When “Evidence-Based” Isn’t Enough

CBT has become the go-to recommendation for almost everything — depression, anxiety, trauma, low self-esteem, OCD. It’s structured, short term, measurable, and easy to research and report. That’s why it ticks the “evidence-based” box so well. It fits neatly into the frameworks preferred by funding bodies and institutions — systems driven by targets, time limits, and budgets. But does that mean it’s what everyone needs?

CBT can be helpful — for some. It can bring awareness to thought patterns, offer tools for managing distress, and can create a sense of control. But what if your pain isn’t a faulty thought? What if your distress is rooted in loss, abandonment, childhood trauma, or years of never being seen?

CBT doesn’t always go there. It’s not designed to. It often bypasses the deeper layers — the complex, relational, emotional landscapes where real transformation happens. Where pain isn’t “irrational,” it’s human. And where so called "unhelpful thinking" is often a strategy that once helped you survive.

When therapy becomes just about symptom reduction or reprogramming your thinking to make you function better in a world that often demands too much and understands too little, it can miss the point. You are not a collection of thoughts deemed distorted by a manual. You’re a person — with a history, with longings, with a story that deserves to be heard, not “corrected.”

Evidence matters. But not all evidence fits into a spreadsheet. What helps one person might not help another. And sometimes the most powerful evidence of change is felt, not measured — in the quiet shift that happens when someone finally feels safe enough to be themselves.