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Psychotherapy Continues Decline as Depression Treatment

Psychotherapy Continues Decline as Depression TreatmentPerhaps we’ve seen the rise and fall of psychotherapy treatment. At least when it comes to depression, the most common mental disorder diagnosed today.

The numbers don’t lie, according to multiple nationally-representative surveys conducted over the past two decades.

At the start of the 1990s, psychotherapy was the treatment of choice for depression, with 71.1 percent of depressed people saying they had been treated with psychotherapy. By 1997, with the newer SSRI antidepressants firmly taking hold in prescribers’ toolboxes, that number had dropped to 60.2 percent.

When the latest research when conducted, they found 53.6 percent of depressed people surveyed in 1998 were in psychotherapy. When they looked again in 2007, that number had dropped to a new all-time low — to only 43.1 percent.

In two decades, psychotherapy went from being the primary treatment employed for depression, to becoming a minority treatment. What happened?

As we wrote in the news article describing the most recent research, “It is unclear whether the decline in psychotherapy use is due to patient preferences or other factors, including scarcity of psychotherapists, the authors note.”

“A review of the literature concerning treatment preferences, however, revealed that most patients with depression prefer psychotherapy or counseling over antidepressant medications,” they wrote. “However, although third-party coverage of antidepressants and other psychotropic medications is typically generous, significant limits commonly exist on coverage of psychotherapy services.”

Traditionally, that’s been true. However, with the passage of the mental health parity law in 2008, insurance coverage must now be equal to what you receive for physical ailments. This suggests that for most people covered by health insurance, their mental health benefits should now support reimbursement for an unlimited number of outpatient psychotherapy visits each year (typically one a week).

Psychotherapy remains the treatment of choice for depression for many reasons — virtually no side effects, typically no long-term dependence, and treatment tends to be time-limited, even for severe clinical depression. Yes, it’s definitely not as easy as taking an antidepressant medication once a day. But for most people who try it, they appear to experience significant relief from their depressive symptoms within 12 to 16 weeks.

I can’t change a trend like this with a blog entry. But I can point out that you should really look at the effectiveness of the antidepressant you’re considering taking, as for many kinds of depression, an antidepressant may be no better than a sugar pill.

You have a choice when it comes to depression treatment. Just because your primary care doctor says, “Hey, why don’t we try you on this antidepressant and see how it goes,” doesn’t mean you should take his advice unquestioningly. Primary care doctors and GPs are not experts in mental health issues — they’re simply repeating what they’ve typically done in the past, because it’s the only thing they can do.

Instead, ask for a referral to a mental health professional if your GP has concerns you may be depressed. Or better yet, seek out such a professional to start with (you typically don’t need to see your family doctor any more for that initial referral). I don’t care if it’s a psychologist, psychiatrist or other mental health professional — I just know they’re going to better understand the depression treatment options available and hopefully present them in a more thoughtful light.

Read the full article: More Seek Out Depression Treatment, But Not Psychotherapy

Psychotherapy Continues Decline as Depression Treatment

John M. Grohol, Psy.D.

Dr. John Grohol is the founder of Psych Central. He is a psychologist, author, researcher, and expert in mental health online, and has been writing about online behavior, mental health and psychology issues since 1995. Dr. Grohol has a Master's degree and doctorate in clinical psychology from Nova Southeastern University. Dr. Grohol sits on the editorial board of the journal Computers in Human Behavior and is a founding board member of the Society for Participatory Medicine. You can learn more about Dr. John Grohol here.

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APA Reference
Grohol, J. (2018). Psychotherapy Continues Decline as Depression Treatment. Psych Central. Retrieved on October 1, 2020, from
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Last updated: 8 Jul 2018 (Originally: 8 Dec 2010)
Last reviewed: By a member of our scientific advisory board on 8 Jul 2018
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