Psychotherapy Better Than CBT Or Meds Alone
> 1/31/2010 5:12:39 PM

Much of the public believes that psychodynamic personal therapy is less scientific than practices centered on medication or behavioral treatments because it hasn't been supported by clinical research. And fewer Americans are seeking psychotherapy. A study sponsored by the American Psychological Association, however, found that subjects involved in ongoing personal therapy regimens not only showed significant improvements but that these benefits could be observed long after treatment periods ended.

Due to the somewhat imprecise nature of measuring personal therapy's ultimate success rates, available research is somewhat limited. But researchers still drew from a large pool of data, reviewing eight previous meta-analyses that encompassed more than 160 long-term studies of subjects undergoing personal therapy. In order to compare and contrast, they also included nine analyses of alternate treatments like cognitive behavioral (CBT) and medication-based therapy.

The key phrase in this new report is "effect size," a number representing the cumulative symptomatic improvement of subjects in the studies considered. If subjects in a given study demonstrate an effect size of 8.0 or higher, the success rates of the treatments in question are said to be significant. The final effect size for the largest meta-analysis used in this study was 9.7, while the highest numbers recorded for popular antidepressant meds hover in the 3.5-4.0 range. This is a very significant finding suggesting that personal therapy is, in the end, far more effective than meds alone. Researchers' most surprising and important conclusion: subjects on the whole continued to improve even months after they'd stopped attending weekly therapy sessions, while the benefits of most other therapies have been observed to decrease over time. Authors also noted that personal therapy led to symptomatic improvements even among those with personality disorders & chronic conditions, like schizophrenia, that usually have a profound effect on subjects' lives.

Does this study silence all debate? Of course not. Comparable reports based on independent data sets are needed to shore up its authors' conclusions. It's not surprising that our quick-fix culture remains somewhat skeptical of personal therapy, which can grow to be a costly form of treatment over time. Researchers aimed, in part, to dispel the widely held opinion that newer, time-limited approaches like cognitive behavioral therapy deliver more concrete results than classic personal therapy. In that sense, they succeeded, encountering no evidence of modern therapies' supposed superiority. They also noted that psychodynamic models often apply to seemingly unrelated practices - psychiatrists, for example, often encourage self-reflection and the extended analysis of personal relationships in addition to prescribing medications.

Most insurance plans offer little or no coverage for personal therapy. We hope that studies like this one can help convince responsible companies to re-evaluate their policies. In an industry obsessed with short-term results, this reluctance to consider psychotherapy is unfortunate but understandable. Still, it's hard to argue against using an approach that so obviously improves the lives of millions who struggle with chronic mental illness.

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