A young, sullen woman in her mid-thirties lays on a couch, speaking of her dissatisfaction with life, while her bearded, middle –aged, male therapist looks through his spectacles and provides bits of insight into her mother’s contribution to her beliefs that she is inadequate and unworthy of love and happiness.
We’ve all seen this mockery of psychotherapy. And, many of us know that this illustration paints an inaccurate and devaluing picture of therapy. Nevertheless, it has created an enduring hesitancy and reluctance to seek psychotherapy when in distress. Somehow, this portrayal persists in our culture’s presumptive vision of the therapy office.
That being said, this is far from modern Evidence-Based Practice (EBP). Like our medical counterparts, psychology has moved further and further along the path of establishing standards of care for psychological treatments based on rigorous, scientific study. In fact, to date, over 140 treatment protocols have been identified as empirically-supported (EST), evidence-based treatments (EBT). The trouble is: how do consumers learn what “best practices” and “first line treatments” are prescribed for the difficulties they are experiencing? How does one find Therapy That Works?
In a society that has come to view mental illness as “a chemical imbalance” and that looks toward medication to “cure” or “fix” this brain malfunction, psychotherapy is often overlooked as effective mental health treatment. However, evidence-based psychotherapy has been demonstrated to be as effective as medication for a number of clinical disorders.
Obsessive-compulsive disorder, for example, has a well-established biological basis (to simplify that which is known, there are are low serotonin levels and dysfunction in the caudate nucleus and putaman). This abnormality can be demonstrated by functional neuroimaging studies. Studies have demonstrated that both treatment with selective serotonin reuptake inhibitors (SSRIs) and cognitive-behavioral therapy (CBT) have resulted in significant changes in regional brain functioning. Moreover, there was no significant difference between the changes made by a course of pharmacological treatment and the changes made by a course of CBT. In other words, both worked equally well. Take that, prescription pad!
Among the most scientifically-supported treatments are cognitive behavioral therapies which aim to help individuals change the ways in which they think about themselves and their world in order to change their emotional experiences, which in turn, affects their behavior, thereby creating more adaptive, functioning and reducing or eliminating symptoms. There are a number of evidence-based treatments, including CBT, as well as others, that are effective in improving daily functioning and, in a society full of a variety of practitioners, it is in the best interest of consumers to be informed.
All therapies are “not created equal.” Not all therapists are trained to provide evidence-based treatments for specific presenting problems. And, not all therapists practice these “best practices.”
Being an informed healthcare consumer is essential to identifying and accessing effective treatment. Here are a few great resources to identify Therapy That Works:
- Society of Clinical Psychology, Division 12 of the American Psychological Association hosts a website on the Research-Supported Psychological Treatments where consumers may search for effective treatments by therapy name or by psychiatric disorder.
- The Association for Behavioral and Cognitive Therapies makes information available on the basics of evidence-based treatments, including common questions.
- EBPP.org (Evidence Based Behavioral Practice) is a project funded by the National Institutes of Health which aims to educate the public and mental health practitioners about evidence based practice.
So, if you or a loved one is struggling with emotional distress, be informed and arm yourself with the knowledge to seek Therapy That Works.
Up next, now that I know what works, how do I find a therapist who provides these treatments?