Talk Therapy & Medication: A Proven Combination

The Talk Therapy vs. Medication newsletter compared and contrasted Talk Therapy and Medication. However, it is now clear that research consistently finds that the combination of anti-depressant medication and cognitive-behavioral therapy is superior to either treatment alone in the reduction of depressive symptomology, both in the short and longer term. This newsletter will explore why this might be true.

It is important that patients and mental health professionals take seriously the data strongly suggesting that the most effective relief of depressive symptoms results from combined psychiatric and psychological treatment. This effort can be greatly facilitated by educating the public and professionals about specific reasons that such collaboration is important.

The reason that the inclusion of anti-depressant medication may facilitate the success of psychological treatment is that many depressed patients are extremely lethargic and unmotivated. Medication often results in an increase in energy and motivation that makes the patient more amenable to psychological therapy. Another is that when the medication results in the patient feeling better, that patient feels hope. That feeling of hope makes psychological therapy easier.

True collaboration between psychologists and psychiatrists could greatly benefit the patient. The current model of outpatient psychiatric practice is for the psychiatrist to conduct an initial diagnostic interview lasting approximately an hour. If as a result of that interview, the patient is prescribed an anti-depressant, the patient is then seen in periodic “med checks” typically scheduled for 15 minutes and usually lasting no more than 10 minutes. These are generally scheduled for every two to four weeks initially and two to three months after the patient has “stabilized”. This practice model is such that patients cannot be closely tracked for symptom change. Typical psychological practice on the other hand, is weekly visits of 45 or 50 minutes. Psychologists are in a unique position to monitor and treat dangerous symptoms, such as suicidal thinking and intent. Psychological therapy can also render psychiatric therapy more effective. One reason is that psychologists’ regular contact with patients can encourage compliance with medication. This regular contact can serve to encourage patience for the two or three weeks that it takes for the medication to become effective. In addition, consistent patient contact can function to keep patients from changing their doses or skipping doses. Psychologists also must often educate patients regarding side effects and encourage them not to discontinue the medication.

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