Scott Alexander examines a study showing no significant difference between CBT and psychodynamic therapy, challenging the idea that CBT is superior and exploring the possibility that most psychotherapies work through non-specific factors.
Longer summary
Scott Alexander discusses a recent study in the American Journal of Psychiatry comparing the efficacy of cognitive-behavioral therapy (CBT) and psychodynamic therapy for depression. The study found no significant difference between the two therapies, challenging the common belief that CBT is superior. Scott reflects on how this contradicts the 'foundation myth' of psychiatry, which claims that evidence-based therapies like CBT replaced less scientific approaches like Freudian psychoanalysis. He explores the possibility that most psychotherapies work through non-specific factors rather than their specific theories or techniques, a concept known as the Dodo Bird Verdict. Scott suggests that CBT's reputation as evidence-based may be due to its proponents conducting more studies, rather than superior efficacy. He concludes by stating his belief that only very basic, targeted therapies have specific effects, while more complex theories of the mind likely rely on non-specific factors.
Shorter summary