Have you ever heard of Meta-Cognitive Therapy (MCT)? How About Intolerance of Uncertainty Therapy (IUT)?
OK, how about Paxil and Prozac?
Well, two out of four ain't bad. After all, billions of dollars in combined sales and plenty of ads will occasionally get you noticed. I'm not saying that's a bad thing -- and to be clear at the outset, this is not a rant against big pharma and their evil plan to have everyone addicted to meds (legal note: the line about "evil plan" is just a joke).
No, what I am saying is that great and sometimes even superior treatments for mental health problems often go unnoticed by the general public.
Which brings me back to the first two treatments mentioned earlier -- yeah, the ones you have probably only heard of if you are a psychologist.
Both psychological treatments were tested in a well designed randomized control trial that was recently published in the journal Behaviour Research and Therapy. The experiment evaluated the effectiveness of these treatments with 126 patients diagnosed with Generalized Anxiety Disorder (1) -a disorder characterized by debilitating, chronic worry.
The results were incredible.
By the end of treatment, 91 per cent of the patients receiving MCT we essentially cured (no longer met criteria for the disorder) as were 81 per cent of the patients who received IUT.
Even more impressive -- the people who recovered stayed healthy even when treatment was over! Six months following therapy, the researchers found that the former patients remained healthy and disorder free.
To understand how big these numbers really are, a large study examining the effectiveness of Paxil found that between 36 per cent and 42 per cent of patients with GAD were considered to be recovered and in remission (2).
It is not possible to compare these studies and conclude that the psychological therapies are twice as effective because of the different study designs and other confounding factors.
However, I think it is instructive to examine what happens to the results from these outcome studies.
When pharmaceutical companies discover that a product is effective, they invest a lot of time and money in promoting the product with physicians and the general public. This makes complete sense and is completely acceptable.
Conversely, when psychologists make comparable, or even better, discoveries with psychotherapy, no one hears about it. There are rarely press releases and your family GP might never learn of this information.
The impact of this difference between how medication and psychotherapy research is disseminated can have a large effect on how mental health problems are treated. There currently exist psychotherapies that can be as effective, and in some cases, more effective than medication (3) -- but medication continues to be the primary treatment option for the majority of treatment seekers. This is quite unfortunate for consumers of mental health.
The solution?
Well, I honestly believe that psychotherapy will never compete with pharmacotherapy. There's no way to invest in the mass distribution of psychotherapy -- and if there's no money, there's no success. I am not trying to be cynical -- this is simply the world we live in.
However, I do believe that governments and health agencies have a responsibility to ensure that the public is aware of all available treatment options for a particular health issue.
Ideally, patients who want to make informed decisions about treatment should not have to learn about their options for the most effective treatments through a Huffington Post blog.
References
1. van der Heiden et al. (2012). Randomized controlled trial on the effectiveness of metacognitive therapy and intolerance-of-uncertainty therapy for generalized anxiety disorder. Behaviour Therapy and Research, 50, 100-109.
2. Rickels et al. (2003). Paroxetine treatment of generalized anxiety disorder: A double-blind, placebo controlled study. The American Journal of Psychiatry, 160, 749-756.
3. Butler, A.C., Chapman, J.E., Forman, E.M., & Beck, A.T. (2006). The empirical status of cognitive-behavioral therapy: A review of meta-analyses. Clinical Psychology Review, 26, 17-31.