Louisville Medicine Volume 69, Issue 8 - Page 13

loss , or specific mental or mood disorders .
The psychotherapy process has been defined as “ the informed and intentional application of clinical methods and interpersonal stances derived from established psychological principles for the purpose of assisting people to modify their behaviors , cognitions , emotions and / or personality characteristics in directions that the participants deem desirable ” ( Norcross , 1990 , p . 218-220 ). It is rooted in a collaborative alliance between therapist and patient ( Norcross , 2011 ). There are myriad approaches to and types of psychotherapy treatments including individual , family , couples or group therapy which serve to provide symptom relief and remission and restore functioning and enhance quality of life ( APA , 2012 ). The American Psychological Association identifies numerous benefits to psychotherapy in treating mental and behavioral health issues . Further research suggests that some cognitive and behavioral interventions , particularly in treatment of mood disorders such as depression and anxiety , demonstrate long-lasting effects and may reduce the risk for subsequent symptom return even after treatment has been terminated ( Hollon , Stewart , & Strunk , 2006 ; Imel , McKay , Malterer , & Wampold , 2008 ). Psychotherapy is a cost-effective option , as well . Research suggests high economic costs associated with long-term pharmacological interventions for some populations , particularly in the context of medication termination and non-adherence ( Tournier et al ., 2009 ).
Different diagnoses and presenting problems will respond differently based on various treatments and types of psychotherapy . As such , it is important to consider appropriate treatment referrals . Cognitive-behavioral therapy has been shown to effectively treat a wide variety of treatment concerns , including depression , anxiety and other mood disorders , substance abuse and trauma ( APA , 2017 ). Interpersonal psychotherapy has also been shown to be effective in treating depression ( APA , 2017 ). It is important to consider differences among individuals and their likelihood to respond to treatments differently . For psychotherapy to be effective , both time and commitment to treatment will be required of the individual .
Integrating psychotherapy into a medical plan facilitates a more complete approach to the well-being of our patients . Further , even a basic understanding of the efficacy of psychotherapy and the endorsement of mental health care by all physicians reduces the stigma around mental and behavioral health concerns . Physicians , not just primary care physicians , are uniquely positioned to facilitate mental health treatment referrals and oversee this process over time .
References
FEATURE
Barnett M . L ., Song Z ., & Landon , B . E . ( 2012 ). Trends in physician referrals in the United States , 1999-2009 . Arch Intern Med . 172 ( 2 ), 163-170 . doi : 10.1001 / archinternmed . 2011.722 .
Chiles , J . A ., Lambert , M . J ., & Hatch , A . L . ( 2002 ). Medical cost offset : A review of the impact of psychological interventions on medical utilization over the past three decades . In N . A . Cummings , W . T . O ’ Donohue , & K . E . Ferguson ( Eds .), The impact of medical cost offset on practice and research . Reno , NV : Context Press .
Geissler , K . H . & Zeber , J . E . ( 2020 ). Primary care physician referral patterns for behavioral health diagnoses . Psychiatric Services , 71 ( 4 ), 389-392 .
Goodrich , D . E ., Kilbourne , A . M ., Nord , K . M ., & Bauer , M . S . ( 2013 ). Mental health collaborative care and its role in primary care settings . Current psychiatry reports , 15 ( 8 ), 383 . https :// doi . org / 10.1007 / s11920-013-0383-2
Hollon , S . D ., Stewart , M . O ., & Strunk , D . ( 2006 ). Enduring effects for cognitive behavior therapy in the treatment of depression and anxiety . Annual Review of Psychology , 57 , 285-315 . DOI : 10.1146 / annurev . psych . 57.102904.190044
Imel , Z . E ., McKay , K . M ., Malterer , M . B ., & Wampold , B . E . ( 2008 ). A meta-analysis of psychotherapy and medication in depression and dysthymia . Journal of Affective Disorders , 110 , 197-206 . DOI : 10.1016 / j . jad . 2008.03.018
Norcross , J . C . ( 1990 ). An eclectic definition of psychotherapy . In J . K . Zeig & W . M . Munion ( Eds .), What is psychotherapy ? Contemporary perspectives ( 218- 220 ). San Francisco , CA : Jossey-Bass .
Norcross , J . C . ( Ed .). ( 2011 ). Psychotherapy relationships that work : Evidence-based responsiveness ( 2nd ed ). New York : Oxford University Press .
Tournier , M ., Moride , Y ., Crott , R ., duFort , G . G ., Ducruet , T ., Tournier , M ., et al . ( 2009 ). Economic impact of non-persistence to antidepressant therapy in the Quebec community-dwelling elderly population . Journal of Affective Disorders , 115 , 160-166 . DOI : 10.1016 / j . jad . 2008.07.004
Ward , M . C ., Miller , B . F ., Marconi , V . C ., Kaslow , N . J ., & Farber , E . W . ( 2016 ). The role of behavioral health in optimizing care for complex patients in the primary care setting . J Gen Intern Med , 31 , 265 – 267 . doi . org / 10.1007 / s11606-015-3499-8
Dr . Nardin Michaels is a practicing post-doctoral fellow at Saint Luke Institute in Louisville , Kentucky . ( non-member )
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