What is psychotherapy?

Psychotherapy is a term that refers to the range of treatments for mental health issues provided by a psychologist or psychotherapist. The mental health issues addressed by psychotherapy are not limited to diagnosable mental illnesses, such as depression and anxiety disorders, but also interpersonal challenges, such as low self-esteem and poor anger management. The psychologist or psychotherapist often start psychotherapy by helping clients to understand their mental health condition, as well as identifying the roles played by their emotions, thoughts and behaviors in the maintenance of these issues. Depending on the needs of the client and the psychologist’s treatment approach, the appropriate treatment strategies are then conducted over a number of sessions.

Can psychotherapy cure mental illness?

Due to the nature of mental illnesses, psychotherapy does not cure depression, addiction, anxiety or phobias. Refer to our article to understand why there is no cure for mental illness.

Psychotherapy can empower clients to overcome their mental health issues in a number of ways, including managing conflicts, regulating unhealthy responses and balancing negative thoughts. Psychotherapy also seek to restore the client’s earlier levels of functioning.

The evidence-based study discussed here demonstrates the effectiveness of a form of psychotherapy.

The current study

Carpenter et. al (2018) conducted a review of the effectiveness of cognitive behavioral therapy (CBT) in treating anxiety-related disorders.

CBT is a class of evidence-based interventions that aims to reduce the psychological pain of a person by changing dysfunctional cognitions and patterns of behavior through the use of various cognitive and behavioral methods. CBT has been regarded as the gold-standard for treatment of various disorders in the current field of psychotherapy (David, Cristea & Hofmann, 2018). CBT has found to be effective in treating a wide range of conditions, including depression, anxiety disorders, eating disorders, sexual disorders and addictions. In the context of anxiety disorders, CBT aims to address maladaptive beliefs about the risk posed by a certain subject of anxiety and the chances of something unfortunate occurring. This is often followed by behavioural experiments that provide opportunities for the clients to overcome anxiety-provoking situations.

Given that anxiety disorders are the most prevalent class of mental disorders, this study focuses on a very prominent area of psychotherapy research. The authors employed a meta-analysis, which involved analyzing data from a total of 41 independent studies about the effectiveness of CBT for anxiety disorders, in order to determine overall trends.

In the studies reviewed by the current paper, a total of 2,843 patients were randomly assigned to CBT or a placebo condition. A placebo is a substance or treatment which is not designed to have therapeutic value. There were 2 main types of placebo in the studies – pill placebo or psychological placebo. The anxiety disorders investigated include acute stress disorder, generalized anxiety disorder, obsessive compulsive disorder, panic disorder, posttraumatic stress disorder and social anxiety disorder.

Findings from the current study

CBT was associated with greater responsiveness to treatment and significant reduction in symptoms. It resulted in significantly greater benefit compared to the placebos. In fact, the effects of CBT extend beyond the symptoms of the anxiety disorder being treated, as improvements in depression and quality of life were observed. The gains from CBT were also maintained after the treatment ended. This is important because psychotherapy does not just aim to provide immediate relief of symptoms but to produce long-term changes in patients’ lives. The authors thereby concluded that CBT is an effective treatment for anxiety and related disorders. While CBT was found to be effective for all anxiety disorders, it was more effective for some disorders than others. This will be further discussed in section below.

Is psychotherapy for me?

Just like how there is more than one way to treat the common flu, there are many different types of psychotherapy. Undeniably, there is no universal treatment for mental disorders. Depending on your condition and symptoms experienced, some forms of psychotherapy would be more suitable than others. Your psychotherapist will identify the therapeutic approach that would be the most effective for you.

What you can expect from psychotherapy:

• Your psychologist will encourage you to talk about your thoughts and feelings, as well as what is troubling you.

• Your psychologist will help you to identify patterns of unhealthy thoughts and behaviors in your life.

• You will gain a clearer understanding of the connections between your thoughts, emotions and behavior, which may be maintaining your psychological suffering.

• Your psychologist will aid in reshaping your negative thoughts and guide you to change problematic behaviors.

• You will learn effective coping skills that help you to gain control of your life.

Although various studies (including the current review paper being discussed) have supported the effectiveness of psychotherapy in treating mental health issues, the effectiveness of the psychotherapy sessions is also dependent on the client. Be prepared to work hard and be challenged by your psychologist to feel uncomfortable. Communicate with your psychologist if you disagree with him/her (it is ok to do so) and if you are experiencing a strong emotional response during the sessions. You are also most likely to be given homework by your psychologist at the end of each psychotherapy sessions. Complete this homework to allow you to apply what you have gained away from the safety of the therapy sessions into the real world.

References

Carpenter, J. K., Andrews, L. A., Witcraft, S. M., Powers, M. B., Smits, J. A., & Hofmann, S. G. (2018). Cognitive behavioral therapy for anxiety and related disorders: A meta-analysis of randomized placebo-controlled trials. Depression and Anxiety, 35(6), 502-514. doi:10.1002/da.22728

David, D., Cristea, I., & Hofmann, S. G. (2018). Why Cognitive Behavioral Therapy Is the Current Gold Standard of Psychotherapy. Frontiers in Psychiatry, 9(4). doi:10.3389/fpsyt.2018.00004

Article written with Tay Shi Ying. Shi Ying is a psychology undergraduate at the Nanyang Technological University (NTU) and aspiring clinical psychologist undergoing internship with ImPossible Psychological Services. She is supervised by our senior clinical psychologist, Haikal.