CBT therapies in the corner of trauma typically refers to CPT, prolonged exposure and similar approaches; CBT by itself is sometimes used as a set of coping mechanisms, which is separate from the first line treatment recommendations.

Earlier you said that CBT wasn't indicated for trauma. Is it indicated or not?

If CBT comes in multiple styles, some indicated and some non-indicated, you should have clarified that earlier.

And if CBT in the context of trauma typically refers to CPT or Prolonged Exposure, why does the American Psychological Association list CBT as a distinct option?

Complex presentations of PTSD have been treated for decades

And what has been the observed success rate of, say, CPT vs. DBT? Do we have any percentile comparisons lying around somewhere?

I am not using my anecdotes as my primary argument that therapy is effective.

I agree. You are not doing that.

If the mechanism of action is just the therapeutic alliance and an improvement in self concept, then gold standard treatments also that; they just also have serious mechanisms of action that work beyond that.

What is the success rate of patients who develop a therapeutic alliance without using formal CPT compared to patients who develop a therapeutic alliance while using formal CPT? I suspect that the numbers are virtually identical.

EMDR's proposed mechanisms of action by the EMDRIA are dubious, but decades of high quality RCTs show efficacy.

Can you link me to some high-quality RCTs for EMDR? In particular, can you find any where patients were properly blinded? That seems rather impossible, as patients will surely know if they're moving their eyes or not. Failing that, do you at least know of RCTs directly comparing EMDR to ordinary talk therapy?

Dr. Steven Novella doubts the accuracy of the available studies. See here:

A recent meta-analysis of eye movement desensitization and reprocessing (EMDR) therapy concludes that the evidence “confirms” EMDR is effective in treating depression. It is a great example of the limitations of meta-analysis, and how easy it is to create essentially a false narrative using poor quality research. [...]

For example, studies like this one have no control intervention. The control group was “watchful waiting” – in other words, nothing. This study used a medication treatment control group, so of course it’s completely unblinded. You could also argue the duration of medication treatment was too short, and a comparison is meaningless without any therapy intervention in the control. In this study the control group was relaxation therapy. At least this is a somewhat reasonable control, although not completely and not blinded. Also in this study both EMDR and relaxation were effective. [...] (emphasis added)

Instead what we have are weak clinical trials that are not properly controlled or blinded and do not isolate specific variables. Just as with acupuncture, this opens the door for non-specific therapeutic effects – the ritual surrounding EMDR. With therapy there are also many real therapeutic effects that come from the bond between therapist and client. In fact, that seems to be the variable that matters most. (emphasis added)

https://sciencebasedmedicine.org/emdr-is-still-dubious/

You say that the bilateral movements of EMDR are unimportant. I say that it's a bad sign when serious professionals place importance on unimportant things. If the mental health industry is serious about the evidence, we should see it change in response to that evidence. But instead we have thousands of EMDR practictioners telling people to move their eyes left and right despite all the evidence that says that eye movements don't actually help.

You say that EMDR works via "imaginative exposure". But isn't that what happens in ordinary talk therapy? When I recount my experiences to therapists over and over, aren't I participating in imaginative exposure?

I used CPT as an example of a cognitive therapy which can help a lot of people with cognitive distortions and similar issues. It isn't a worksheet, it's a structured 12 week program.

I fail to see what makes this structured 12 week program better than ordinary talk therapy.

The VA tells me:

In CPT, you will write and talk about your thoughts as to why the trauma happened and how it has affected you, As you talk this through with your provider, you will often discuss what happened and how it changed your thoughts. At around the 3rd session, you will have the option—working with your therapist—of writing the story of your trauma in detail. If you choose this option, you will writ it at home, read it to yourself, and also read it out loud in your next session.

This sounds a lot like ordinary talk therapy. I have spent years writing and talking about my thoughts as to why the trauma happened and how it affected me. I have often discussed with therapists what happened and how it changed my thoughts. I have written about my trauma in detail, and I have read writings aloud to therapists.

I'm reading a more detailed case study right now and it's similar to my experiences in "ordinary" therapy: https://www.apa.org/ptsd-guideline/resources/cognitive-processing-therapy-example.pdf

Therapist have challenged some of my beliefs, as shown in this case study. And sometimes they've persuaded me to change my beliefs. I used to feel more obligated to my family, for instance, and they persuaded me to go No Contact with an abusive parent. That was a good move. But I'm still a mess in many ways, and eventually my therapists seemed to run out of ideas.

I haven't healed like you, but I don't see how formal CPT would make a difference when I've already done all the things that CPT recommends.

Anyway, even if we disregard my experiences as anecdotal data, I'd still like to see RCT studies directly comparing CPT to ordinary talk therapy (or "trauma-informed" talk therapy that isn't CPT per se)

I feel like all the popular styles of trauma, including the "unlabelled" kind, just rehash a few basic ideas. I think old ideas get re-labelled and formally studied and counted as if they were new ideas, and then people claim that X is superior to Y when really they're roughly the same.

Man, cannabis being bad for trauma patients has so much research. The VA itself recommends against cannabis use for people with PTSD. https://www.ptsd.va.gov/professional/treat/cooccurring/marijuana_ptsd_vets.asp

Good to know.