When CBT is not Appropriate

When CBT is not appropriateIt would be foolish, and even irresponsible, to claim that CBT will work for all people and for all problems, especially in a peer group situation. It is not some magic cure-all, something both professional counsellors and the group understand.

Cognitive Ability
The importance of the word “cognitive” is one key indicator. The dictionary defines cognition as:

“The psychological process of acquiring knowledge and understanding through thought, experience, perception, intuition and reason. It requires the ability to form and modify beliefs and attitudes through decision making and problem solving.”

If someone is so ill that they do not possess enough cognitive ability to understand, yet alone do, what is necessary to change their way of thinking, then they are probably not going to get very far.

This is not their fault, but simply means they need professional medical treatment before they will be ready to try CBT.

Underlying Psychiatric Disorder
Another point the group is aware of is, we are not professional counsellors. A new member may have a psychiatric disorder that none of the group members picks up on. People become very good at hiding their real problem from others.

A counsellor would most likely have the extra training and skills to recognize this during therapy, and decide the person needs psychiatric treatment before seeing them any further.

The Problem is not Cognitive
Lastly, even if someone has had treatment by a professional, and knows what their problem is, it may not be something that can be solved or even helped by using CBT.

For example, someone with a diagnosis of schizophrenia, is not going to be able to overcome it by simply changing how they think.

It would be very naive to believe we can cure someone’s psychiatric problem by merely changing how they handle their thoughts. That was never the intention of CBT, the people who developed it, or the therapists that use it.

Can We Help at All?
While the group may decide CBT is not going to be of use for a particular person, that doesn’t mean they would not get any benefit at all from attending group meetings.

We don’t rely only on CBT, but a wealth of experience accumulated by being members of organizations such as A.A, R.I. or Grow. Very often, people are at a loss following treatment, having nowhere to go for ongoing support. Simply being able to come to the group each week and talk about whatever is bothering them at the time, can be of great help.

Becoming part of a group enables social interaction, something that they may very well have lost through their illness. It is not always necessary that we try to fix people. Sometimes simply accepting them as valuable people, despite their illness, can be just as important for their well-being as their previous, formal treatment.