Eficacitatea terapiilor cognitiv-comportamentale din a treia generaţie – o analiză narativă a literaturii

Cognitive-behavioral therapies (CBTs) do not represent a single, conceptual and practical, psychosocial intervention, but a developing group of directive, structured, collaborative psychotherapies, which benefit from an important level of evidence, according to the results of many randomized clinical trials. As a consequence, these therapies are recommended by clinical guidelines and international best practice guidelines for a wide range of mental disorders. Due to their format that allows the operationalization of key concepts and structured application in clinical settings, CBTs allow for monitoring the evolution of symptoms through psychometric tools and validation of results through statistical analysis. CBTs have evolved over time, starting from interventions based on operant conditioning and classical, Pavlovian, learning, passing through the influence of cognitivism, to the holistic paradigm, which incorporates oriental techniques, along with classical methods. The focus of the therapeutic approach also changed, from the content of thinking to the thought process. Metacognitive therapy, acceptance and commitment therapy, dialectical behavior therapy, compassion-based therapy and cognitive therapy based on mindfulness are the most important representatives of the new generation of cognitive-behavioral therapies. Their area of ​​applicability is wide and their effectiveness is variable, being proven especially for depressive and anxiety spectrum disorders, but with some peculiarities in the field of personality disorders (especially borderline for dialectical behavior therapy), psychotic disorders, eating disorders, stress-related pathology, ADHD etc. It is important to encourage the research in the field of CBTs, especially because of the need to support adjuvant therapies in pharmacotherapy-resistant cases. CBTs may also be recommended as first-line therapy in patients who request an evidence-based psychosocial intervention, when certain psychiatric disorders are of mild intensity (e.g. anxiety, stress-related or depressive disorders) or when there are clear contraindications for the use of another treatment.