CBT's Achilles' Heel
from Therapy for Social Change Podcast Hosted by Rebecca Hyman
The CPT protocol uses as its measure of effectiveness an assessment tool which the client fills out each week before session. The assessment lists all the symptoms outlined in the Diagnostic and Statistical Manual’s diagnostic category for PTSD. From week to week, the assessment tracks the level of symptom severity the client is experiencing, and their level of daily function. Each week, the symptoms are noted, and the level of function is assessed. If the client’s symptom score goes down by a certain percentage by the protocol’s close, the treatment is considered a success. How much of what counts as “probable” in CBT is rooted in a false generalizing of a certain kind of situated experience? And what forms of stigma, and pathologizing diagnoses, can greet those who come from a different situated context? What is the unacknowledged ground upon which the definition of what “mental health” looks like stands? Whose experiences, class positions, and racialized world views are embedded in these definitions, which are then put forth in evidence-based practices like CPT as universal traits? *Please note that the client I describe in this post is a composite of many veterans with whom I have worked throughout my time as a trauma therapist. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit therapysocialchange.substack.com
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