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Talk:Cognitive behavioral therapy

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The contents of the Computerised CBT page were merged into Cognitive behavioral therapy on 2011-08-15. For the contribution history and old versions of the redirected page, please see its history; for the discussion at that location, see its talk page.

Sources for a rewrite

There are thousands of secondary reviews, compliant with WP:MEDRS, of CBT listed on PubMed; here is a small sample of those reviews that are freely available, recent, and can be used for the complete rewrite needed here.

Here are some that are not freely available, but may be useful if someone can get hold of them:

  • Ridgway N, Williams C (2011). "Cognitive behavioural therapy self-help for depression: an overview". J Ment Health. 20 (6): 593–603. doi:10.3109/09638237.2011.613956. PMID 22126636. {{cite journal}}: Unknown parameter |month= ignored (help)
  • Thoma NC, McKay D, Gerber AJ, Milrod BL, Edwards AR, Kocsis JH (2012). "A quality-based review of randomized controlled trials of cognitive-behavioral therapy for depression: an assessment and metaregression". Am J Psychiatry. 169 (1): 22–30. doi:10.1176/appi.ajp.2011.11030433. PMID 22193528. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  • Kowalik J, Weller J, Venter J, Drachman D (2011). "Cognitive behavioral therapy for the treatment of pediatric posttraumatic stress disorder: a review and meta-analysis". J Behav Ther Exp Psychiatry. 42 (3): 405–13. doi:10.1016/j.jbtep.2011.02.002. PMID 21458405. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  • Hirshfeld-Becker DR, Micco JA, Mazursky H, Bruett L, Henin A (2011). "Applying cognitive-behavioral therapy for anxiety to the younger child". Child Adolesc Psychiatr Clin N Am. 20 (2): 349–68. doi:10.1016/j.chc.2011.01.008. PMID 21440860. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  • Thompson RD, Delaney P, Flores I, Szigethy E (2011). "Cognitive-behavioral therapy for children with comorbid physical illness". Child Adolesc Psychiatr Clin N Am. 20 (2): 329–48. doi:10.1016/j.chc.2011.01.013. PMID 21440859. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  • Rathod S, Phiri P, Kingdon D (2010). "Cognitive behavioral therapy for schizophrenia". Psychiatr. Clin. North Am. 33 (3): 527–36. doi:10.1016/j.psc.2010.04.009. PMID 20599131. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  • da Costa RT, Rangé BP, Malagris LE, Sardinha A, de Carvalho MR, Nardi AE (2010). "Cognitive-behavioral therapy for bipolar disorder". Expert Rev Neurother. 10 (7): 1089–99. doi:10.1586/ern.10.75. PMID 20586690. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)

There are many many more where those came from: this article is seriously outdated, in need of expansion, and in a state of disrepair. SandyGeorgia (Talk) 18:41, 18 April 2012 (UTC)

I can do some work on the Schizophrenia and Psychosis part when I have more free time after my finals. I literally just wrote at 20-page paper on CBT for Schizophrenia and read a bunch of studies as well as a treatment manual by Beck. I'll see what I can do. Ayzmo (talk) 04:11, 21 April 2012 (UTC)
Thanks ! Please make sure to stick to secondary sources such as those listed above-- I had to remove all manner of primary sources, uncited text, and original research here. With the exception of the "History" section, it no longer has primary sources and OR, but the writing is still incomplete and rough. There is plenty of information about CBT in general, and wrt specific conditions, and dealing with the history of CBT in the recent high quality sources above, that there is no need for this article to have relied so heavily on primary sources or outdated sources. SandyGeorgia (Talk) 11:08, 21 April 2012 (UTC)

More reviews

Just combined you list of PubMed CBT Review list to tthe Reviews from my private CBT collection to create a new Cognitive Behaviour Therapy (CBT) Review collection it may help dolfrog (talk) 12:28, 21 April 2012 (UTC)

Dolfrog, I have never learned how to link to a saved PMID search-- they go away when I try to link. How did you do that ? Could you please explain here or on my talk? SandyGeorgia (Talk) 14:17, 21 April 2012 (UTC)
The first step is to create a PubMed account, and when you carry out a search you can save the results to either a new or exisitng research paper collection. For a single research paper example you select the "Send to" menu option top right, and choose "collections" and from there you can add the paper to one of your existing research paper collections or start a new collection. For the results of a search you select the articles you want (tick box on left side) and again select the "Send to" option as before, and that will add all the selected articles to your chosen collection. Next choose "My NCBI" select "Manage Collections" at trhe bottom of the collections box, which then brinks up all of yoyr PubMed Research paper collections, and from the "Settings/Sharing" column slect the "private" option which takes you to your collections admin page, select "Public" (Middle of page) and save, you select "Edit settings" from top menu, which takes you back top collection admin page which will now include a URLyou can post anywhere to you research paper collection. I hope this explains all dolfrog (talk) 10:31, 22 April 2012 (UTC)
Thank you so much ... I've used the "Send to" function, but didn't realize that by having an account, one could save lists. Would you mind reposting this to the talk page at Misplaced Pages:Misplaced Pages Signpost/2008-06-30/Dispatches, so I'll know where to find it for relinking in the future ? Thanks again ! SandyGeorgia (Talk) 16:01, 22 April 2012 (UTC)

I'm surprised no-one has invoked Cochrane yet....aaargh, 111 to wade through! Casliber (talk · contribs) 18:29, 21 April 2012 (UTC)

  • Holy cow, there's so much secondary info easily accessible, and this is such an important topic-- this really should be an FA, or at least a GA. On schizophrenia, I defer to your judgment. If we all want to work to really fix this mess up, the area I'm most equipped to help with is TS/OCD. SandyGeorgia (Talk) 19:24, 21 April 2012 (UTC)

French tertiary source and chart

The only tertiary source I could find is by INSERM. We are currently having a discussion about it's validity elsewhere on this discussion page but I also made a chart reflecting it. Specifically for CBT it used 31 meta-reviews and 19 control trials.

The basis for chart in the study be seen here

Disease or condition Effectiveness of psychotherapy treatment in adults

(checkY-Proven,checkY-Presumed,☒N-No effect)

Psychoanalysis Cognitive behavioral therapy Family or couple therapy
Schizophrenia (acute phase, with medical drugs)
☒N
checkY
checkY
Schizophrenia (stabilized, with medical drugs)
☒N
checkY
checkY
Depression (hospitalised on antidepressants)
☒N
checkY
☒N
Moderate depression
☒N
checkY
☒N
Bipolar disorder (with medical drugs)
☒N
checkY
checkY
Panic disorder (with anti-depressants)
checkY
checkY
☒N
Post-traumatic stress
checkY
checkY
☒N
Anxiety disorders (GAD, OCD, phobias)
☒N
checkY
☒N
Bulimia
☒N
checkY
☒N
Anorexia
☒N
checkY
checkY
Personality disorders
checkY
checkY
☒N
Alcohol dependency
☒N
checkY
checkY

CartoonDiablo (talk) 18:21, 20 June 2012 (UTC)

French survey table

I reverted this because it isn't possible to constitute the hole field of reserch in effevtivness in only one table mirroring only one govermental survey. I read WP:MEDRS but I didn't found the point which approve this precede. If you only pick one survey in a field of hundreds of studys, metastudys, reviews & surveys and think this is NPOV I'm sure this gonna be a long discussion. WSC 04:59, 20 June 2012 (UTC)

CartoonDiablo re-added it because he/she said it is a MEDRS reliable source and the removal was 'POV'. I think CartoonDiablo needs to read MEDRS again. According to google scholar this source only has 3 citations, and it's actually 8 years old, not 6. It isn't POV to remove a source because it isn't high quality - that's what MEDRS tells us to do! --sciencewatcher (talk) 19:41, 20 June 2012 (UTC)
First of all my mistake, the study is actually a tertiary source because it reviews numerous secondary sources (which are themselves reviews of literally hundreds of effectiveness studies) to get its result. Specifically for CBT it used 31 meta-reviews and 19 control trials. That means it is the highest possible standard as a medical study.
And secondly there is no standard per MEDRS for how often a study needs to be cited (or have any citations at all) to be a reliable source.
This material has also been removed from the psychoanalysis article on the same baseless grounds. As far as things go, I urge Widescreen either to find another tertiary source that comes with different conclusions so as to show that it's disputed or I'll reinstate the material. CartoonDiablo (talk) 18:04, 20 June 2012 (UTC)
Just because it's a tertiary source doesn't automatically make it the 'highest possible standard'. Citations are one of the tools we use to determine the quality of a source, and this study only has 3 citations. Generally if it is a high quality secondary or tertiary source it should have hundreds of citations after 8 years. --sciencewatcher (talk) 19:41, 20 June 2012 (UTC)
Not to be obtuse but I don't see number of citations as any kind of requirement per MEDRS (although I could just be missing it) and if it's not I don't see why it should be used. That aside, Widescreen's reason is certainly not valid given that it's a tertiary source with 30+ meta-studies (secondary sources) for CBT alone.
As to the low number of citations, (which I agree is a general concern) an explanation could be that it's a foreign study which doesn't have any of the therapies (CBT included) listed in either the abstract or title making it difficult to search for if someone didn't already know what the study was about. My general feeling is it's the best reliable source (excluding any yet to be found tertiary sources) and would stand up to any expert evaluation.
The other thing I want to mention about it is its methodology which, unlike other secondary or primary studies, deals specifically with diseases which helps to eliminate discrepancies for rare diseases like schizophrenia. That is, in other studies it uses a sample of patients and judges it on the effectiveness of the treatment based on the sample, but if only a small number of the sample have rare and difficult to treat illnesses (as statistically it would) then the outcomes would still look rather good. But this is of course a side issue. CartoonDiablo (talk) 21:28, 20 June 2012 (UTC)
+1 to sciencewatcher. What about the traditional evidence grade classification? Not that I'am agree with it. I for meta study, II for RCT etc.? besides this is rather a pub health survey than real psychotherapy research. Additional, thers much more to say about the effectivness of Psychotherapie than that. WSC 22:36, 20 June 2012 (UTC)
From what I got from that comment, it's not just "a pub health survey;" the study conducted 19 of it's own trials in addition to 31 meta-studies (that is, each meta-study is based on hundreds of other studies). The study effectively looked at the data of thousands if not tens of thousands of people' there's no way it can just be explained away. CartoonDiablo (talk) 22:47, 20 June 2012 (UTC)
Psychotherapy research is an complicate and wide field. You can't discribe this field with only one single study. Thats nonserious. Apart from this, in other meta or meta meta studys CBT reaches significant effects in much more disorders than the french survey suggest. Why don't you refer to this studys if you want to spread your cognitiv pov? The NCBI got a lot of sources. Check it out! WSC 23:05, 20 June 2012 (UTC)
I'll explain this a third time, this "one single study" is a review of literally hundreds if not thousands of "single studies" (by virtue of reviewing secondary studies) in addition to its own independent trials, making it a tertiary source.
Given a lack of a valid reason to exclude it as well as the non-reason for few citations (the closest MEDRS policy being: "an older primary source that is seminal, replicated, and often-cited in reviews can be mentioned in the main text in a context established by reviews." which has nothing to do with number of citations for tertiary sources) I'm reinstating the content. CartoonDiablo (talk) 23:17, 20 June 2012 (UTC)
I think you might need to read WP:SCHOLARSHIP. Number of citations is one of the main ways we determine which sources to include in wikipedia. --sciencewatcher (talk) 23:52, 20 June 2012 (UTC)
First, this presents only the view of the authors of what is needed to proof a therapy as effective. The most experts have other standards. Second, when they include thousends and thousends of studys, why can they only testify the effectivity of twelve special disorders? Disorders in very special terms, like "acute phase, with medical drugs" or "hospitalised on antidepressants". What do they mean with psychoanalysis? psychoanalysis in long term psychotherapy with about 100 sessions in a hospitalised setting? You don't know what kind of conditions the study apply. So you can't display them without any comments about the parameter of the study desinge. --WSC 04:52, 21 June 2012 (UTC)
  • There are two problems here 1. the quality and relevance of the study. 2. the presentation in table format. I think it may make sense to include the French survey, but not in a way that gives it undue weight. The checklist table format gives an enormous amount of prominence to the result of this survey which I don't think its quality merits. That format also glosses over all possible caeveats and study design issues and presnts its results as undisputabkle fact - it even uses the word "proven" which is obviously much too strong for something like this. If the French survey is to be included it should be in prose format and alongside other similar surveys. The table checklist is simply unacceptable.·ʍaunus·snunɐw· 14:23, 21 June 2012 (UTC)
My bad but yeah, I think given the circumstances it's still a valid source. To Widescreen, the study addresses all those questions in it.
To Maunus, I don't think it constitutes Undue weight because it's the single largest review of psychological effectiveness that exists. The study uses 31 meta-studies and 19 of it's own trials (meaning hundreds if not thousands of individual studies) for CBT alone, there is no weight to undue it.
As I've said numerous times, the study looks at all those questions right in it making claims of poor scholarship for missing "possible caeveats" absurd. As towards presenting the findings as "undisputabkle fact" it does no such thing; "proven" is one category along with "presumed" (but not proven) and having no effect. There's nothing wrong with the notion that using dozens of meta-studies on effectiveness on different diseases would result in some treatments being "proven" to be effective, while others "presumed" or having no effect. CartoonDiablo (talk) 14:49, 21 June 2012 (UTC)

A word on citations

After reviewing it based on the Google Scholar Citation Counter the study actually has about 1548 citations in 58 publications. The problem seems to be no one is mentioning the study by its title. However a refined search leads to higher results.
Just for reference, the study was part of a much broader government health report making it difficult to isolate the citation of that one psychotherapy study. It's also the only INSERM study done on psychotherapy. The chance of a study mentioning "psychotherapy" "efficacy" and "INSERM" outside that context is virtually non-existent. Even narrower searches including phrases like "psychoanalysis" net hundreds of citations. The lowest I've gotten is 587 citations.
The point being, there is no citation problem, just as sciencewatcher pointed out as a criteria, the study does in fact have hundreds of (if not more than a thousand) citations but it's not cited it as "Psychotherapy—Three approaches evaluated." CartoonDiablo (talk) 16:26, 21 June 2012 (UTC)
That does seem to suggest that including the study is merited. But not necessarily in the table form you propose.·ʍaunus·snunɐw· 16:38, 21 June 2012 (UTC)
Why not? The study (to my knowledge) is the largest evaluation of psychotheraputic effectiveness that exists, each technique's effectiveness is based on dozens of meta-studies and it's widely cited. The only reason that I can think of for the chart not being used is if another large tertiary source of therapeutic outcomes put the study's findings in question. Thus far, it is the most authoritative study by orders of magnitude, not being able to have a chart based on it is absurd.
Let me just say that I've seen medical charts based on much less, using this chart seems like a no-brainer. CartoonDiablo (talk) 19:57, 21 June 2012 (UTC)
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