Therapy and Medication May Be More Effective than Drugs Alone
Having been trained in counseling psychology, I've been exposed to a variety of approaches to psychotherapy. Among my very favorite modalities were cognitive-behavioral therapy (CBT) and existential therapy, perhaps because these two approaches theoretically bridged the practical and the philosophical. I've always believed that counseling and psychotherapy can provide real help to those struggling with mental health issues, except in some of the most severe circumstances.
That's why I was pleased to read about a recent study by Bristol University's school of social and community medicine that supports the use of CBT alongside antidepressant medication among depressed individuals who do not find relief from psychopharmacology alone. While mental health professionals have intuitively known that psychotherapy works all along, this was the first large-scale study that evaluated the effectiveness of CBT paired with medication against drugs by themselves in the treatment of depressive disorders.
The study included 439 individuals ranging in age from 18-75 years who had been diagnosed with depression and had been taking antidepressants for at least six weeks with no relief or improvement. The participants were then either treated with CBT in addition to the medication or simply instructed to continue the medication regimen alone. The groups were then followed and compared for a year.
The researchers found that 46% of those who received CBT in addition to medication showed a positive response to treatment, reporting at least a 50% reduction in depressive symptoms. Meanwhile, only 22% of those receiving medication alone showed improvement.
I'm so glad that such a rigorous study was undertaken in order to explore the combination of therapy and psychotropic medication. In our quick-fix society, we are often inclined to search for a magic pill to make our lives better, whether the improvement we seek is emotional, physical, or even spiritual. The reality is that most challenges in life take work to sort out and resolve - and CBT can provide an empirically-based structure to that work. If you are struggling with depression and are interested in adding CBT to your medication regimen, here are some basics about the approach:
What is CBT?
According to the National Association of Cognitive-Behavioral Therapists, CBT is "a form of psychotherapy that emphasizes the important role of thinking in how we feel and what we do."
How does CBT work?
Actually, CBT is a general approach that can take several forms. Rational emotive behavior therapy, dialectical behavior therapy, and cognitive therapy are just a few of the forms of CBT. However, all forms of CBT generally have three things in common:
- CBT assumes that our thoughts cause our feeling and behaviors, not external factors such as the people and events around us. Therefore, changing our thoughts can improve our mental health.
- CBT is relatively brief, often lasting between 15 and 20 sessions.
- CBT is instructive and directive, often involving specific homework assignments.
Where do I find a CBT therapist?
Check the databases maintained by the National Association of Cognitive-Behavioral Therapists as well as the Association for Behavioral and Cognitive Therapies for CBT therapists near you.
Wiles, N., Thomas, L., Abel, A., Ridgway, N., Turner, N., et al. (2012). Cognitive behavioral therapy as an adjunct to pharmacotherapy for primary care-based patients with treatment resistant depression: Results of the CoBalT randomized controlled trial. The Lancet, 6736(12), 61552-61559.