The hegemony of cognitive-behaviour therapy in modern mental health care
Abstract
Cognitive-behaviour therapy (CBT) has been a central plank in the mental health policies of many Anglophone countries in recent years. This emphasis reflects the triumph of modern rationalism in two senses. First, the appeal of CBT to policy makers rests largely on its claims of being evidenced-based and quickly effective. Second, it is committed to a view of eudemonia (the good life) in which rationality predominates over non-rationality to generate the greatest happiness for the greatest number. Both aspects, which appeal to policy makers, warrant sociological interrogation. This article provides a brief history of CBT to highlight the rhetoric of rationalism it has espoused successfully. Then, using the UK Depression Report as a point of departure, it compares this success of CBT with the criticisms it has encountered. Both positions of advocacy and critique are examined in relation to disciplinary knowledge and professional interest work. These orientations from poststructuralist accounts of the modern episteme, on the one hand, and neo-Weberian sociology of the professions, on the other, help us understand the current controversy surrounding CBT.
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CBT most directly targets cognition and the mastery system, partially impacts survival (coping) processes, and has only minimal impact on attachment or spirituality.
“It can be argued that CBT most directly targets cognition and the mastery system, partially impacts survival (coping) processes, and has only minimal impact on attachment or spirituality (Bosmans, 2016; Pilgrim, 2011; Stewart-Sicking, 2015).”
From A hope intervention for adolescents: a randomized controlled trial delivered by paraprofessionals (2025) · cites this paper as Pilgrim, 2011
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- Authors
- Pilgrim, D.
- Affiliations
- University of Lancashire (GB)
- Corresponding author
- Pilgrim, David
- ORCID
- Pilgrim, David
- Venue
- Health Sociology Review
- Publisher
- Informa UK Limited
- Published
- 2011-06
- Volume
- 20
- Issue
- 2
- Pages
- 120-132
- ISSN
- 1446-1242 (ISSN-L)
- 1839-3551
- OpenAlex
- W2085899221
- Cited by
- 29
- References
- 26
- Citations by year
- 2025: 2 · 2024: 2 · 2023: 1 · 2022: 2 · 2021: 3 · 2020: 2 · 2019: 1 · 2018: 2 · 2017: 1 · 2016: 3 · 2015: 5 · 2014: 1 · 2013: 2 · 2012: 2
- FWCI
- 1.72
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Health Sociology Review (publishedVersion)
- CLOK (University of Central Lancashire) (submittedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychology and Mental Health
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
- Social Sciences › Psychology › Clinical Psychology › Historical Psychiatry and Medical Practices
- Keywords
- cognitive behavioral therapy, mental health policy, rationalism, evidence-based practice, sociology of professions, disciplinary knowledge, mental health services
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