Despite the evidence, a decline Between 1998 and 2007 the percentage of patients in outpatient mental health facilities receiving psychotherapy alone fell from 15.9 percent to 10.5 percent, while the percentage of patients receiving medication alone increased from 44.1 percent to 57.4 percent. Credit: Olfson & Marcus, 2010
Psychotherapy has issues. Evidence shows that some psychosocial treatments work well for common mental health problems such as anxiety and depression and that consumers often prefer them to medication. Yet the use of psychotherapy is on a clear decline in the United States. In a set of research review papers in the November issue of the journal Clinical Psychology Review, psychologists put psychotherapy on the proverbial couch to examine why it’s foundering.
Their diagnosis? Much as in many human patients, psychotherapy has a combination of problems. Some of them are of its own making while some come from outside the field itself. Fundamentally, argue Brandon Gaudiano and Ivan Miller, Brown University professors of psychiatry and human behavior whose review paper introduces the section they edited, the psychotherapy community hasn’t defined, embraced, and articulated the ample evidence base clarifying their practice, while drug makers and prescribers have done so for medications. In a system of medicine and health insurance
that rewards evidence-based practice and looks upon biology as a more rigorous science, psychotherapy has lost ground among physicians, insurers and policymakers.
Starting in the 1950s Carl Rogers brought Person-centered psychotherapy into mainstream focus. (Photo credit: Wikipedia)
“One might think that this deep and expanding evidence base would have promoted a similar increase in the use of psychosocial interventions that at least would have paralleled the one witnessed over the recent years by psychotropics, but it decidedly has not,” Gaudiano and Miller wrote. “Thus a time that should have been a relative boon for psychotherapy based on scientific standards has become more of a bust.”
Specifically, between 1998 and 2007 the proportion of patients in outpatient mental health facilities receiving psychotherapy alone fell from 15.9 percent to 10.5 percent, while the number of patients receiving medication alone increased from 44.1 percent to 57.4 percent, according to a 2010 study in the American Journal of Psychiatry. Depressed patients receiving both psychotherapy and medication fell from 40 percent to 32.1 percent. Psychotherapy was once in the picture for more than half such patients but is not now.
I have been an addiction professional and social worker since 1994. I started blogging in 2005 as the Clinical Director at Dawn Farm. I no longer work at Dawn Farm and am now the Director of Behavioral Medicine at a community hospital, and a lecturer at Eastern Michigan University’s School of Social Work.
Views expressed here are my own.
Keep in mind that the field, the contexts in which the field operates, and my views have changed over time.
View all posts by Jason Schwartz
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2 thoughts on “Why is talk therapy going out of favor?”
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