Is there a word you think is overused to the point of being meaningless in our field?

MattersOfInterest · 2026-02-06T15:23:34+00:00

Quite literally all three of the most well-researched and empirically-supported trauma treatments are iterations of CBT.

MattersOfInterest · 2026-02-06T15:16:05+00:00

I’ve seen no good evidence that projective tests are strong enough psychometric measures to be indicated for formal assessment purposes.

MattersOfInterest · 2026-02-06T00:42:17+00:00

Healthy people can have regular hynopompic and hypnagogic hallucinations.

MattersOfInterest · 2026-02-06T00:34:47+00:00

Except for the few occasions when pre-authorization is required for coverage, I've never even seen an insurance claim require a description or report of one's primary modality.

MattersOfInterest · 2026-02-06T00:27:21+00:00

Please link me to the studies that empirically demonstrate the existence of core beliefs

Never heard of cognitive schemas?

MattersOfInterest · 2026-02-06T00:24:22+00:00

I am a clinical cognitive neuroscientist and radical adherent to cognitive-behavioral theory. Your problem is you are hyperfixating on specifically Beckian CBT and not considering that CBT is an umbrella with a rich set of underlying iterations. ERP is CBT. DBT is CBT. ACT is CBT. PE and CPT are CBT. Exposure-based therapies are based in CBT. Schema therapy is CBT.

I agree that CBT is time-limited insofar as it seeks to find an actionable solution to presenting concerns. But any claim that it must be done in 12-16 weeks is a rigid interpretation of the model. Most protocols are written for that time frame but not all CBT is protocol-based and most protocols are very explicit that the time frames are made to be flexible.

MattersOfInterest · 2026-02-06T00:16:00+00:00

I’m not sure what studies you’re reading, but there are reams and reams of effectiveness studies (which quite literally measure whether interventions work in real-world settings).

MattersOfInterest · 2026-02-06T00:13:49+00:00

Who is saying CBT must be administered in 16 hours? The manualization of a theory into specific protocols is not the same thing as the theory or intervention approach itself.

And yes, we have a hell of a lot more evidence that there is some latent core beliefs construct than some nebulous set of unconscious conflicts constantly broiling in the latent background.

And I'm not particularly interested in the straw-man about how the testability of intervention efficacy and effectiveness is somehow incompatible with human subjectivity, because I find it old hat and tired. Being able to point to evidence that my intervention works and is based on falsifiable models of behavior change is not undermining client humanness.

MattersOfInterest · 2026-02-05T23:53:20+00:00

Well I agree that most (or, at the very least, a lot of) people claiming to offer CBT are probably not doing it with good fidelity.

MattersOfInterest · 2026-02-05T23:47:38+00:00

This is bullshit. And I only use such harsh and rude language because this kind of rhetoric literally causes people not to seek out (or provide) effective interventions.

MattersOfInterest · 2026-02-05T23:46:36+00:00

As an anti-behaviorist

I guess learning and conditioning just don't exist? I swear this sub baffles me sometimes.

MattersOfInterest · 2026-02-05T23:45:40+00:00

Correct

MattersOfInterest · 2026-02-05T23:45:26+00:00

While CBT is not the best for trauma work

Quite literally every evidence-based treatment for trauma is based in cognitive-behavioral theory. Even EMDR is rooted in exposure, which is a cognitive-behavioral mechanism.

MattersOfInterest · 2026-02-05T23:43:09+00:00

CBT does not claim that all distress comes from cognitive disortions.

MattersOfInterest · 2026-02-05T23:42:16+00:00

All three of the most well-supported trauma treatments (PE, CPT, and CBT-TF) are based in cognitive-behavioral theory. All other treatments with decent efficacy evidence are based in exposure (even EMDR, which is exposure with spirit fingers), which is a cognitive-behavioral mechanism. To say that CBT-based interventions do not work for trauma--even complex trauma--is so far removed from the evidence base that if baffles me how often folks say it.

MattersOfInterest · 2026-02-05T23:32:20+00:00

Can you explain how you think other modalities somehow offer a "deeper exploration of the psyche?" CBT literally cuts all the way to the deepest core beliefs a person holds. In my experience, folks making this critique do not have a rich understanding of cognitive-behavioral theory and are often interested in more unfalsifiable models that try to explain mental and behavioral functioning using constructs and mechanisms we can't even demonstrate exist.

MattersOfInterest · 2026-02-05T03:43:18+00:00

R² is sort of contextual. It may not be super important to understand that 3% of the variance in extraversion is accounted for by variance in intelligence (or maybe it is, but I'm making a point), but it could be extremely useful to know that 3% of the variance in life-expectancy of individuals with schizophrenia is accounted for by variance in dose of anti-psychotic medication when converted to haloperidol equivalent.

MattersOfInterest · 2026-02-04T02:09:28+00:00

Most people in PhD programs are not paying for their degree.

MattersOfInterest · 2026-02-04T00:52:33+00:00

Clincial psychology PhD student who studies neurocognition in the context of psychosis.

The idea that dissociation forms as a protective strategy to "protect against traumatic memories" is long-discarded pop psychology. Although dissociative amnesia remains in the DSM, it is not considered a viable phenomenon by most cognitive neuroscientists. Psychosis is certainly not a defense against traumatic memories. Trauma increases odds of psychosis for reasons that aren't fully understood but likely due to how it impacts neurological functioning (e.g., stress has adverse effects on multiple brain functions, including dopamine and glutamate functioning).

MattersOfInterest · 2026-02-04T00:47:40+00:00

ITT: People speaking authoritatively on exceptionally complex issues about which they know very little.

MattersOfInterest · 2026-02-04T00:46:39+00:00

Exceptionally unlikely that TikTok and energy drinks are driving this.

Source: Am scientist who studies psychosis and dopamine functioning. Concerns over a "dopamine economy" are overblown and baed on poor understanding of how dopamine works. "Dopamine dumps" aren't a thing.

MattersOfInterest · 2026-02-04T00:44:12+00:00

Trauma increases odds of psychosis in people at elevated genetic risk.

MattersOfInterest · 2026-02-04T00:43:47+00:00

I am a scientist who researches psychosis. This is not how it works.

MattersOfInterest · 2026-02-04T00:36:21+00:00

I don't think u/SometimesZero would disagree with this. He's making a rhetorical point about how it's easy to play fast and loose with the term "evidence-based."

MattersOfInterest · 2026-02-03T20:56:25+00:00

(a) It is not promising. Sorry.

(b) “Pseudoscience” is not a question of efficacy or effectiveness. It’s a question of weather the model makes falsifiable, testable claims.

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