So what are the alternatives? Well, the logical alternative to psychiatric medication is psychotherapy. As a psychologist, I actually view psychotherapy as not just an alternative, but actually the first line of treatment for most psychological disorders. However, I am a realist, and I know that in this technological age filled with advertisements of every kind for psychiatric drugs. Many people may not longer see psychotherapy as the first line of treatment as I do.
The research literature is too voluminous to try and analyze it here, just as actually analyzing the effects of psychiatric drugs cannot be done in a small blog post. If you are really interested in the research literature on the efficacy of psychotherapy, try the National Library of Medicine web site, http://www.pubmed.com/. Then type in "efficacy of psychotherapy" or "metaanalysis of psychotherapy outcome". If you want even more information, try Michael Lambert's latest edition of the book titled Bergin and Garfield's Handbook of Psychotherapy and Behavior Change (only $185.20 in hardcover!).
Numerous types of psychotherapy are available. Psychotherapies used to be classified in the following ways: cognitive, behavioral, psychodynamic, client centered, eclectic, group therapy, family therapy, and so on. However, these days classifications of therapy tend to focus on diagnostic categories and which of the types of therapies listed above have been found to be efficacious. These are referred to as empirically verified therapies.
Here is a list of therapies proven to be efficacious in research research studies. This list was created through the American Psychological Association and was copied from the American Psychological Association web site.
Examples of Empirically Validated Treatments
Well-Established Treatments Citation for Efficacy Evidence
ANXIETY AND STRESS:
Cognitive behavior therapy for panic disorder with and without agoraphobia ...... Barlow et al. (1989); Clark et al. (1994)
Cognitive behavior therapy for generalized anxiety disorder............................ Butler et al. (1991); Borkovec et al. (1987)
Group cognitive behavioral therapy for social phobia..................................... Heimberg et al. (1990); Mattick & Peters (1988)
*Exposure treatment for agoraphobia.......................................................... Trull et al. (1988)
*Exposure treatment for social phobia......................................................... Feske et al; Chambless (1995)
Exposure and response prevention for obsessive-compulsive disorder............. Balkom et al. (1994)
*Stress Inoculation Training for Coping with Stressors................................... Saunders et al. (in press)
Systematic desensitization for simple phobia ............................................. Kazdin et al; Wilcoxon (1976)
DEPRESSION:
Cognitive therapy for depression ...............................................................Dobson (1989); DiMascio et al. (1979)
Interpersonal therapy for depression.........................................................................................Elkin et al. (1989)
HEALTH PROBLEMS:
*Behavior therapy for headache................................................................. Blanchard et al. (1987); Holroyd & Penzien (1990)
*Cognitive behavior therapy for irritable bowel syndrome................................ Blanchard et al. (1980); Lynch & Zamble (1989)
*Cognitive behavior therapy for chronic pain .............................................. Keefe et al. (1992); Turner & Clancy (1988)
*Cognitive-behavior therapy for bulimia........................................................ Agras et al. (1989); Thackwray et al. (1993)
Interpersonal therapy for bulimia ................................................................ Fairburn et al. (1993); Wilfley et al. (1993)
PROBLEMS OF CHILDHOOD:
*Behavior modification for enuresis............................................................. Houts et al. (1994)
Parent training programs for children with oppositional behavior ...................... Walter et al; Gilmore (1973); Wells & Egan (1988)
MARITAL DISCORD:
Behavioral marital therapy......................................................................... Azrin, Bersalel et al. (1980); Jacobson & Follette (1985)
SEXUAL DYSFUNCTION:
Behavior therapy for female orgasmic dysfunction and male erectile dysfunction LoPiccolo & Stock (1986); Auerbach & Kilmann (1977)
OTHER:
Family education programs for schizophrenia ............................................... Hogarty et al. (1986); Falloon et al. (1985)
Behavior modification for developmentally disabled individuals ....................... Scotti et al. (1991)
Token economy programs ......................................................................... Kazdin (1977); Liberman (1972)
Probably Efficacious Treatments Citation for Efficacy Evidence
ANXIETY:
Applied relaxation for panic disorder ........................................................... Öst (1988)
*Applied relaxation for generalized anxiety disorder....................................... Barlow et al., (1992); Borkovec & Costello, (1993)
*Exposure treatment for PTSD................................................................... Foa et al. (1991); Keane et al. (1989)
*Exposure treatment for simple phobia........................................................ Leitenberg et al; Callahan (1973); Öst et al. (1991)
*Stress Inoculation Training for PTSD ......................................................... Foa et al. (1991)
*Group exposure and response prevention for obsessive-compulsive disorder .. Fals-Stewart et al. (1993)
*Relapse prevention program for obsessive-compulsive disorder..................... Hiss et al. (1994)
CHEMICAL ABUSE AND DEPENDENCE:
*Behavior therapy for cocaine abuse .......................................................... Higgins et al. (1993)
*Brief dynamic therapy for opiate dependence.............................................. Woody et al. (1990)
*Cognitive therapy for opiate dependence.................................................... Woody et al. (1990)
*Cognitive-behavior therapy for benzodiazepine withdrawal
in panic disorder patients ...................................................................... Otto et al. (1994); Spiegel et al. (1993)
DEPRESSION:
*Brief dynamic therapy ............................................................................. Gallagher-Thompson & Steffen(1994)
*Cognitive therapy for geriatric patients....................................................... Scogin et al; McElreath (1994)
*Psychoeducational treatment ................................................................... Lewinsohn et al. (1989)
*Reminiscence therapy for geriatric patients .............................................. Arean et al. (1993); Scogin & McElreath (1994)
*Self-control therapy ................................................................................ Fuchs & Rehm (1977); Rehm et al. (1979)
HEALTH PROBLEMS:
*Behavior therapy for childhood obesity ...................................................... Epstein et al. (1994); Wheeler & Hess (1976)
*Group cognitive-behavior therapy for bulimia .............................................. Mitchell et al. (1990)
MARITAL DISCORD:
Emotionally focused couples therapy ......................................................... Johnson et al; Greenberg (1985)
Insight-oriented marital therapy.................................................................. Snyder et al. (1989, 1991)
PROBLEMS OF CHILDHOOD:
*Behavior modification of encopresis .......................................................... O'Brien et al. (1986)
*Family anxiety management training for anxiety disorders............................. Barrett et al. (in press)
OTHER:
Behavior modification for sex offenders....................................................... Marshall et al. (1991)
Dialectical behavior therapy for borderline personality disorder........................ Linehan et al. (1991)
Habit reversal and control techniques ......................................................... Azrin, Nunn et al; Frantz (1980)
Azrin, Nunn & Frantz-Renshaw (1980
It is an encouraging list. It is somewhat outdated now, but it shows just how far psychotherapy conceptualization and research has come.
It is important not to let the TV commercials subtly influence you into thinking that medication for psychological problems is all that exists. The problem is not that other treatments do not exist; the problem is that they have not been adequately publicized to the public.
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