Is There Proof That Psychotherapy Works?

Psychotherapy is a multibillion-dollar industry—Americans spent nearly $9 billion on it in 2004—whose product is difficult to quantify. So it’s only natural for us to wonder what we're getting for our money.

Does psychotherapy work? The short answer is yes. “Psychotherapy is remarkably effective,” says Bruce Wampold, PhD, a professor of counseling psychology at the University of Wisconsin-Madison. “For almost all mental disorders, it’s as effective as medication—and it’s longer lasting. People become resistant to medication, but they don’t get resistant to psychotherapy.”

Beyond that, the questions get trickier. There are hundreds of variations of psychotherapy—are some better than others? Which treatment is best for depression? Which is best for anxiety disorder? Which is best if you are depressed and anxious? Patients and therapists—not to mention insurance companies—increasingly want to know the results they can expect when they match a treatment to a condition, but the answers to such questions are hard to pin down.

In the mid-1990s, the American Psychological Association (APA) took a step toward answering them when it issued a list, which it has continued to update, of treatments supported by empirical evidence. To make the cut, a treatment has to have been proven beneficial (that is, better than no treatment at all) in at least two scientific studies, and it must also have a written manual that enables other therapists to apply it consistently to clients with similar conditions.

These guidelines have helped fuel a trend in recent years toward “evidence-based” psychotherapy. The growing body of research evaluating the effectiveness of the various therapeutic techniques is more influential than ever. The U.S. Department of Health and Human Services has created a registry for evidence-based treatments that rates the quality of research supporting the treatment on a 0–4 scale, and some insurance companies and state health-care systems (such as the one in Oregon) have altered their reimbursement policies to favor evidence-based therapies.