Some patients say that psychotherapy (without medication) is helpful less than half the time! Though this percentage varies depending on diagnosis and much of the reporting is anecdotal, there is at a detailed and well-done 2003-2004 study that focuses on depression and its treatment. SAMHSA, the federal Substance Abuse and Mental Health Services Administration, reports that:

Adults with depression in the past year who received medication as well as talked to a professional were most likely to perceive their treatment as extremely helpful or helped a lot.

… [But] Of the adults who talked with a doctor or other professional for their depression [and didn’t receive medication], 40.5% reported it as extremely helpful or helped a lot, 29.2% reported that it offered some help, and 30.2% reported it was little or no help.

… [And] Of the adults who received medication for their depression, 52.7% reported it as extremely helpful or helped a lot, 28.0% reported that it offered some help, and 19.3% reported it was little or no help.

It’s unbelievable. Nearly one-third of patients with depression reported that therapy was pretty much useless. Can you imagine if antibiotics or a particular surgery failed a third of the time? Would the FDA allow this to continue? What if your car’s brakes were little or no help a third of the time? Psychotherapy is a health and safety issue, too.

Perhaps more questions need to be asked, such as: What were the professionals who were treating the 40.5% of patients who said it was “extremely helpful or helped a lot,” doing right? What methods, techniques, and therapy tools did these psychotherapists use? How did these patients find these therapists—were they referred by a doctor or other professional? Where do these therapists practice—in a particular state or region; in an outpatient clinic, inpatient program, or in private practice? Where did these therapists get their training? What were their credentials?

Responsibility for successful treatment lies with the therapist.

Recalcitrant or unmotivated patients must be inspired and motivated to succeed in their therapeutic goals. If goals are set and not met in a reasonable time-frame, then therapists are obligated to try new approaches or refer the patient to a therapist who has more experience in treating patients with particular issues. If personality disorders or any other problem exists that might be considered challenging to both patients and therapists, then specific training in evidence-based treatments must be acquired, or again, the patient should be referred to a therapist with skills and proven success with these issues.

For more on this issue, please listen to this brief MP3 of Michael Dresser and me discussing the Therapy Crisis and Solutions on the Dresser After Dark radio show, or on BlogTalkRadio as part of a collection of interviews with a variety of interesting guests.

The first edition of our monthly newsletter, Cup of Soup, is coming out in a couple of days. You can subscribe at www.richardzwolinski.com. Please let us know what topics you would like us to write about.

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    Last reviewed: 19 Feb 2010