CBT superiority is a myth: The Four Professors Joint Statement

Joint Statement Issued by Professors Mick Cooper and Robert Elliott (both University of Strathclyde), William B Stiles (Miami University) and Art Bohart (Saybrook Graduate School)

The government, the public and even many health officials have been sold a version of the scientific evidence that is not based in fact, but is instead based on a logical error. This is how it works: 1) More academic researchers subscribe to a CBT approach than any other. 2) These researchers get more research grants and publish more studies on the effectiveness of CBT. 3) This greater number of studies is used to imply that CBT is more effective.

This is a classic example of the logical fallacy known as ‘argument from ignorance’ ie the absence of evidence is taken as evidence of absence.

Although CBT advocates rarely make this claim so boldly, their continual emphasis on the amount of evidence is misunderstood by the public, other health care workers, and government officials, a misunderstanding that they allow to stand without correction. The result is a widespread belief that no one takes responsibility for. In other words, a myth.

This situation has direct negative consequences for other well-developed psychotherapies, such as person-centred and psychodynamic, which have smaller evidence bases than CBT. These approaches are themselves supported by substantial, although smaller, bodies of research. The accumulated scientific evidence clearly points to three facts: 1) People show large changes over the course of psychotherapy, changes that are generally maintained after the end of therapy. 2) People who get therapy show substantially more change than people who don’t get therapy, regardless of the type of therapy they get. 3) When established therapies are compared to one another in scientifically valid studies, the most common result is that both therapies are equally effective. A case in point is person-centred and related therapies (PCTs): In a meta-analysis of more than 80 studies to be presented by Robert Elliott and Beth Freire at the Norwich conference, PCTs were shown to be as effective as other forms of psychotherapy, including CBT.

In view of these and other data, it is scientifically irresponsible to continue to imply and act as though CBTs are more effective, as has been done in justifying the expenditure of £173m to train CBT therapists throughout England. Such claims harm the public by restricting patient choice and discourage some psychologically distressed people from seeking treatment. We urge our CBT colleagues and government officials to refrain from acting on this harmful myth and to broaden the scope of the Improving Access to Psychological Treatments (IAPT) project to include other effective forms of psychotherapy and counselling.

7 July 2008
PCE Conference
University of East Anglia, Norwich, UK