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tlogan's picture

I hate to straddle, but.....

I must also apologize for the tardiness of my response. I must start out my response with a question, directed at no one in particular, with the aim of satisfying my own curiosity: How are CBT therapies developed? As Alex says, CBT therapies, like drug treatment strategies, work best when individualized for each patient. How is this done, especially if we have no hard evidence to show what each therapy is targeting? I understand that fMRI is the best measure of change, due to the fact that we can't section patient's brains post CBT, but there must be some historical/literature basis for each technique, or else they would not be continued in practice. Do not take this as an argument for the use of drugs solely based on the idea that one can test them, as I agree with many who think CBT can be quite effective when the conditions are right.

I also heartily support the point that a combined approach is most likely to be effective, and that treatment should be specialized based on the person; though perhaps I am ill-informed, but what are the limits of CBT? Dr. Yarin pointed out that CBT and learning are somewhat analagous, but are there things that cannot be unlearned? Or biolochemical factors that prevent the acceptance of CBT, that can be ungated?

Either way, I must state that I do support the "quick-fix" of drug application if this is what is needed to allow an individual to function effectively, and perhaps once some stability is achieved, CBT can attempted. I don't feel bound to immediately denounce psychopharmacology as a corporate conspiracy, because in the end, it is the physician who controls how much/which drugs the patient will recieve (that is based on the assumption that the physician has the patient's best interests at heart). I feel as though it is unfair to assume that every company that stands to make a profit intends to take advantage of the consumer.

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