Therapy is about as much of the American experience these days as baseball, pickup trucks and apple pie. Professional counseling is now seen as more than just a last resort for psychological distress but as a healthy, essential path for resolving personal issues. In 2019, nearly 20% of Americans received some form of mental health treatment ranging from medication to therapy. Over 40% of Americans have seen a counselor at some point in their lives.
Recently in The New York Times, journalist Susan Dominus asked an important question, especially given that the U.S. is in the grip of an ever-worsening mental health crisis: “Does therapy really work?”
On one hand, dozens of studies confirm the value of talk-based therapy. A landmark 1977 study, for example, found that those with significant psychological distress “fared better than 75% of those with similar diagnoses who went untreated.” University of Wisconsin-Madison researcher Bruce Wampold put it, “the fact that you can just go talk to another human being … and get effect sizes that are measurable” is kind of miraculous.
Other research, Dominus explains, is less clear. A 2021 study found that more than half of depression patients saw little or no benefit from talk therapy, and only one-third found their depression receding long term. Another study found that only 50% of patients responded to cognitive behavioral therapy regarding anxiety disorders. The uncertainty has led some to push for alternative treatments, including more prescriptions of drugs like psilocybin, the active ingredient in so-called magic mushrooms. One prominent researcher mused, “Maybe we have reached the limit of what you can do by talking to somebody.”
Of course, the results of therapy depend on a number of factors. While counseling is a powerful tool, it can only aim at the question: “What’s going on inside of me?” Often missed, which is especially consequential for a culture in a crisis of mental health, are the fixed reference points outside of ourselves by which we can be known and orient who we are.