Because of its clear support for research, cognitive-behavioral therapy predominates in international guidelines for psychological and social treatments, constituting a first-line treatment for many disorders.
This is stated in an article recently published in the online journal Frontiers of Psychiatry, through which this type of therapy is addressed, arguing why it is considered the reference psychological treatment.
As the authors point out, this article arises due to the increase of professionals who argue for plurality in Psychotherapy and question cognitive-behavioral therapy as a reference treatment. Against this argument, they state that CBT is the reference psychological treatment for several reasons, including the following: (1) It is the most researched form of psychotherapy, (2) no other type of psychotherapy has been shown to be systematically superior to CBT, and (3) the theoretical models/mechanisms of change in cognitive-behavioral therapy have been the most studied and are in line with the current predominant paradigms of human mind and behavior (e.g., information processing).
According to their text, modern CBT is a general term for empirically supported treatments aimed at clearly defined psychopathologies, approached with specific treatment strategies. More recently, it has included a more transdiagnostic/process-based and personalized approach, with the ultimate goal of linking the therapeutic technique to the process and the individual client.
With regard to the theory/mechanisms of change, the article states that cognitive-behavioral therapy is integrated into the general paradigm of information processing, where the causal role of explicit or implicit cognitions in the generation of emotions and behaviors is already well established. In this regard, the authors state that currently “there are no other psychological treatments with more research support to validate their underlying constructs”. On the other hand, they recall that some psychological treatments, especially those derived from classical psychoanalysis, “are unsupported or controversial with respect to the underlying constructs, while others (such as, for example, interpersonal psychotherapy) are at an incipient stage.
They also point out that CBT has been the first form of psychotherapy tested with the strictest evidence-based framework criteria used in the health field (similar to those used in the case of pharmacotherapy). Thus, because of its clear support for research, the authors conclude that cognitive-behavioral therapy dominates international guidelines for psychological and social treatments, making it a frontline treatment for many disorders, as contained in the guidelines of the National Institute for Health and Care Excellence (NICE) and the American Psychological Association. In the words of the authors of this article, cognitive-behavioral therapy “is, in fact, the reference model in the field of psychotherapy, which is included in major clinical guidelines based on its rigorous empirical basis, not for various political reasons, as some colleagues seem to suggest.
However, despite constituting an effective therapy, the article ends with the reflection that there is still room for improvement, “since in many situations there are patients who do not respond to CBT and/or have relapses”. In this sense, the importance of improving cognitive-behavioral therapy, both in terms of efficacy and in its underlying theories/mechanisms of change, is highlighted, advocating an integrated scientific Psychotherapy, with cognitive-behavioral therapy as the fundamental platform for integration.
