Cognitive behavioural therapy (CBT) is a wonderful therapeutic advance, but it should not be regarded as a panacea for the treatment of all mental illnesses, a conference in Dublin will be told today.
Dr Michael McDounagh, consultant psychiatrist and cognitive behavioural psychotherapist at St Patrick's Hospital, Dublin, warns that CBT is not a replacement for biological treatments such as medication and ECT (electro-convulsive therapy) and it should be part of a multidisciplinary approach.
"CBT has had such evidence-based success across all the anxiety and mood disorders and even in addictions and schizophrenia that there is a danger of getting carried away and thinking that CBT can be used as a treatment for other mental illnesses," he says. "There are other forms of therapy that can also be helpful such as family therapy and there is also a need for various social interventions to ensure people have adequate housing and financial support."
Cognitive behavioural therapy is based on the idea that our thoughts cause our feelings and behaviours, not external things, such as people, situations and events, so we can change the way we think to feel better even if the situation does not change.
Dr McDounagh will be one of the keynote speakers at the Institute of Cognitive Behavioural Therapy Ireland's first annual conference entitled Developing Quality Cognitive Behavioural Therapy in Ireland.
He will highlight the need for the HSE to provide proper training in CBT as there is a huge shortage of trained therapists.
"I think it's important to talk about what form or model of CBT we want in Ireland, delivered by whom and what level of support and supervision therapists are given. A trained therapist might be very skilled but might only be given an hour a week in their job as a psychiatric nurse or an occupational therapist to actually provide CBT to patients."
According to Dr McDounagh, it's "a fallacy" that most psychiatrists are anti-CBT, pointing out that few, if any, psychiatrists are stuck in a biological or chemical view of mental illness these days. The norm is that most psychiatrists refer patients on for psychotherapy, especially CBT, he adds.
"We do refer them on for psychotherapy, but public and private patients often have to wait months for an appointment and they and their families want something now," he explains.
Chairman of ICBT Ireland Bruce Stevenson says CBT therapists are working in a wide range of fields from the religious, education and the civil service to the nursing and medical professions, the armed forces and private practice. "However, it does not work well for loss and grieving. I find it particularly effective in treating alcohol and drug addiction," he says.
