field. Urstadt (talk) 03:37, 9 December 2014 (UTC)Urstadt

Several sections are a mess, I've already started revisions
I will be chipping away at fixing the lead section of this article. There are some slight, but significant confusions. One example, that I already removed, was the sentence that originally read, "The name refers to behavior therapy, cognitive therapy, and therapy based upon a combination of basic behavioral and cognitive principles and research." This is not an accurate representation because CBT is not based off of principles and research. It is based off of theoretical principles and assumptions, and the research merely validates if these assumptions are effective in therapy. To a well-seasoned practitioner, this is miniscule. To a person with no Psych background, seeking CBT therapy for the first time, that would be significantly misleading. It's basic quibbles and nuances like these that need revision. Feel free to check my work and contribute thoughts as I work it through. I will also post a reply here when I feel I have finished with my revisions. Urstadt (talk) 09:46, 6 December 2014 (UTC)
 *  Reply - The sentence, "CBT was primarily developed through an integration of behavior therapy (the term "behavior modification" appears to have been first used by Edward Thorndike) with cognitive psychology research, first by Donald Meichenbaum and several other authors with the label of cognitive behavior modification in the late 1970s. This tradition thereafter merged with earlier work of a few clinicians, labeled as Cognitive Therapy (CT), developed first by Albert Ellis as Rational Emotive Therapy (RET) and later Aaron Beck." is not at all accurate. First off, the behavioral approaches come primarily from B.F. Skinner and his associates. It also emerged from a psychoanalysis perspective. the label "CT" comes only from Beck. Ellis had RET, which was based off of a repackaging of Adler's Individual Psychology. CBT is that label that encompasses Beck and Ellis. Urstadt (talk) 03:39, 9 December 2014 (UTC)
 *  Reply - Ok, I have cleaned up the lead section. I also moved the history section to the front of the article and cleaned it up. The information on there was good, there were just some missing elements of the history of CBT and it was disjointed. Key events in history weren't sequentially written; it was jumping all over the place. I mostly just rearranged a lot of prior work, added some of my own, and tweaked a few factual errors. Urstadt (talk) 02:08, 11 December 2014 (UTC)
 *  Reply - Patel Zeel made a good point about "cognitive distortion" being poorly defined on this page. So, I plan on correcting that as well the next few weeks. Urstadt (talk) 03:39, 9 December 2014 (UTC)

Request Removal From Medicine Portal
CBT is not a medicine. It is a theoretical practice that makes assumptions about what causes human suffering and makes corresponding assumptiond about how to alleviate symptoms. To put any psychotherapy in the same category as a medicine is very misleading. In fact, psychotherapists are ethically obligated to inform clients and patients via a signed Informed Consent that these therapies are not the same as medicine. For more information, please see What's Behind the Research? Discovering Hidden Assumptions in the Behavioral Sciences by Slife and Williams. Urstadt (talk) 03:24, 12 December 2014 (UTC)
 *  Reply - Please, do not change what I wrote. If you want to contribute to the discussion, post a reply. But leave what I wrote alone. Thank you. Urstadt (talk) 02:14, 27 December 2014 (UTC)

CBT definition in first two lines
An anonymous user changed a quote in the first two lines of the lead section to read: "structured, short-term, research-based psychotherapy system for a wide range of psychiatric and psychological problems..."[1] However, this is not what the author says in Cognitive Behavior Therapy: Basics and Beyond. So, I undid the change. Here is a link to a scanned image of the page quoted in the first two lines of the lead section. Urstadt (talk) 03:17, 27 December 2014 (UTC)

Submission
Hello, this is my first edit on Wikipedia so I apologize in advance for any mistakes I make or even if the changes I suggest sounds ridiculous. I noticed that in the medical use for cognitive behavioral therapy that eating disorders appears over and over again. I wished to add something to the criticism section about that use of cognitive behavioral therapy and this therapy's problem with drop out rates. I will focus on use of cognitive-behavioral therapy to treat anorexia nervosa and how the success rates are not necessarily the highest. Here is my suggested change:

Criticisms
This high drop-out rate is particular evident in the treatment of anorexia nervosa, a eating disorder commonly treated by cognitive behavioral treatment. A considerable percent of patients either drop out of therapy and often revert back to their aneroxia behaviors before completing the therapy.
 *  Reply - : Agreed. Do it. Urstadt (talk) 23:12, 25 April 2015 (UTC)

Definition
There are issues with this "is a "structured, short-term, present-oriented psychotherapy for depression, directed toward solving current problems and modifying dysfunctional (inaccurate and/or unhelpful) thinking and behavior."


 * 1) It is way too complicated. We are writing for a general audience thus it is not appropriate as the first sentence of the article
 * 2) It is no longer correct as CBT is used for many conditions

Thus restored " is a short-term psychotherapy used in a number of mental illnesses" Doc James  (talk · contribs · email) 04:42, 28 February 2015 (UTC)


 *  Reply - : Thank you for starting a conversation on here about this. I completely agree with your first point, actually. I didn't think about it being too complicated for a more lay audience. As a licensed clinical mental health counselor, it makes all the sense to me and that's why I didn't make the connection that an untrained audience may not quite "get it." Good work. As for point two, I emphatically disagree. As I type this, I am looking at two college text books and Judith Beck's CBT book (the horse's mouth on CBT), and they all say it is for depression. I am trained in continuing education seminars that it is for depression, but indicated for other mental illnesses as well. It was originally designed for depression because of Beck's experiences with free association sessions and his mother's depression. However, we use it for other conditions. Saying what it is used to treat is not the same as what it is. The other thing to remember is that the term "cognitive-behavior therapy" is mainly an umbrella term to include all cognitive-based psychotherapies including DBT, REBT, PPT (at one point), Cognitive Processing Therapy, Acceptance and Commitment Therapy, EMDR, etc. But, now that I've said that, I am more inclined to agree with you about mentioning a variety of mental illnesses. Hmmm... I am glad we're talking this out on here. I still personally feel it is important to explain that it is for depression and then differentiate that from how it is used for other conditions, especially because different cognitive-based therapies ameliorate different symptoms from different conditions. It's just good education that way, and because a general audience with no training in psychotherapy wouldn't otherwise know that. How would you feel about having the first sentence say, "CBT is a short-term psychotherapy originally and primarily designed to treat depression, but is now being used in a number of mental illnesses." ??? Urstadt (talk) 20:46, 1 March 2015 (UTC)
 * How about "CBT is a short-term psychotherapy originally designed to treat depression, which is now also used for a number of mental illnesses." Doc James  (talk · contribs · email) 00:02, 1 March 2015 (UTC)
 *  Reply - : Yeah, that will work. Are you going to make the changes, or do you want to me to? Also, I think I am going to make a brief mention of the depression roots of CBT in the history section. I have some other changes I want to make to my work in that section anyway. So, keep an eye and let me know if you have any thoughts about those changes, too. Thank you for talking with me on here. I appreciate your time in working with me. Urstadt (talk) 20:46, 1 March 2015 (UTC)
 * Done. And yes please update the history section. A picture for the lead would also be nice if you could upload one. Doc James  (talk · contribs · email) 21:17, 1 March 2015 (UTC)
 *  Reply - : Image uploaded. Will get to history section (as mentioned I would above) soon. Thanks. Urstadt (talk) 23:28, 25 April 2015 (UTC)

Quotes
We should paraphrase the definition not quote it and refs go after punctuation. Doc James (talk · contribs · email) 15:20, 6 May 2015 (UTC)
 *  Reply - My bad on the punctuation. Old habits of APA. Regarding the paraphrasing, we have now drifted too far away from what Beck says in the CBT handbook. We're no longer paraphrasing, we are changing the definition: it's gone from it being a psychotherapy to it now being a form of brief psychotherapy, so on and so forth. CBT is the quintessential brief psychotherapy. It was the first of its kind. It's not a form of, it is. The information on this page has drifted so far from how CBT is described and presented in therapy. Now, if the wiki moderators don't care about hurting the credibility of page, then fine. But, as it stands now, the information on this page is close, however, it's not accurate. Urstadt (talk) 03:51, 7 May 2015 (UTC)
 * We can shorten it to "CBT is a form of psychotherapy" That makes it 100% correct and keeps it simple. Doc James  (talk · contribs · email) 12:06, 7 May 2015 (UTC)
 * Reply- Thank you.

claims based on primary sources
Computerized CBT (CCBT) has been proven to be effective by randomized controlled and other trials in treating depression and anxiety disorders,[24][26][48][49][50][51][52] including children,[53] as well as insomnia.[54] Some research has found similar effectiveness to an intervention of informational websites and weekly telephone calls.[55][56] CCBT was found to be equally effective as face-to-face CBT in adolescent anxiety[57] and insomnia.[54]
 * 54: "A Randomized, Placebo-Controlled Trial of Online Cognitive Behavioral Therapy for Chronic Insomnia Disorder Delivered via an Automated Media-Rich Web Application"
 * 57: "A randomized controlled trial of online versus clinic-based CBT for adolescent anxiety"
 * 53:"Computer-Assisted Cognitive Behavioral Therapy for Child Anxiety: Results of a Randomized Clinical Trial" (49 children, 3 therapies.)

WP:MEDPRI would apply, no? <font style="color:DarkGreen;background-color:#FAFAFF;">Ssscienccce (talk) 19:59, 23 September 2015 (UTC)

Medical terminology
I continue to be troubled by the verbiage on this page referring to CBT as a medicine and/or having medical uses. I feel it is not representative of what CBT truly is. As a therapist, I am ethically obligated to inform my clients that these, and other, interventions are not "medicines", "cures", or anything of the sorts. CBT is merely a theory of what causes human suffering and one plausible way to alleviate it. This is actually well-documented within the APA. I fear that clients unfamiliar with it might with read this page and come to a CBT therapist with unreasonable expectations. A recent meta-analysis out of Norway, documenting the consistent decline in CBT effectiveness since 1978, proposed clients' excess expectations as one reason for its decline. What are the thoughts of the community anent this? Urstadt (talk) 20:45, 4 November 2015 (UTC)
 * Another option may be to leave the page exactly as it is but make mention of this issue in the criticism section of the article. Urstadt (talk) 01:47, 8 November 2015 (UTC)

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Howdie - adding some references to this article
I a adding some references from 2017 where I think they support existing statements. I welcome your feedback. I am new at this LadyArwen2226 (talk) 23:02, 28 November 2017 (UTC)

Mindfulness-based cognitive behavioral hypnotherapy
We need a better description and citation for this. I do not have time to compose it now, but here are links: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2866254/ https://iacp.memberclicks.net/assets/CBTBR/cbtbr-vol_311c.pdf https://books.google.com/books?id=1_NcsDZ17icC&lpg=PP1&pg=PA61#v=onepage&q&f=false] Richard-of-Earth (talk) 07:57, 7 December 2017 (UTC)

Cognitive behaviour therapy or cognitive behaviour therapies?
It seems that CBT is an umbrella term for a number of cognitive and behavioural techniques used for treatment of psychological disorders. This article as it currently stands switches between talking about Beck's CBT and the more general umbrella term of cognitive behaviour(al) therapies.

For example:


 * Hitchcock, C., Rudokaite, J., Patel, S., Smith, A., Kuhn, I., Watkins, E. and Dalgleish, T., 2019. Role of autobiographical memory in patient response to cognitive behavioural therapies for depression: protocol of an individual patient data meta-analysis. BMJ Open, 9(6), p.e031110.

Similar in the Cochrane Database of Systematic Reviews, they discuss cognitive behaviour therapies/CBTs as un umbrella term... "cognitive therapy, rational emotive behaviour therapy, problem‐solving therapy, self‐control therapy, a coping with depression course and other CBTs."... then talk about third wave CBTs.


 * Uphoff, E., Ekers, D., Dawson, S., Richards, D. and Churchill, R., 2019. Behavioural activation therapies for depression in adults. Cochrane Database of Systematic Reviews, (4). Vancouver https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD013305/full

Lots more examples in the literature. Its bothered me for some time. Not sure how to handle it.

Notgain (talk) 12:23, 18 June 2019 (UTC)

TF-CBT missing
A discussion or link to TF-CBT is currently missing from this article. Notgain (talk) 12:26, 18 June 2019 (UTC)

Distinguish Beck's CBT and other models
Currently the article does not distinguish very well between Beck's CBT and other models of cognitive and behavioural therapies, such as REBT. Notgain (talk) 05:24, 20 July 2019 (UTC)


 * You need third party sources to avoid WP:OR -<b style="color: #801818; font-family: Papyrus;">Snowded</b> <small style="color: #708090; font-family: Baskerville;">TALK 07:17, 20 July 2019 (UTC)


 * It is quite obvious if you look at the for Cognitive behavioral therapy. It includes entries: cognitive behaviour therapies as well as cognitive and/or behaviour therapy as well as cognitive therapies, cognition therapies, and cognitive psychotherapies. Here is a couple of quotes: “CBT is an umbrella term for various treatments using cognitive and behavioral techniques.”  “Modern CBT is an umbrella term of empirically supported treatments for clearly defined psychopathologies that are targeted with specific treatment strategies[3]” Notgain (talk) 09:53, 20 July 2019 (UTC)
 * No issue if you use a third-party source, but you referenced a primary source in the edit - and there are two aspects (i) Umbrella term (you have references for that) and (ii) Beck founded it (you used a primary source. -<b style="color: #801818; font-family: Papyrus;">Snowded</b> <small style="color: #708090; font-family: Baskerville;">TALK 09:57, 20 July 2019 (UTC)


 * I revised my edit and also "which" tagged the bit that I have an issue with. "The CBT model" implies there is just one model rather than a collection of evidence-based techniques and strategies aim at treating specific psychopathologies. Notgain (talk) 11:49, 20 July 2019 (UTC)

schizophrenia
The article currently says, "Several meta-analyses have suggested that CBT is effective in schizophrenia". I understand that is is recommended as an addon to standard care for schizophrenia by NICE but it should be noted that Cochrane review reported CBT had "no effect on long‐term risk of relapse". There was no evidence that CBT had an additional effect above standard care. No firm conclusions can be made until further data is available. The article should reflect this. Notgain (talk) 13:23, 27 July 2019 (UTC)
 * Your citation is pretty straightforward. Says it does not work. Go ahead and add it as you see fit. Richard-of-Earth (talk) 21:41, 27 July 2019 (UTC)


 * I was thinking that the section on schizophrenia, psychosis and mood disorders be split out. ie. Cover depression in the section stub depression I created for that purpose. Notgain (talk) 05:14, 30 July 2019 (UTC)

Evidence for third paragraph
I was unable to find high quality reviews to fully support these statements in the lead third paragraph: "When compared to psychoactive medications, review studies have found CBT alone to be as effective for treating less severe forms of depression and anxiety, posttraumatic stress disorder(PTSD), tics, substance abuse, eating disorders and borderline personality disorder.[citation needed] It is often recommended in combination with medications for treating other conditions, such as severe obsessive compulsive disorder (OCD) and major depressive disorder, opioid use disorder, bipolar disorder and psychotic disorders.[citation needed]" For example, in the first sentence I have not seen any high quality evidence to support or refute the claim that CBT is more effective for PTSD alone compared to when CBT treatment is combined with medication. Gartlehner et al (2017) found moderate evidence that CBT in treatment of MDD may have similar effect as (2nd gen) anti-depressants: As far as I am aware with tics, the CBT approach has been shown in meta-analysis to have a similar effect size to anti-psychotic medication Not sure about borderline personality disorder. Notgain (talk) 11:51, 1 August 2019 (UTC)
 * Replication crisis strikes again. Perhaps you could find some pundit on the subject who comments on the lack of quality studies in this area. Basically medications are big business, so there is money for studies. CBT is not big business, so not so much money for studies. But all that is WP:OR without a citation to support it. Richard-of-Earth (talk) 19:05, 1 August 2019 (UTC)

Socio-political concerns
A new section called Socio-political concerns has been added by. As it stands, it doesn't clearly state what the actual critique is supposed to be. Also, one of the sources seems to be someone's personal blog. What do other people think? Should this section stay?--Megaman en m (talk) 18:17, 4 August 2019 (UTC)


 * The article does not yet cover the theoretical foundations of CBT. The criticism would make more sense in that context. Notgain (talk) 02:05, 5 August 2019 (UTC)

Drop out rates
I have edited the drop out rates section as the referenced meta analysis only showed CBT having a 17% higher drop out rate, not the five times higher that was claimed previously. If someone has a source for the five times higher please add it before reverting Abram-sha (talk) 06:04, 10 May 2020 (UTC)

Medical uses section intro needs more focus
The section under Cognitive_behavioral_therapy is a mess. Can the section introduction get more focus or move some of the content into subsections? Honestly I'd probably just suggest cutting a good amount of it out to maintain more focus and readability. Thinking to tag it with some template but adding a section here for notice also in case there needs to be discussion around adding the template. Shaded0 (talk) 04:39, 30 November 2020 (UTC)

Schizophrenia section may be contradictory
Is it just me or is the schizophrenia section under "Medical uses" sorta contradictory? It states "Several meta-analyses suggested that CBT is effective in schizophrenia" but right after it says "Cochrane reviews reported CBT had "no effect on long‐term risk of relapse" and no evidence that CBT had an additional effect above standard care" along with "...determined that there's no clear advantage over other, often less expensive interventions...". It might be me misunderstanding it but the first quote says it's effective, the second says it's not. So which is it? — Preceding unsigned comment added by MaxGame5o (talk • contribs) 23:24, 14 November 2020 (UTC)
 * Looking over the Cochrane ref, they are usually a good guide, following WP:MEDRS. Since the Cochrane source is relatively recent (2018), and the older sources are from 2010 and earlier, I'd say remove the language suggesting it's effective, in favor of language stating it's inconclusive. Shaded0 (talk) 04:54, 30 November 2020 (UTC)

Wiki Education Foundation-supported course assignment
This article is or was the subject of a Wiki Education Foundation-supported course assignment. Further details are available on the course page. Student editor(s): LadyArwen2226.

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