Does Psychotherapy Work?

This is a question that has plagued psychiatrists and psychologists for many years but it has been finally addressed by Nobel Laureate Dr.Eric Kandel. A neurobiologist whose training in psychiatry lead him to an interest in the efficacy of psychotherapy, Kandel decided to trade his couch for a lab coat to see if psychotherapy actually works.

With a string of scientific papers and a plethora of fields of interest – behaviorist psychology, cognitive psychology, neuroscience and molecular biology – Kandel is no scientific lightweight. Yet he was disappointed that psychoanalysis was not more scientific, i.e. the effects of going to see a therapist could only be measured anecdotally for each individual patient. If a patient improved after therapy, it could be put down to the therapy itself. But if therapy did not seem to make any significant changes, it was not possible to determine whether that was caused by an outside influence, rather than the therapy itself. Typical external causes would be a poor therapist/client match, a therapist who is not trained in the particular field required to assist the client, or a client who is resistant to the therapy itself. In all three of the above, therapy will not be successful.

But until Kandel decided to return to the lab and get his hands dirty so to speak, the efficacy of therapy was totally reliant on patient outcome. Kandel’s work has changed all that. Forming the Ellison project, Kandel set about using the emerging science of brain imaging to evaluate the outcome of psychotherapy.

Although drug treatment has revolutionized psychiatry in recent decades, Kandel realized that anyone practicing psychiatry knows that drug therapy is effective but not perfect. Nor does it promote long-term, permanent change. Effective psychotherapy can and does. And now, with the benefit of brain imaging, at last therapists have the proof that “talk-therapy” combined with effective strategies, particular cognitive-behavioral therapy (CBT) really does work. By taking a scan prior to treatment, and another scan down the track, imaging can reveal the changes in the brain as therapy proceeds.

In the future it is hoped that biological markers for all mental illnesses can be located and studied in a systematic way to actually observe the progress of particular types of therapy on varying conditions.


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