Patients Prefer Talk Therapy to Psychiatric Medications, Report McLean Hospital Researchers

July 23, 2013

Despite declining trends in the percentage of people receiving talk therapy, in a paper published last month in the Journal of Clinical Psychiatry (PMID: 23842011, doi: 10.4088/JCP.12r07757), McLean Hospital and Harvard Medical School investigators found that 75% of patients interviewed preferred psychological talk therapy to medications for the treatment of anxiety and depression.

“We know that people tend to do better in a treatment that matches their preference, so studying treatment preference isn’t just an issue for health policy advocates, it is a way of working toward achieving better outcomes for people in need,” said Michael Otto, PhD, Professor of Psychology at Boston University and an author of the paper.

The team reviewed 34 studies, looking at the desired treatment options of over 90,000 people interviewed in primary care and specialty care settings in an effort to examine whether a continued increase in psychiatric medication prescriptions and decrease in receipt of talk therapy was linked with a general preference for medication.

“We were surprised to find a large preference for psychological therapies relative to medication. People reported that they would prefer a psychological or talk therapy at a rate of 3-to-1,” said R. Kathryn McHugh, PhD, Assistant Professor at Harvard Medical School and a psychologist in McLean’s Division of Alcohol, Drugs, and Addiction, who was the lead author of the study. “Since this was a review and synthesis of other studies, we could not answer the question as to why treatment trends are so out of line with treatment preference, but we speculate that some of the trend toward an increased reliance on medication treatment may be attributable to the limited number of therapists trained in state-of-the-art talk therapy such as cognitive-behavioral therapy, low insurance reimbursement rates for talk therapy sessions, and perhaps reliance on primary care physicians as mental health providers.”

Although both younger people and women had a particularly strong preference for psychological treatment, all groups studied preferred psychotherapy.

McHugh explains why it’s essential to have researchers examining the big picture of findings across multiple studies.

“Studies like these are important—not only do we want to understand general patient preference in order to inform doctors and health care systems of which types of treatment options people generally prefer but to also provide policy makers with the data to make decisions informed by the type of care of that people want to receive. Improving the availability of evidence-based treatments that are in line with patient preferences will likely lead to both more accessible and more effective mental health care.”

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