Benefits of Talk Therapy

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01
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Part
01

Benefits of Talk Therapy - Children (18 and Younger)

Talk therapy, also known as "psychotherapy", has shown to be clinically beneficial for children and adolescents dealing with trauma-related difficulties, eating disorders, depression, anxiety and behavior disorders, learning difficulties, personality disorders, and developmental issues. Online virtual therapies have also shown to be effective resources for addressing the mental health needs of young patients, although they do need to be combined with proper outside motivation. Below you will find a deep dive of my findings.

Please note that, due to the nature of the academic sources, some of them have been published within more than 24 months, but were still included due to the fact that the research provided continues to be relevant.

TYPES OF PSYCHOTHERAPY FOR CHILDREN

As listed by the American Academy of Child & Adolescent Psychiatry, the different types of psychotherapy for children and adolescents:

Cognitive Behavior Therapy (CBT) — Helps treat mood, anxiety, depression and behavior, by looking into confused or distorted thinking patterns. Specialized forms of CBT can help children cope with traumatic experiences.

Dialectical Behavior Therapy (DBT) — Generally prescribed to treat older adolescents with chronic suicidal feelings or thoughts, those who engage in intentional self-harm, or have Borderline Personality Disorder, helping them through a combination of group and individual sessions.

Family Therapy — Explores patterns of communication and offers support and education, involving other members of the family in addition to the child.

Group Therapy — Using the power of group dynamics, this form of psychotherapy involves treating multiple patients at the same time, led by one or more therapists. Benefits include increased understanding of mental illness and improvement of social skills.

Interpersonal Therapy (IPT) — Developed and tested for depression, IPT focuses on the way interpersonal events affect an individual's emotional state. Difficulties are framed in interpersonal terms and problematic relationships are addressed afterward.

Play Therapy — Using toys and other tools familiar to children, this type of therapy helps them recognize, identify, and verbalize their feelings. The counselor observes the way the child uses the materials and identifies themes or patterns that can help understand the problems the patient is facing.

Psychodynamic Psychotherapy — Through the understanding of what motivates a child's behavior, their thoughts and their feelings, this form of therapy can help identify typical behavior patterns, defenses, and responses to inner conflicts and struggles. It normally involves several sessions per week.

BEST PRACTICES: CONFIDENTIALITY

This American Psychology Association article from March 2002 discusses best practices for psychologists working with adolescents regarding ethics and confidentiality. The confidentiality issue is considered from three perspectives: law, clinical practice, and ethics. As a general rule, minors cannot consent to being treated themselves and need the consent of a parent or guardian, who in turn gets full access to the child's treatment information. There can only be a few rare exceptions to this rule, such as minors who are married, serving in the military, seeking substance abuse or sexually transmitted disease treatment. From the clinical perspective, a paradox arises: good treatment normally requires a zone of privacy, which is refused to the child by the law. Ethically, the therapist's clinical judgment is used to establish whether revealing information to a parent can help or be counterproductive to the treatment, and it is accepted within the realm of treatment best practices that a professional can withhold such information for the sake of treatment success, in many cases achieving better communication between the patient and their guardians when they disclose any necessary information themselves.

BEST PRACTICES: PARENT INVOLVEMENT IN CHILDREN'S TREATMENT

Parenting has great impact in the outcome of therapy treatments in young children. This study by N. Bornsheuer and Richard E. Watts titled "Play Therapy and Parent Consultation: A Review of Best Practices" covers parents' active role and involvement in their children's treatment through consultations with the counselor and the importance of establishing a working relationship with the professional. The goal is to ensure that the parents' skills work hand in hand with those of the professional, ensuring that the benefits acquired during treatment are continued once it terminates.

Some best practices for the involvement of parents in children's mental health treatments, as cited in this 2008 paper titled "Best Practices in Children’s Mental Health" by the University of Kansas, are making sure to provide culturally competent services; showing due respect and concern to parents; increasing knowledge of resources and treatment options; using framework for the initial phone call, first session, and any ongoing sessions; facilitating collaboration during treatment; and providing hope to parents that the situation can improve.

THE Benefits of PSYCHOTHERAPY

As described by this study published by the US Department of Health & Human Services, a specific form of psychotherapy, Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), which is an evidence-based counseling framework that addresses the needs of children and adults suffering from post-traumatic stress disorder (PTSD), has proven useful in reducing PTSD symptoms, as well as behavioral difficulties in children with depression. Randomized clinical trials showed greater gains with fewer sessions that sustain over time, comparing TF-CBT to others such as supportive therapy, nondirective play therapy or child-centered therapy. It has been proven that children showing improvement normally face less intrusive thoughts and avoidance behaviors; are able to better cope with reminders and trauma-associated emotions; show fewer signs of depression, anxiety, disassociation, behavior problems, sexualized behavior, and trauma-related shame; demonstrate improved interpersonal trust and social competence; develop better personal safety skills; and become more prepared to cope with future trauma reminders (as stated by Cohen, Deblinger, Mannarino, & Steer, 2004). Similar positive responses were proven to be true for parents, as well (also stated by Cohen, Berliner, & Mannarino, 2000; Deblinger, Lippmann, & Steer, 1996). TF-CBT studies have shown parents experience reductions in depression and emotional distress associated with the child’s trauma, as well as PTSD symptoms. This also results in an enhanced ability to support their children.

Additionally, the effects of psychodynamic therapy (an evidence-based treatment with proven results similar or greater than those of other psychotherapies) do not only sustain over time, but they also grow stronger (Harvard Medical School, 2010).

Kennedy (2004) performed an independent systematic review of research that looked at the effectiveness of psychoanalytic psychotherapy in children and young people. Similarly, Kennedy and Midgley (2007) conducted a thematic review.

The systematic review found child psychotherapy to be effective in treating patients coping with depression, anxiety and behavior disorders, personality disorders, learning difficulties, eating disorders, and developmental issues.

At the same time, it was found to be helpful in the treatment of sexually abused girls, as well as those who have suffered early emotional deprivation, and children with poorly controlled diabetes, helping them manage their emotional response to the illness.

Effectiveness OF VIRTUAL THERAPY ON CHILDREN

As per this paper by Stephen M. Schueller, Ph.D., Colleen Stiles-Shields, M.A., M.S., and Lana Yarosh, Ph.D., effective online and virtual therapies have been both developed and evaluated for children and adolescents, treating several mental and behavioral health conditions. Children and adolescents have unique capabilities and interests when it comes to technology-based interventions, making the development of such treatments especially important. Innovative therapies use social networking, games, and virtual humans, and appear to be on track for important contributions in the near future. The use of online treatments and virtual therapists has the potential to successfully expand the mental health options available to a wider population of patients.

Several randomized trials have demonstrated the efficacy of online tools and web-based applications in reducing depression and/or anxiety symptoms, and eating and alcohol abuse disorders in children and adolescents. Internet-based tools address somatic health problems in youth, including obesity, smoking, HIV/AIDS risk, and sexual risk. Although measurable improvements have been made, Internet interventions very much depend on the context they are used in to enhance motivation. It is estimated that less than 10% of the population is ready to engage a lifestyle change online with no further help from peers.

CONCLUSION

Psychotherapy has proven to be clinically beneficial for children under 18 years of age coping with PTSD, eating disorders, depression, anxiety and behavior disorders, learning difficulties, personality disorders, and developmental issues. Online virtual therapies can be easily directed at this target group because of their unique relationship with technology, but do need to be combined with motivation from the patient's context. Parent's involvement in treatment is a key best practice for its success; and when it comes to minors, the law requires full disclosure of a patient's treatment to their guardians. However, confidentiality is also a big factor in creating trust between the therapist and the patient, so professionals have to cope with deciding whether sharing information can help, and are sometimes able to direct the patient to share it themselves, thereby, improving communication with their parents.
Part
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Part
02

Benefits of Talk Therapy - Adults (Over 18 years)

Talk therapy, otherwise known as psychotherapy, has long been proven to be beneficial against various mental health illnesses, such as depression, anxiety, and others. In turn, it has also been shown to reduce the medical costs of mental health patients by 17 percent. Best practices of psychotherapy include cognitive behavioral therapy, family therapy, and more. With the technology available in the Digital Age of today, however, talk therapy has been merged with virtual or online programs, and these digital therapies have also been proven to be as beneficial as face-to-face talk therapy.

Psychotherapy: "Talk Therapy"

First of all, "talk therapy" can be defined in various ways, but the most credible medical resources, such as from the National Institute on Mental Health (NIMH), presents "psychotherapy" as another word for "talk therapy". With this association then, psychotherapy, or talk therapy, covers a wide array of treatment methods meant to help mental health patients identify and change their problematic emotions, thoughts, and behaviors. Some of these treatment methods include relaxation and mindfulness techniques, exposure therapy for anxiety disorders, supportive counseling, and identification of ways to cope with stress.

Now, empirical data on the effectiveness of talk therapy can be found below. From here onward, however, talk therapy will be referred to as psychotherapy as the sources use "psychotherapy" more than "talk therapy". Based on the definition by NIMH, this change of terms is valid since "talk therapy" and "psychotherapy" are the same.

How Effective Is Psychotherapy

Various available data in the public domain shows how beneficial psychotherapy is in treating a variety of mental health disorders and even in reducing the medical costs of mental health patients and primary care patients as well. For the most credible data on this claim, information from mental health authorities — the American Psychological Association (APA), the National Institute on Mental Health (NIMH), the Substance Abuse and Mental Health Services Administration (SAMHSA), and the National Alliance on Mental Illness (NAMI) — have been used. The information have also been classified according to their sources for the purpose of this research brief.

AMERICAN PSYCHOLOGICAL ASSOCIATION
An older source on psychotherapy comes from the APA. This source was published in 2012, and it contains the APA's Resolution on the Recognition of Psychotherapy Effectiveness. This resolution was based on decades of researches on psychotherapy that the APA still held as true in 2012. As such, the information in the resolution can also be considered as true even today in 2018.

In the resolution, psychotherapy was said to be an effective treatment that helped depression and anxiety disorder patients return to "a level of functioning". This return comes after even a relatively short treatment course, which was also typically used for "well-functioning individuals in the general population". In fact, research by Hollon, Stewart & Strunk in 2006 and by Shedler in 2010 showed that psychotherapy results usually lasted longer than results from psychopharmacological treatments. Psychotherapy results also tended to require little to no additional courses of treatment. The study illustrated by citing how psychotherapy patients with depression or anxiety disorders gained various skills, which are essential after treatment termination. Even after treatment termination, patients tended to continually improve.

Another benefit of psychotherapy lies in medical costs of mental health patients. Chiles, Lambert, & Hatch in 2002 studied mental health patients who received and didn't receive psychotherapy treatment. They found out that those who did receive treatment had medical costs reduced by 17 percent. Those who did not receive treatment, on the other had, experienced a 12.3 percent surge in their medical costs. This study falls in line with Dixon-Gordon, Turner & Chapman's research in 2011, and Lazar & Gabbard's in 1997. These studies showed that psychotherapy provides cost-effectiveness, disability reduction, morbidity reduction, mortality reduction, work function improvement, and psychiatric hospitalization decrease. Psychotherapy even reduced the "unnecessary use of medical and surgical services" on patients with serious mental illnesses.

Psychotherapy even went so far as to reduce medical costs for primary care patients. Cummings, O'Donahue, and Ferguson in 2003 found that psychotherapy reduced primary care costs by 20 to 30 percent above psychological care costs. This reduction came when behavioral health was integrated into primary care. Moreover, Lorig, Sobel, Steward, Brown, Bandura, and Ritter in 1999 discovered that psychotherapy in small group sessions of patients with chronic disease yielded $10 savings for every $1 spent on medical care.

NATIONAL INSTITUTE ON MENTAL HEALTH
Aside from the APA's, information from NIMH also supported the benefit of psychotherapy in older adults with depression. NIMH said that psychotherapy can even be comparably effective as a first treatment as ingestion of an antidepressant. Older adult patients, in fact, like psychotherapy treatment more than additional medication atop existing medication for other ailments. NIMH did concede, however, that patients with severe depression may be treated better with a mix of medications and psychotherapy or medications alone.

SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION
Information from SAMHSA focused on anxiety disorders with regard to psychotherapy. Three kinds of psychotherapies were identified as best practices. One was cognitive behavioral therapy (CBT) which proved effective against anxiety disorders. Through cognitive behavioral therapy, patients could learn "new ways of thinking, acting and reacting" to circumstances that triggered their anxiety. Social anxiety disorder could be particularly addressed too since patients could learn social skills.

The second kind of psychotherapy was family therapy that improved family communication, resolving any conflicts between family members. This kind of psychotherapy could be used if a patient with an anxiety disorder experienced symptoms because of family, aside from other factors. The family, in this case, would learn to avoid triggering the patient's anxiety.

The third kind of psychotherapy was acceptance and commitment therapy (ACT) that could be an alternative for cognitive behavioral therapy. ACT worked especially well for older adult patients with generalized anxiety disorder. Patients could learn to stop struggling for control over circumstances and to pursue meaningful activities instead.

NATIONAL ALLIANCE ON MENTAL ILLNESS
NAMI enumerated other best practices of psychotherapies against mental illnesses, while it also mentioned cognitive behavioral therapy again. CBT, according to studies, worked effectively against a variety of mental illness aside from anxiety disorders. CBT could also work against eating disorders, schizophrenia, depression, and bipolar disorder. Furthermore, brain activity imaging proved CBT as an effective brain functioning booster.

On the other hand, dialectical behavior therapy decreased "frequency and severity of dangerous behaviors" in mental health patients. Additionally, eye movement desensitization and reprocessing could "replace negative emotional reactions to difficult memories" with positive reactions or at least, less-charged reactions. This replacement could occur within a span of 20 to 30 seconds of repetitive back-and-forth eye movements.

How Effective Is Digital Psychotherapy

With the benefits of face-to-face psychotherapy established, digital psychotherapy can now be put in question. So far, studies show how digital psychotherapy can be just as beneficial, and even sometimes more beneficial than, face-to-face psychotherapy against mental health problems. Again, some studies included below are older than two years old but an APA article in 2017 vouched for their validity.

A University of Zurich study, published in 2013 in the Journal of Affective Disorders, found that 53 percent of 31 patients with depression had improved through online therapy, while 50 percent of the other group of 31 patients improved through in-person counseling. After three months, 57 percent of the online patients recovered from their depression, while only 42 percent of the patients who underwent conventional therapy recovered.

In another study in 2012 by the Johns Hopkins University, discovered a 25 percent drop in hospitalization days of around 100,000 veterans when they chose to undergo online counseling. The study noted that the percentage drop was slightly more than that of patients who underwent face-to-face counseling.

A study by the Stanford University School of Medicine, published in the journal of American College Health in 2014, also showed how digital psychotherapy could lead patients to seek face-to-face therapy. College students with eating disorders, in the study, likely sought out higher level of psychotherapy. They only made the search, however, after treatment through a digital body-image program and asynchronous messaging on the platform of Lantern, an online therapy company.

In a 2017 feature article on the American Psychological Association, the benefit of digital psychotherapy for mental health patients proven through the studies above was reinforced. In fact, the APA already had guidelines in place for telepsychological practice. At the end of the article, the APA also included a list of popular online therapy services that included TalkSpace, the inclusion which may vouch for the application's effectiveness as a digital psychotherapy service. In spite of this, the APA did offer some precaution. The article admitted that online psychotherapy may not be for everyone, and that patients should still reach out for face-to-face psychotherapy when dealing with more serious mental problems.

Conclusion

Based on overwhelming research, talk therapy, or psychotherapy, through the best practices of cognitive behavioral therapy, family therapy, and more, will benefit mental illness patients with depression, anxiety disorders, or other illnesses. Based on other studies, even talk therapy in a digital format can be as beneficial in treating mental illnesses as face-to-face therapy. Aside from the mental health benefits, talk therapy also effectively decreases mental health patients' medical costs by 17 percent.
Sources
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