The most common therapy modality in the US is Cognitive Behavioral Therapy (CBT) or what is commonly referred to as talk therapy. The focus of CBT is on identifying and revising distorted thoughts and belief systems that create stress or other disturbances in people’s lives and relationships. This modality involves reality testing and establishing new behavioral habits that help people cope better with their situation.
However, even while CBT is considered an evidence based practice, the effectiveness is quite limited. In a large scale study conducted by the National Institute of Mental Health looking at CBT for depression (Treatment of Depression Collaborative Research Program), CBT was only 1.2 points better than no therapy on a 54 point Hamilton depression scale. In this and other trials, CBT had an effectiveness rate ranging between 17% and 24% under the most ideal, rarified laboratory conditions. In real world circumstances, we see CBT's effectiveness decrease to the 5% mark. These results for the effectiveness of CBT have remained consistent from that early trial to much more recent studies which is to say the state of the art in evidence based psychotherapy yields a 75% to 95% failure rate for the treatment of depression.
If we turn our attention to CBT and post traumatic stress disorder (PTSD), the randomized control trial data used by the American Psychological Association to recommend CBT as a trauma treatment is even more problematic. Excerpting from Jonathan Shedler’s excellent summary article on the topic: