Do Psychological Therapies Work?
The increasing use of psychological therapies, either as the primary therapy or as a supplement to medication, suggests they can be effective. But do psychological therapies work in all cases or are some better than others? In this Sharepost my focus is on the efficacy of psychological techniques for panic disorder, social phobia and generalized anxiety disorder.
It is well known that tricyclic antidepressants and benzodiazepines (e.g. Valium) can reduce anxiety. The problem in both cases is their use tends to be a short-term solution. All drugs carry the problem of side-effects and relatively high relapse rates when it is withdrawn. However, controlled studies comparing the effects of cognitive behavioral therapy (CBT) with medication tends to find CBT more effective. After six months or more of treatment some estimates point to a 40 percent relapse rate with drugs compared with a five percent relapse rate with CBT.
Most research evidence for the effectiveness of treatments is relatively recent. This is mainly due to the variety of techniques that have been developed over a comparatively short time period. Evaluations of exposure and cognitive restructuring techniques suggest a fairly modest 38 percent success rate, whereas group CBT may be as high as 65 percent. Until the evidence accumulates the picture remains somewhat blurry as to which technique or combination of techniques is most effective.
Generalized Anxiety Disorder (GAD):
As with panic, the use of benzodiazepines is really a short-term measure. To date, the use of Buspirone, which appears to have an effect on GAD, is less likely to produce the number of side effects seen with drugs such as Valium. In terms of psychological therapies, CBT compared with other behavioral-based therapies, appears to result in more pronounced and more stable changes. Long term gains appear more likely with CBT than with drug-only therapies.
Very often it is the combination of one or more drugs along with psychological therapies that provides a springboard from which to progress. When it comes to psychological therapies there are no guarantees of effectiveness in all cases. In this respect it is no different to drugs. However, when compared to drug-only therapy, there is ample evidence to show that psychological therapies are more likely to succeed in the long-term.