Isaac M Marks1. 1. Institute of Psychiatry, London SE5 8AF, UK. I.Marks@iop.kcl.ac.uk
Abstract
BACKGROUND: Psychiatric therapy needs assessment regarding its maturation as a therapeutic science. AIMS: Judgement of whether such a science is emerging. METHOD: Four criteria are used: efficacy; identification of responsible treatment components; knowledge of their mechanisms of action; and elucidation of why they act only in some sufferers. RESULTS: Brief behavioural, interpersonal, cognitive, problem-solving and other psychotherapies have a mature ability to improve anxiety and depressive disorders reliably and enduringly, often only with instruction from a manual or a computer. Therapy's cost-effectiveness and acceptability deserve more attention. We know little about which treatment components produce improvement, how they do so and why they do not help all sufferers. CONCLUSIONS: Therapy is coming of age regarding efficacy for anxiety and depression, but is only a toddler regarding the scientific principles to explain its effects.
BACKGROUND: Psychiatric therapy needs assessment regarding its maturation as a therapeutic science. AIMS: Judgement of whether such a science is emerging. METHOD: Four criteria are used: efficacy; identification of responsible treatment components; knowledge of their mechanisms of action; and elucidation of why they act only in some sufferers. RESULTS: Brief behavioural, interpersonal, cognitive, problem-solving and other psychotherapies have a mature ability to improve anxiety and depressive disorders reliably and enduringly, often only with instruction from a manual or a computer. Therapy's cost-effectiveness and acceptability deserve more attention. We know little about which treatment components produce improvement, how they do so and why they do not help all sufferers. CONCLUSIONS: Therapy is coming of age regarding efficacy for anxiety and depression, but is only a toddler regarding the scientific principles to explain its effects.