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Coaching Chronicles Part II: Downsides of CBT

I have supported clients with this technique, but note that it isn't suitable for everyone. It is not something I often use with Grief Recovery Work, but can be very powerful for highly motivated individuals that are wanting to transform their lives - or just a small part of it.

I know some coaches specialise deeply in this therapy, however it really can't be used in isolation for everyone. There are some potential downsides or limitations associated with CBT that I've seen as a Coach, and also that are recognised more broadly:

Not a One-Size-Fits-All Approach!

CBT is a structured and goal-oriented therapy, which may not resonate with individuals who prefer more open-ended or exploratory therapeutic approaches. Some people may find it too directive or rigid.

Limited Focus on Past Trauma

CBT primarily focuses on the present and future, often with less emphasis on exploring past traumas or deeply rooted psychological issues. Individuals with complex trauma histories may require a more comprehensive therapeutic approach.

Requires active participation

CBT requires active participation and effort from the client. Those who are not ready or motivated to engage in self-reflection and homework assignments may not benefit as much from this approach.

Reliance on cognitive skills

Some individuals may struggle with the cognitive aspects of CBT, particularly if they have cognitive deficits or disorders that affect their thinking abilities. I have often supplemented art therapy to support these components.

Short-term focus

CBT is often considered a short-term therapy, and while it can provide significant relief and coping skills in a relatively brief time, individuals with chronic or deeply ingrained issues may require longer-term treatment. Essentially if the reliance becomes too heavy on sessions with the therapist and the person isn't integrating what is learned, then this is quite a short-term focus. It can provide relief, but then other therapies would need to be introduced.

Not suitable for severe mental illness

CBT may not be the primary treatment for severe mental illnesses such as schizophrenia or bipolar disorder. These conditions often require medication and more specialised therapeutic approaches.

May not address underlying causes

While CBT is effective in managing symptoms and changing thought patterns, it may not always address the underlying root causes of mental health issues, especially if they are related to external factors like socioeconomic issues or systemic factors.

Homework & Self-Work

CBT often involves homework assignments and self-monitoring, which can be challenging for individuals with time constraints, limited resources, or low motivation.

Reliance on therapist competency

The effectiveness of CBT can vary based on the competence and skill of the therapist. Not all therapists are equally proficient in delivering CBT, which can impact the quality of treatment.

Emphasis on positive thinking

While changing negative thought patterns is a key component of CBT, some individuals may find the emphasis on positive thinking unrealistic or overly simplistic.

I have found that point 8 - homework, self work and people remaining focused is often the biggest challenge for even highly motivated individuals.

It's important to note that the downsides of CBT don't apply to everyone, and CBT can still be a highly effective form of treatment for many people. The choice of therapy is made in consultation with a qualified mental health professional who can assess an individual's specific needs and circumstances. Additionally, some of the limitations of CBT can be mitigated through modifications or by combining CBT with other therapeutic approaches when necessary.


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