Wherever you look in the research literature, you will see research articles praising cognitive behavioral therapy (CBT). Despite the best efforts of the pharmaceutical industry, the academic researchers have managed to maintain enough independence to challenge the assumption that drugs are the best way of treating any disease or disorder. But it’s all very well for researchers to write articles. This is only useful information if the world changes a little. The are two key changes required. The first comes in the attitude of hospitals and the top physicians. The healthcare services industry is built on a for-profit model that makes the most efficient use of the smallest number of employees to deliver care to the maximum possible number of patients. Unfortunately, one-to-one therapy is an expensive way to use the time of any senior member of staff. Unless you create a new departmental empire for the senior staff to run, they will not support the move to provide CBT, and the hospital will refuse because it will not make enough money unless. . . The second change would have to come from the health insurance industry. The insurers have been hit by regularly increasing medical costs, all of which have been passed on to you as higher premiums. The insurers would have to adjust their payment strategies to prefer short-term therapy costs to long-term drug costs.
So what exactly is CBT? In a way the label is the answer. “Cognitive” = thinking. “Behavior” is easily defined. This is a short-term therapy designed to give you strategies for coping in your present circumstances, i.e. you focus on what you need to do “now”. You are encouraged to look for the cause and effect of what you think and how you act. This is not the same as classical psychological analysis which looks back in time for the deep-rooted causes of problems. This is a practical survival course. If you have a phobia, how do you overcome it? If you cannot go into a crowded room because of social anxiety disorder, what can be done? This makes it good for moderate anxiety states and it has proved a cheap way of helping people learn basic survival skills.
Like all emerging disciplines, it has been staking out its claim for leadership in the field of therapy and counseling. It has therefore made enemies. They accuse it of making exaggerated claims for its success rates. Quick fixes are just that, i.e. if you think of a car, a “fix” is often only good for a short time before full repairs have to be made. Nevertheless, CBT is rising to the top of the heap because it’s more positive. It reacts to situations rather than merely offering general advice as counseling.
In all this, there’s still a place for drug therapy. Because CBT resources are in short supply right now, there can be delays before getting an appointment. During this time, using Valium over the short-term keeps your anxiety under control and gives the therapist a better chance once the first appointment comes around. One of the first things that will be discussed is whether you will continue the Valium. It’s a high priority to taper off your reliance on drugs as soon as possible. That way, you can have a strategy for life without Valium or any comparable drug.