Cognitive-Behavioral Therapy (CBT) is one of the most widely recognized forms of psychotherapy. Google almost any mental health concern, and you will see CBT mentioned over and over again. But any good trauma therapist will know, CBT isn’t all its cracked up to be and may not be the best choice for you. While CBT can be helpful, its popularity is due more to its simplistic formula best suited for insurance companies requirements than its appropriateness or effectiveness.

Here are 10 concerns we have with CBT:

1. Limited focus on underlying causes: 

CBT primarily targets surface-level thoughts and behaviors. CBT may not be the best choice if the underlying causes of a person's issues are rooted in their past or subconscious mind. For those wanting to heal unresolved trauma or childhood wounds, there may be more suitable therapy modalities. 

2. Rigid format: 

The formulaic structure of CBT can feel impersonal, rigid, and isolating for those who prefer a more relational, exploratory, or open-ended approach. CBT exercises and interventions can feel prescriptive and artificial. 

3. Exacerbates Self-Critical Thoughts: 

CBT focuses on labeling thoughts and “adaptive” or “maladaptive”, which can exacerbate self-critical and shaming thoughts and feelings. For those who experience self-criticism, therapy approaches like Internal Family Systems or Person-Centered therapy will be more healing. 

4. Not A Well Rounded Trauma Treatment: 

Because trauma often does not get stored in the brain as a normal conscious and biographical memory, focusing on cognition and behavior may exacerbate a client’s symptoms. The effects of trauma are often experienced subcortically (in the subconscious), in the body (somatically), emotionally (right hemisphere), or as a dysregulated nervous system. CBT has a limited focus on these areas.

5. Not all issues are Cognitive: 

When someone is anxious or overwhelmed, the “logical” part of the brain shutdown. CBT emphasizes the left hemisphere of the brain (ie the verbal side), and can ignores both the body and the right hemisphere of the brain (ie experiential/emotional/nonverbal).

6. Short-term focus: 

CBT is generally considered a short-term therapy, which may not be ideal for individuals who desire an ongoing or open ended counseling style where they can talk about whatever feels most pressing that week. 

7. Overemphasis on self-help: 

Some individuals may feel overwhelmed or pressured by the emphasis on self-help techniques in CBT. They might prefer a therapy that relies more on the therapist's guidance and support or emphasizes organic exploration and verbal processing.

8. Limited scope for exploring emotions: 

CBT tends to prioritize thoughts and behaviors over emotions. For people who need to work through deep-seated emotional issues or trauma, other therapeutic modalities like psychodynamic or experiential therapies may be more appropriate. Similarly, for those who tend to intellectualize their issues, CBT may exacerbate emotional avoidance. 

9. Lack of holistic approach: 

CBT often focuses on specific problems or symptoms, and it may not take into account the broader context of a person's life, including their relationships, social environment, and overall well-being.

10. Incompatibility with specific goals: 

If an individual's therapeutic goals are more oriented toward personal growth, self-exploration, or understanding the meaning of life, CBT may not align with these objectives.

It's important to remember that therapy is not one-size-fits-all, and the choice of the most suitable therapeutic approach should be based on an individual's unique needs and preferences. Ethredge Counseling Group is committed to high quality holistic therapy modalities that will explore the underlying cause, not putting a bandaid over the surface issue.

If you live in South Carolina or Tennessee and are interested in mental health counseling, you can schedule a 20min free consultation with a licensed professional counselor by following the link below!