Does Psychotherapy Really Work? Does the talking cure, in fact, cure?

Psychotherapy is a profession whose mainspring is love. Nearly everyone who visits a therapist has a love disorder, and each has a story to tell — of love lost or denied, love twisted or betrayed, love perverted or shackled to violence. — Diane Ackerman

Psychotherapy, often referred to as talk therapy, is a form of treatment that utilizes communication as a tool to help people overcome various mental health issues and emotional difficulties. Despite its long history and widespread use, the effectiveness of psychotherapy continues to be a subject of considerable debate. However, empirical evidence suggests that psychotherapy can have significant benefits for individuals dealing with mental health issues.

The Efficacy of Psychotherapy

Numerous research studies have consistently affirmed the efficacy of psychotherapy. A meta-analysis by Barkham & Lambert (2021) demonstrated that the average person who participates in psychotherapy is better off by almost 80% than those who don’t receive any form of treatment. Moreover, the American Psychological Association (APA) highlights that therapy effectively decreases individuals’ depressive and anxiety symptoms, improves their quality of life, and enhances their ability to cope with different life challenges (APA, 2013).

Various studies have also revealed the long-term benefits of psychotherapy. In a study conducted by Hollon et al. (2005), patients who underwent cognitive therapy for depression showed significantly lower relapse rates compared to those who only used medication. This underscores that psychotherapy, apart from providing immediate relief, equips individuals with the skills to manage future mental health challenges effectively.

Specific Therapy Types

The effectiveness of psychotherapy is not limited to a single modality or approach. Instead, several types of psychotherapy demonstrate consistent, positive outcomes. Cognitive-behavioral therapy (CBT), for instance, has been shown to be effective in treating conditions like depression, anxiety, and post-traumatic stress disorder (Hofmann, Asnaani, Vonk, Sawyer, & Fang, 2012). Similarly, dialectical behavior therapy (DBT) has been found to be effective in treating borderline personality disorder and other related conditions (Linehan et al., 2006).

In my early professional years I was asking the question, How can I treat, or cure, or change this person? Now I would phrase the question in this way: How can I provide a relationship which this person may use for his own personal growth? — Carl Rogers

Psychotherapy and Medication

Another important aspect to consider is the interaction between psychotherapy and medication. In many cases, combining medication with psychotherapy can enhance treatment outcomes. A systematic review by Cuijpers et al. (2014) suggested that combining antidepressant medication with psychotherapy for depression can be more effective than using either intervention alone.

However, it’s crucial to note that medication should not be considered a replacement for psychotherapy. Rather, it often serves as a helpful adjunct, particularly in cases of severe mental health issues. Furthermore, psychotherapy can offer certain benefits that medication does not, including helping individuals understand their condition, learn coping skills, improve relationships, and reduce the likelihood of relapse.

Barriers to Psychotherapy Effectiveness

Despite the evidence supporting psychotherapy’s effectiveness, there exist potential barriers that can hinder its efficacy. These include the quality of the therapeutic alliance, the skill of the therapist, cultural appropriateness of interventions, and client motivation and engagement (Norcross & Wampold, 2011). As such, it’s essential to continuously evaluate and modify treatment plans to ensure they meet individual needs.

While the effectiveness of psychotherapy can vary among individuals and conditions, the preponderance of research evidence suggests that it is an effective treatment for a variety of mental health issues. Combining psychotherapy with medication, if appropriate, can further enhance treatment outcomes. Recognizing and addressing potential barriers to its effectiveness is also critical to ensure successful therapeutic outcomes.

References

American Psychological Association. (2013). Recognition of psychotherapy effectiveness. Psychotherapy, 50(1), 102–109. https://doi.org/10.1037/a0030276

Barkham, M., & Lambert, M. J. (2021). The efficacy and effectiveness of psychological therapies. In M. Barkham, W. Lutz, & L. G. Castonguay (Eds.), Bergin and Garfield’s handbook of psychotherapy and behavior change: 7th edition (pp. 135–189). John Wiley & Sons, Inc..

Cuijpers, P., Karyotaki, E., Weitz, E., Andersson, G., Hollon, S. D., & van Straten, A. (2014). The effects of psychotherapies for major depression in adults on remission, recovery, and improvement: a meta-analysis. Journal of Affective Disorders, 159, 118–126..

Hofmann, S. G., Asnaani, A., Vonk, I. J., Sawyer, A. T., & Fang, A. (2012). The efficacy of cognitive behavioral therapy: A review of meta-analyses. Cognitive Therapy and Research, 36(5), 427–440.

Hollon, S. D., DeRubeis, R. J., Shelton, R. C., Amsterdam, J. D., Salomon, R. M., O’Reardon, J. P., Lovett, M. L., Young, P. R., Hanman, K. L., Freeman, B. B., & Gallop, R. (2005). Prevention of relapse following cognitive therapy vs medications in moderate to severe depression. Archives of General Psychiatry, 62(4), 417–422.

Linehan, M. M., Comtois, K. A., Murray, A. M., Brown, M. Z., Gallop, R. J., Heard, H. L., Korslund, K. E., Tutek, D. A., Reynolds, S. K., & Lindenboim, N. (2006). Two-year randomized controlled trial and follow-up of dialectical behavior therapy vs therapy by experts for suicidal behaviors and borderline personality disorder. Archives of General Psychiatry, 63(7), 757–766.

Norcross, J. C., & Wampold, B. E. (2011). Evidence-based therapy relationships: Research conclusions and clinical practices. Psychotherapy, 48(1), 98.