Effectiveness of Therapy

Do people still lie on a couch in therapy? Do they talk deeply about their feelings? Does it even work?

• What is psychotherapy?
• What are different forms of therapy?
• How do we know if a therapy is effective?
• What therapy is effective for depression?
• What therapy is effective for anxiety?

Effectiveness of Therapy Definition

So we've heard of the term therapy, but what is psychotherapy? Are there any differences? Does it actually work?

Psychotherapy is pretty much the same as therapy! The only difference is that when you say psychotherapy, it specifically means it's relating to mental health. You could say therapy and someone might think you're going to rehab your pulled muscle, but if you say psychotherapy, someone will know it's not for a bodily muscle. There are varying forms of psychotherapy, many of which are effective for different mental health illnesses.

Fg. 1 Does the patient still lie on a couch in therapy? pixabay.com.

How do you Measure Effectiveness?

It is important to remember when discussing the effectiveness of therapies is that it is a difficult concept to measure, as are mental health disorders in the first place. Is there a concrete way to measure this or do you have to trust what the patient says? As a clinician, can you see a change or do you base your entire diagnosis and course of therapy on what the patient tells you? Are patients getting better or is it just cognitive dissonance?

Skeptics of therapy say that patients will report that therapy improved their well-being because when they started therapy they were in such a crisis that merely since that crisis has stopped they credit their change to therapy. Skeptics also comment on the therapists' reports of the effectiveness of therapy. They say that therapists will remember the positive comments and compliments, but what about the people who left their treatment and never got better in the long run? Those ex-patients would probably not go back and tell their old therapist that it didn't work.

Keep in mind that the results from studies measuring effectiveness might not present the entire truth.

Forms of Psychotherapy

So now that we know what psychotherapy is, let's take a quick look at different forms of psychotherapy before we dive into how effective they are.

Behavioral Therapy

Behavioral therapy focuses on changing unwanted behaviors. If someone changes their bad or unwanted behaviors, then they can improve.

Exposure Therapy

Exposure therapy falls under the umbrella of behavioral therapy. It is typically used with people with phobias and anxiety disorders. In a safe environment, the person will be gradually exposed to something that they are scared or anxious of.

Cognitive Therapy

Cognitive therapy focuses on changing thoughts. If someone changes their thoughts, their behaviors can then improve.

Cognitive Behavioral Therapy (CBT)

CBT focuses on having someone change their thoughts, thought processes, and behaviors in order to help them with their mental health disorder. If they change the way they think about and respond to a situation, they will be better suited for it in the future.

Dialectical Behavioral Therapy (DBT)

DBT is the sibling of CBT! DBT is very similar to CBT but is tailored to specifically treat borderline personality disorder, focusing on emotional regulation and how to handle distress.

Effectiveness of Therapy for Depression

When someone is diagnosed with depression (called major depressive disorder if you want to use its clinical name), they have two main routes for treatment if they choose to do so. The first one is selective serotonin reuptake inhibitors, also called SSRIs. SSRIs are an anti-depressant medication whose job is to block certain neurotransmitters (such as serotonin which makes you happy) from entering neurons. The more serotonin hanging out in the brain and not in neurons has a great chance of causing an increase in mood.

The second possibility for treatment for someone diagnosed with depression is psychotherapy! For people with depression, the most common form of therapy is cognitive behavioral therapy, CBT. Therapists work with their patients on targeting the negative thoughts and behaviors and work on changing those detrimental patterns.

Is it Effective?

Studies have shown that CBT is effective in helping treat symptoms of depression. When researchers are examining this, they are comparing people with depression who are receiving therapy to people with depression who are not receiving therapy. In both categories, people do get better, but more so for those with treatment. Studies have found that there is less relapse and fewer symptoms after someone goes through CBT.

Depression, unlike specific phobia, does not have one core feature for the therapist to work on to help the patient. For someone with specific phobia, the therapist knows exactly what to target the therapy towards. Since depression has a less specific problem, studies have found that therapy is less effective than if there is one specific problem being addressed.

Reports have shown that therapy on its own is often not as effective as it is when combined with SSRIs. Typically, for those with depression, it is a combination of both of these methods of treatment that produce the largest change. CBT can do a lot on its own, but for many people with depression, can do even more when paired with medication.

Effectiveness of Therapy for Anxiety

People who are diagnosed with anxiety can also treat it with medications and/or therapy. SSRIs have been used to treat people with anxiety. Along with SSRIs, benzodiazepines, antihistamines, and beta-blockers are all other possible medications prescribed for someone diagnosed with anxiety.