Once a worker at the Department of Social services told me that our mutual client should start receiving cognitive-behavioral therapy (also known as CBT) instead of whatever therapy the worker assumed the client was receiving. At other times, physicians and clients have asked for CBT. In each case, I stammered in response something like, "Well, I was already providing CBT. CBT is a part of my what I do." Unfortunately, some people have the impression that CBT is so much better than all other treatments that, if a client's problems haven't ended yet, then the client must not be receiving CBT.
CBT is useful treatment approach, but we cannot conclude from the existing evidence that it is superior to other therapies. Like high octane gasoline or bottled water, its prestige outweighs its value. It is true that it has been tested more often, so it has more evidence behind it--evidence that leaks out into mainstream media, causing the reputation of CBT to grow. But there is evidence to support other therapies. Moreover, there is considerable overlapping among the various treatment approaches, so it is very difficult to tease out what are the effective and unique parts of CBT, and what are the effective parts found in the other approaches.
So what is CBT, and what are some of the other approaches that inform my practice? In cognitive therapy, clients learn about self-defeating thoughts they have been experiencing and, in behavioral therapy, they learn to take actions to change their mindset. Another therapy is psychodynamic therapy, where clients learn about their unconscious feelings, some of them dating back to childhood, so that they are able to cope with those feelings and not undermine themselves. It is a modification of the ideas first proposed by Sigmund Freud. (I recommend the hilarious and moving novel by David Lodge titled Therapy, where a comparison of psychodynamic therapy and CBT provides one of the leitmotifs). Another therapy is motivational interviewing (or MI), in which clients learn about their motivation for change and what it will take to increase that motivation. My treatment approach is an amalgam of CBT, psychodynamic therapy, and MI. I was originally drawn to psychodynamic therapy--or rather an older version of psychodynamic treatment called psychoanalytic therapy--when I used it to analyze authors and literary texts. I still find psychodynamic treatment to be the most interesting one, but the degree to which I provide any treatment is related to how I assess my client, and how the client assesses his or her own needs.