Mental-health care has come a long way since the remedy of choice was trepanation — drilling holes into the skull to release “evil spirits.” Over the last 30 years, treatments like cognitive-behavioral therapy, dialectical behavior therapy and family-based treatment have been shown effective for ailments ranging from anxiety and depression to post-traumatic stress disorder and eating disorders.
The trouble is, surprisingly few patients actually get these kinds of evidence-based treatments once they land on the couch — especially not cognitive behavioral therapy. In 2009, a meta-analysis conducted by leading mental-health researchers found that psychiatric patients in the United States and Britain rarely receive C.B.T., despite numerous trials demonstrating its effectiveness in treating common disorders. One survey of nearly 2,300 psychologists in the United States found that 69 percent used C.B.T. only part time or in combination with other therapies to treat depression and anxiety.
C.B.T. refers to a number of structured, directive types of psychotherapy that focus on the thoughts behind a patient’s feelings and that often include exposure therapy and other activities.
Instead, many patients are subjected to a kind of dim-sum approach — a little of this, a little of that, much of it derived more from the therapist’s biases and training than from the latest research findings. And even professionals who claim to use evidence-based treatments rarely do.
It’s refreshing to see such a prominent and well known newspaper advocating for Evidence Based Therapy (EBT). The dominance of non scientific/evidence based treatment is especially rampant when it comes to patients with substance abuse problems.
As Cindy Brody stated on a CMC blog, the list of questions posed at the end of the Times article could quite helpful to anyone looking for a therapist more versed in EBT’s.
Looking for a good therapist, one that can help you most effectively address the challenges you want to work on, is a daunting task. Different experts will sometimes give wildly divergent opinions as to what can best help you. Educating yourself about the types of treatment, training, etc that have been shown to be the most impactful will help you navigate this system and pick someone who you not only feel comfortable with, but who also has the skill set best suited for your needs. In terms of additional questions to ask when seeking addiction treatment specifically, Anne Fletcher’s new book, Inside Rehab, provides a fantastic list to help you discriminate between the tons of programs that supposedly use evidence based practices, and find those that actually use the ones you need based on your individual situation.