Key points

CBT practitioners expect patients to be engaged participants in the questioning of their beliefs.

Beliefs associated with problematic behavior are more like articles of faith than anything else.

Addressing the function of a belief can transform "sacred cows" into regular issues.

There’s a lot of evidence showing that cognitive-behavioral therapy (CBT) works if by “works,” you mean it provides statistically significantly more symptom relief than is provided by doing nothing (Shedler, 2015, 2025). The catch is that statistical significance can mean almost no relief at all, the difference of a couple of points on a 45-point scale. It’s like saying a weight-loss program works if the average participant goes from 100 pounds overweight to 97 pounds overweight. With enough partic

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