Dr. Judith Beck on the future of cognitive therapy and psychotherapy

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Dr. Awais Aftab: What do you think the future of psy­chother­a­py is? What would you like it to be?

Dr. Judith Beck: A num­ber of years ago, a col­league asked my dad whether he expect­ed cog­ni­tive ther­a­py to even­tu­al­ly dom­i­nate the field of psy­chother­a­py. He respond­ed, “I hope good ther­a­py even­tu­al­ly dom­i­nates the field of psy­chother­a­py. Just good ther­a­py.” My father has always said, and I agree, that if sig­nif­i­cant research demon­strates greater sup­port for the the­o­ret­i­cal frame­work and treat­ment of a dif­fer­ent psy­chother­a­py, then that psy­chother­a­py should sup­plant CBT. So far that has not hap­pened. To the con­trary, as the years have gone by, there is more and more sup­port for CBT con­cep­tu­al­ly and in treat­ment efficacy.

In terms of the future of CBT, I think we will con­tin­ue to use research from oth­er fields (such as neu­ro­bi­ol­o­gy, evo­lu­tion­ary biol­o­gy, and cog­ni­tive sci­ence) to refine the­o­ry and guide ther­a­py. We will con­tin­ue to seek out what treat­ments work best for whom under what con­di­tions. We will have a stronger empha­sis on iden­ti­fy­ing key process­es to tar­get core medi­a­tors and mod­er­a­tors based on testable theories.

I think CBT will con­tin­ue to be adapt­ed for more prob­lems, diag­noses, and con­di­tions. We will train many kinds of care­givers, teach­ers, front-line work­ers, police, and even politi­cians. More and more health care providers, such as occu­pa­tion­al ther­a­pists, phys­i­cal ther­a­pists, pri­ma­ry and spe­cial­ty care providers will use CBT. Even­tu­al­ly, if the US adopts a sin­gle-pay­er med­ical sys­tem, I think we will see a triage sys­tem like the Improv­ing Access to Psy­cho­log­i­cal Ther­a­pies pro­gram in the UK and oth­er coun­tries. We will see inno­v­a­tive ways to deliv­er treat­ment, such as by grand­moth­ers sit­ting on friend­ship bench­es in Zim­bab­we or lay coun­selors in pri­ma­ry care in India. We will see a greater use of tech­nol­o­gy for self-admin­is­tered and com­put­er-assist­ed ther­a­py by way of apps and com­put­er pro­grams and a greater use of tex­ting and tele­health ser­vices. We will also see appli­ca­tions of tech­nol­o­gy to bet­ter deliv­er train­ing and super­vi­sion of trainees and for mon­i­tor­ing and eval­u­at­ing therapists.

And if research con­tin­ues to con­firm the effi­ca­cy of CT‑R, I pre­dict that we will see prin­ci­ples of CT‑R incor­po­rat­ed into the treat­ment of all indi­vid­u­als, regard­less of diag­no­sis, sever­i­ty of con­di­tion, set­ting, care provider, or deliv­ery method.

–> Read the full, in-depth inter­view over at Psy­chi­atric Times: The Past, Present, and Future of Cog­ni­tive Behav­ioral Ther­a­py: Q&A with Judith S. Beck, PhD 

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