Thursday, March 13, 2008

What is therapy?

Can anyone just do psychotherapy? Is talk therapy mere talk? Many people who have never been in therapy think so. I often here people say, "What is so hard to be a therapist? You just talk," or, "does talking really help?"
This Tuesday's NY Times Health section played into that myth. It spoke about how there are virtually no therapists in India's rural areas and studies find that developing countries have as much anxiety and depression as afluent developed ones. A new project has taken people with no psychological background and are trained for a week in how to be good listeners. They then go out and serve as therapists.
Let me quote a little from the article:
Instead of doctors, the program trains laypeople to identify and treat depression and anxiety and sends them to six community health clinics in Goa, in western India....
Dr. Simon, a psychiatrist who studies mental health in the developing world, said the Goa strategy grew from a crucial idea. Unlike, say, heart disease and stroke, which can require expensive interventions, depression is relatively simple to diagnose and treat. Many studies have shown that talk therapy and antidepressants lead to significant improvement in most patients.

I disagree. Depression is not so simple to treat. Many cases are resistant to treatment. Many people who recover from depression relapse. And its not that simple to even diagnose. It can be confused with the depressive part of bipolar disorder. All I have wrtitten is just for starters. If depression was so easy to diagnose and treat psychologists wouldn't make $150 for 45 minute weekly sessions. Psychiatrists wouldn't make $400 for a first time diagnosis.
There are many modailities of therapy. We started out with psychoanalasis, many now practive Cognitive Behavioral Therapy, others take a psychodynamic aproach. There is a reason these people have PhDs.
Having someone to talk to in a local health center is always better than nothing. And a week of training can't hurt. But lets not get confused about what real therapy is.

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