Does Therapy Really Help?

DEPRESSION, ANXIETY, RELATIONSHIP ISSUES,
REPEATING THE SAME OLD PATTERNS. . .

Nearly 50 million Americans suffer from emotional problems.  Many individuals seek help from a psychologist or therapist and find relief.  In fact, a study conducted by Consumer Reports found that 90% of psychotherapy participants reported improvement. This study  reported that people who  chose their own therapist (as opposed to being limited to therapists on their insurance panel) reported more benefits.  The amount of time the person participated in therapy was also correlated to satisfaction--people who participated in therapy for six months or more reported more improvement than those who participated in shorter courses of therapy. 

What happens in psychotherapy is not easily described in general statements--it varies depending on the therapist and client, and the particular problems the client brings forward. There are many different methods the therapist may use to deal with the problems that you hope to address. Psychotherapy requires a very active effort on your part. In order for psychotherapy to be optimally successful, you will need to work on issues discussed in therapy, both in session and on your own.  The ultimate goal of effective psychotherapy is to for you to learn to be your own therapist.  Effective psychotherapy will teach you to observe, monitor, and adapt your own thoughts, behaviors, emotions, and motivations. 

Scientific studies (Teasdale, J.D., Moore, R.G., Hayhurst, H., Pope, M., Williams, S., & Segal, Z.V., 2002) as well as clients’ own reports (Consumer Reports, October, 2004 & November, 1995) report beneficial changes as a result of psychotherapy. Recently, current technology in brain imaging has allowed scientists to see the changes in the brain that occur as a result of psychotherapy (Goldapple, K., Segal, Z., Garson, C., Lau, M., Bieling, P., Kennedy, S., & Mayberg, H., 2004).  Therapy often leads to better relationships, solutions to specific problems, improved coping abilities, and significant reductions in feelings of distress.

 
THERAPY WORKS!

Studies conducted by Consumer Reports in 2004 & 1995 are unique in that they surveyed thousands of readers who had participated in therapy to report on the success of their treatment.  Following is information gathered from the 2004 & 1995 studies:

• “Respondents who said their therapy was ‘mostly talk’ and lasted at least 13 sessions had better outcomes than those whose therapy was ‘mostly medication.’”  (Consumer Reports, October, 2004, pg. 22)

• “Consumers who did their own research and monitored their own care reported better results.”  (Consumer Reports, October, 2004, pg. 22)

Nearly 90% of the 4,000 people who responded to the 1995 Consumer Reports survey said that they were managing life better after getting help.  The people who were the most upset at the beginning of treatment reported the most improvement. 

MENTAL HEALTH PROFESSIONALS:

Clinical psychologists graduate from college, attend four to five years of graduate school in psychology, and complete a comprehensive research project (dissertation) to earn a Ph.D.  (Psychologists who earn a Psy.D. attend a graduate program that does not require a dissertation.)  Psychologists also complete an internship (approximately 2,000 hours) and one year of postdoctoral supervised training (an additional 2,000 hours) and must pass national and state examinations to be licensed as a psychologist.  These rigorous training requirements are important to prepare psychologists for the complex problems people can bring to therapy.  Psychologists are highly skilled in assessment and treatment of emotional problems, from mild adjustment issues to serious mental illness. 

The licensing requirements for psychologists are at a higher threshold than those for Licensed Professional Counselors (LPC's) or licensed social workers (LCSW's or LMSW-AP's), which require a masters degree (rather than a doctorate) for licensure.  However, many professionals with subdoctoral licenses complete additional training and are very experienced in their fields.

Psychiatrists attend medical school (rather than graduate school in psychology), then complete a psychiatric residency.  Psychiatrists are skilled in prescribing psychotropic medications, such as antidepressants and anti-anxiety medications.  Some psychiatrists provide only medication management, while others also provide psychotherapy.  Because psychiatrists specialize in mental health and psychotropic medications, they are often preferable to general practitioners when psychotropic medications need to be adjusted and/or carefully managed.

THERAPY AND MEDICATIONS:

Psychologists licensed in the State of Texas do not prescribe medication; most psychologists, including Dr. Ware and Dr. Liss, develop a network of skilled psychiatrists to refer to for medication concerns. 

Many therapy clients choose to work in therapy without the use of medications; other therapy clients choose to utilize psychotropic medications as an adjunt to therapy.  You should feel free to discuss with Dr. Ware or Dr. Liss the benefits of seeking a medication consultation.  The ultimate decision to take psychotropic medication is one that is made by the client, with input provided by a physician.  

Current research suggests that psychotherapy is as effective as medication for some psychological issues.  Most people responding to the Consumer Reports surveys said they improved with medications alone, psychotherapy alone, or a combination of the two.  People who did not take medications and instead participated solely in psychotherapy improved about as much as people who used medication plus therapy, if the therapy lasted 13 sessions or more.  Studies also suggest that psychotherapy has more lasting benefits than medication, which intuitively makes sense as the benefits of medication stop when the medication stops. 

If a client wants to try medications, Dr. Ware and Dr. Liss will work with a psychiatrist to make sure the client gets the benefit of both approaches. 

THE MORE YOU GIVE, THE BETTER YOU GET:

Although we all would like to fix problems in our lives as quickly as possible, the Consumer Reports study showed that therapy which lasted more than six months was more effective than shorter therapies.  It has probably taken you many years to acquire the problems you bring to therapy and a therapist needs time to help you understand those problems and work them out.

Clients who are more involved in choosing a therapist and participating in therapy get better faster.  If you are considering therapy, you may want to interview two or three psychologists before you choose one.  Be prepared with a list of questions.  You may want to ask about education, years of practice, and whether or not they have treated the types of problems you bring to therapy.  Also, pay attention to how you feel talking to the therapist—there must be a good “fit” between the client and therapist for a good working relationship.

 
IN SUMMARY:

The Consumer Reports article, “Does Therapy Help?” reinforces what many other studies have found:  psychotherapy works.    The longer the treatment and the more involved the client, the more it works.  If you are considering therapy, consult with several licensed psychologists, don’t be afraid to ask questions, and choose one you are comfortable with.  You can expect to improve if you are willing to do the work.

Kate Scharff, MSW, has written a book entitled, Therapy Demystified:  An Insider's Guide to Getting the Right Help (Without Going Broke).  This book is a great resource for those wanting to know what to expect from therapy, how to choose a therapist, etc.

References

Consumer Reports:  Mental health:  Does therapy help?  November, 1995.

Consumer Reports:  Drugs vs. Talk therapy.  October, 2004. 

Goldapple, K., Segal, Z., Garson, C., Lau, M., Bieling, P., Kennedy, S., & Mayberg, H.  (2004).  Modulation of cortical-limbic pathways in major depression:  Treatment-specific effects of cognitive behavior therapy.  Archives of General Psychiatry, (61), pg. 34-41.

Scharff, Kate.  (2004).  Therapy Demystified:  An Insider's Guide to Getting the Right Help (Without Going Broke).  New York:  Marlowe & Co.

Teasdale, J.D., Moore, R.G., Hayhurst, H., Pope, M., Williams, S., & Segal, Z.V. (2002).  Metacognitive awareness and the prevention of relapse in depression:  Empirical evidence.  Journal of Consulting and Clinical Psychology, (70), 275-287.