The maturing of therapy. Some brief psychotherapies help anxiety/depressive disorders but mechanisms of action are unclear.
BACKGROUND
Psychiatric therapy needs assessment regarding its maturation as a therapeutic science.


OBJECTIVE
Judgement of whether such a science is emerging.


METHODS
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.
Marks
Isaac M
IM
Institute of Psychiatry, London SE5 8AF, UK. I.Marks@iop.kcl.ac.uk
D001008:Anxiety Disorders / Q000523:psychology / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D003866:Depressive Disorder / Q000523:psychology / Q000628:therapy*; D006801:Humans; D017060:Patient Satisfaction; D011614:Psychotherapy, Brief / Q000191:economics / Q000379:methods*; D016032:Randomized Controlled Trials as Topic; D013813:Therapy, Computer-Assisted / Q000379:methods; D016896:Treatment Outcome