Some Mild Advertising for the Psychology "Industry"

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Whenever a pharmaceutical company finds a new a drug that works (even mildly), they follow up with a marketing campaign. This is understandable in the sense that they devote money to research and development, and they are in the business of making profits, so they have to get a return on their investment. The conflict of interest inherent between (1) needing to make money, and (2) helping and protecting the public at large, is another issue altogether and won't be addressed here.

Their system is so very effective. Psychology on the other hand, is near immobile in comparison. This is not to say that psychological treatments are not as effective. Quite the contrary. In fact, psychological treatments often work as well as, if not better than medications. Unfortunately, you'll rarely hear about this.

The field of psychology is not well understood by the general population to begin with. Many people make assumptions based on popular media (laying on couches and spouting Freudian theories that blame your mother). As such, for those readers who might not be aware, I'd like to briefly compare psychology and pharmaceutical research.

First, both types of research make use of randomized controlled trials to test the relative efficacy of their treatments. When testing a drug, you can compare the drug's efficacy to a placebo (a substance that appears to be a drug, but actually has no effect). Similarly, psychologists will often compare treatments to either no-treatment groups (ex: people on wait-list for treatment), or people who receive basic counseling (simply talking about problems). This allows psychologists to assess whether the new treatment is an improvement over a basic standard.

Now, what kind of new treatments do psychologists develop? Well, every year millions of dollars are spent by psychological researchers on basic research examining all aspects of human psychology. Researchers study things like attention and memory biases, personality traits and genetics, emotion regulation, behavioural principles, etc. This basic research can then be used to expand upon existing treatments, or generate new ones. Cognitive-Behavioural Therapy is a treatment that is always being studied and modified in order to improve treatment outcomes.

Thus, psychologists conduct basic research and outcome trials similar to pharmaceutical companies. And what you find is that psychological treatments are often just as effective as medications for disorders such as depression, PTSD, Generalized Anxiety Disorder, Social Anxiety Disorder, Panic Disorder, and OCD. In fact, there is research showing that psychological treatments are superior to drugs in some ways. For example, when people with depression stop taking their medication, they are more likely to relapse compared to when they have stopped seeing their psychologist.

Also, psychological treatments don't have the side effects that drugs have. Furthermore, some people who take SSRIs to treat depression sometimes become worse with each new drug they take. Or, if they take benzodiazepenes for anxiety, they can become addicted to this medication.

Needless to say, seeing a psychologist can offer just as many benefits, if not more than taking medication for mental health problems. Unfortunately, most people don't know about it. Psychologists do not have the resources to advertise their findings. When Pfizer develops a new drug, you'll know. When psychologists develop a new treatment, you'll rarely hear about it. When was the last time you saw this in the newspaper: "Psychologists Find Highly Effective Treatment for OCD!" This headline is true. Exposure and response prevention is a highly effective treatment for OCD -- as effective as medication. But no one knows this.

So, whenever I see a client for 12 sessions and successfully treat their Depression or Anxiety Disorder, they are often surprised. They might say "I've tried 5 different drugs for the past 10 years, and now I get better after 3 months of CBT!"

Anyway, I know this blog is not exactly Time Magazine, but it's at least one more resource for people who may not know about the benefits of working with a psychologist.

Dr. Roger Covin
Montreal Psychologist
www.drcovin.ca

References 

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.

DeRubeis, R.J., Gelfand, L.A., Tang, T.Z., Simons, A.D., 1999. Medications versus cognitive behavior therapy for severely depressed outpatients: mega-analysis of four randomized comparisons. Am. J. Psychiatry 156, 1007–1013.

DeRubeis, R.J., Hollon, S.D., Amsterdam, J.D., Shelton, R.C., Young, P.R., Salomon, R.M., et al., 2005. Cognitive therapy vs. medications in the treatment of moderate to severe depression. Arch. Gen. Psychiatry 62, 409–416.

Imel, Z.E. et al. (2008). A meta-analysis of psychotherapy and medication in unipolar depression and dysthymia. Journal of Affective Disorders, 110, 197-206.

Leykin et al. (2007). Progressive Resistance to a Selective Serotonin Reuptake Inhibitor but Not
to Cognitive Therapy in the Treatment. Journal of Consulting and Clinical Psychology, 75, 267-276.