Oliver Burkeman’s recent Guardian article on cognitive behavioural therapy (CBT) falling out of favour prompted a raft of conversations among therapists here. There was probably less debate and more agreement. Counsellors know from their work with thousands of people that there isn’t one ‘type’ of therapy or even one therapeutic school of thought that works for everyone. We know there isn’t and never will be a single silver bullet when it comes to mental health.

But for a while CBT for adults (work with children and young people is different) certainly seemed to have that reputation, and in part that was down to the evidence it generated. Evidence for all mental health treatments is imperative but difficult. With CBT it’s easier to analyse progress. It translates well into self-help computer programmes and is relatively cheap. So it’s clear to see why it’s been heavily promoted under the Government’s IAPT (Improved Access to Psychological Therapies) programme.

What we have found, however, in our long experience of delivering service, is that people always need choice. The right approach depends on the person, but also on the issues and challenges they’re facing. The best and most effective therapists have to be excellent at forming working relationships with a client: the golden therapeutic alliance. Above all, therapists have to be self-aware and they have to keep up to date with training and skills in many therapeutic modalities.

Sometimes a CBT approach can work wonders as it can shift the client’s awareness and give them practical tools to analyse the way they see the world, feel and behave. A humanistic approach (such as person-centred for example), however, can help them understand why and how they have formed such beliefs, and importantly, to develop a sense of acceptance and safety which allows change to occur. Burkeman is right to raise the issue of trends within therapy, but most professionals know that choice and accessibility is what matters.

Elaine Bousfield
Founder and chair, XenZone