No Evidence of the Effectiveness of Psychotherapy? – 3 New Things

This week I learned three new things about psychotherapy and depression.

I’m a fan of psychotherapy for everyone. In fact, if we could get the mid-East folks to sit down for some good counselling, I think it would be more effective in bringing peace than anything you can do with a gun.

With that said, there are limitations to therapy and sometimes therapy is not all it’s cracked up to be. So this week, a look at three perspectives on psychotherapy:

  • Psychotherapy is no better than placebo in treating depression?
  • Which type of psychotherapy is better for depression?
  • How does psychotherapy change the brain?

1. Is Psychotherapy Better Than a Placebo in Treating Depression?

When the study came out  a couple of years ago alleging that antidepressants were no better at treating mild-to-moderate depression than a placebo, the antipsychiatry world went crazy (if you will). All their dire claims, it seems, had been proven true.

Well, the sky hasn’t fallen yet, but interestingly the same kind of analysis, when applied to psychotherapy, can also allege that psychotherapy is no better than a placebo too.

Can Psychotherapy Treat Depression?Placebo for Therapy

Of course, there is no such thing as a placebo in therapy. There is no “inert” counselling session. Scientific literature attempts to compare cognitive behavioural therapy (CBT), interpersonal therapy (IP) and others against wait-listed participants and those who have received therapy not containing the specific therapeutic technique being tested. Basically, they tell a therapist not to therapy. Which is a pretty tough thing to ask a human to do. And naturally, humans aren’t going to do it well.

Does Psychotherapy Work to Treat Depression?

I would say yes, therapy, various types, including cognitive behavioural, interpersonal and supportive therapy, all help treat depression. However, some suggest the jury is still out on how effective therapy really is in treating depression.

2. What Therapy is Best for Depression?

[push]Psychologist Gary Greenberg states CBT is more of an ideology and a “method of indoctrination into the pieties of American optimism.”[/push]

When selecting a therapy for depression one has many choices but the prevailing one in the scientific community right now is cognitive behavioural therapy (CBT). Everybody loves it. It’s the golden child. CBT is a highly intellectual and analytical therapy that is short-term and action-oriented so it’s no wonder that people like it.

In the same article as the one talking about therapy effectiveness in the treatment of depression, they also discuss which therapy is best for depression, and it kind of seems like none of the therapies are best. (This could be because, statistically, some people respond better to one treatment while others respond to other treatments and when you lump them all together, a similar percentage responds to each.)

3. What Does Psychotherapy Do to the Brain?

As I have mentioned several times, depression decreases brain volumes over time – ie, depression shrinks your brain. It does this through decreasing neurogenesis (the creation of new neurons); however, electroconvulsive therapy (ECT) and antidepressants have both been shown to increase neurogenesis and brain volume.

Interestingly, so does psychotherapy.

More on brain changes as a result of psychotherapy here.

Until next week all. I’ll learn more and do better.

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