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Comment by gnramires | Hacker News Reader

I'm not a psychologist, but I believe CBT (cognitive behavioral therapy) has made pretty good progress in the recent decades. Is that correct?

I think studying well defined and important things is... extremely important :) I think for example it should be possible to measure remission from depression.

I also think though that psychology could 'make philosophy out of its physics' (in an analogy with an experimental field like chemistry or material science), and form theories about happiness, well being, etc.. that are grounded in insightful philosophies. And then try to measure or make some progress and recommendations to guide the field (like, how should we define well being, how should we measure it, and what kind of interventions help it).

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Much to be said about the second half of your comment, enough that I'll leave it to the better educated. On the former, an article titled "the declining effect of CBT" was foundational to my disillusionment regarding new therapy techniques. Nothing is new under the sun, but fresh techniques often overperform in talk therapy studies. A long symbiotic relationship between providers and those in need have resulted in a blooming field, and metastudies generally show all talk therapies as slightly more effective than [only] drugs, and all drugs as [only!] slightly more effective than no intervention.

I am not of the field, bit did dig into the CBT hole (both reading and consulting a trained therapist), and I have the impression that the effects are overstated (and, at least for me, this was totally the wrong approach). The main issue I see with the studies I tried to look at was that they compared the answers to some psychometric scales between people following a CBT method and people following "talk therapy". My problem with it is that, while CBT is pretty formalized and can be "administered" in a not so terrible way even by an if-statement based chatbot [1], "talk therapy" is a very broad category, and the effects will be mostly dependent on not only the skill of the therapist, but also the fit between the therapist and the client. So yes, CBT will consistently give small results, but comparing it to consulting a random non-CBT therapist is as absurd as comparing the travel time by bus to the travel time by jumping in and out of random trains until you reach the destination.

[1] before I get attacked on this: I do not say that there are no good therapists with CBT training - but I am confident most of them would still be very good even without the training or method.

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