# Not All CBT Is Created Equal



## yeah_yeah_yeah (Mar 27, 2007)

Yes it does exist, in my opinion, but its very hard to find. Back in the 70's, 'traditional' CBT was developed because they realised that Behavioural Therapy (exposure) did not work for a large amount of people for conditions like depression. They realised there was a big thinking aspect to it, as well as behavioural. They brought out CBT and it was great for depression and things like that. *However, it was always a bit hit and miss for Social Anxiety.*

A team of psychologists at one of the UK's top universities - Cambridge - worked for a long time to understand why SA did not respond as well as other Axis I disorders (thats depression, eating disorders, OCD and so on) to standard CBT, and modified it heavily to tailor it to this unique disorder. The two psychologists that published their work were Clark and Wells, and their approach is vastly different from standard CBT for SA and is vastly more effective.

However, finding someone who is versed in this method is difficult in the US it seems. In the UK most therapists use it and in fact working with a therapist here in Scotland finally got me over my SA.

I think the simple rule of thumb is, if they are cheap, you arent getting Clark and Wells. This is where the world of finance screws around with getting better. The method of Clark and Wells is used in the book Overcoming Social Anxiety and Shyness by Gillian Butler, but of course there are many elements that need to be done with a psychologist that cannot be done with the book alone. In addition, working with a book cannot give you the important emotional support, including validation and encouragement.

I think the 'turbo' combination would be an experienced CBT therapist who is versed in Clark and Wells AND compassion / mindfulness based therapy. Hard to find, yes. Worth looking for? Definitely. For added power, an SSRI in the mix will work well for many people.

Also get a thorough psychological assessment AND BE 100% HONEST. Do not hide any shameful little detail - because those details could be the very root of your problem. They are Psychi_atrists_ - not psychics  If you dont mention it, they can't identify it - and so they cannot TREAT IT. SA can be a side-symptom of other disorders, especially Bipolar Affective Disorder and the Personality Disorders. If you have one of these its very important you seek help in a 'timely manner' - as some posh folk over here seem to say  For the Personality Disorders CBT will only treat the Axis I symtpoms eg SA and depression. Other therapies are required to address the PD itself. (n.b. It is known that PD's are vastly underdiagnosed due mainly to unfounded notions that they are untreatable, and in the case that they _are _ treatable - that a long term insurance payout would not be popular with the Medical Companies.)

Ross


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## meggiehamilton (Nov 12, 2003)

I just ordered that book that you reccommended. It should get here in 3-8 business days. I cant wait.


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## CopadoMexicano (Aug 21, 2004)

If sa is a symptom of another disorder Im basically screwed. not many local certified therapists in specializing in anything but marriage and counseling. I might have to travel or move,.


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## LostPancake (Apr 8, 2009)

Just resurrecting this thread because it has such useful information - I've learned a lot from reading yeah_yeah_yeah's posts on here, and just stumbled across this one again. It didn't get many replies, unfortunately.

I did CBT in 1992-3 but it wasn't based on the Clark and Wells model, and I wasn't even diagnosed with social anxiety - I don't think my therapist knew about it. It was helpful, but not quite enough - I struggled and relapsed into anxiety over the years.

I did get the Butler book last year, but wound up putting it down due to boredom halfway through (not a good sign - I can usually focus on psychology books pretty well). I'll be picking it up again though, as I'm going through the Dr Richards audio program in the online CBT group here, and wanted to supplement it with some of the attentional training stuff that's apparently in the book.



yeah_yeah_yeah said:


> The method of Clark and Wells is used in the book Overcoming Social Anxiety and Shyness by Gillian Butler, but of course there are many elements that need to be done with a psychologist that cannot be done with the book alone. In addition, working with a book cannot give you the important emotional support, including validation and encouragement.
> 
> I think the 'turbo' combination would be an experienced CBT therapist who is versed in Clark and Wells AND compassion / mindfulness based therapy. Hard to find, yes. Worth looking for? Definitely. For added power, an SSRI in the mix will work well for many people.
> 
> SA can be a side-symptom of other disorders, especially Bipolar Affective Disorder and the Personality Disorders. If you have one of these its very important you seek help in a 'timely manner' - as some posh folk over here seem to say  For the Personality Disorders CBT will only treat the Axis I symtpoms eg SA and depression. Other therapies are required to address the PD itself.


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