Psychotherapy Is Worth It: A Comprehensive Review of Its Cost-Effectiveness

by Group for the Advancement of Psychiatry, Susan G. Lazar MD (Editor)

Overview

In Psychotherapy Is Worth It: A Comprehensive Review of Its Cost-Effectiveness, edited by Susan G. Lazar, M.D., and co-authored with members of the Committee on Psychotherapy of the Group for the Advancement of Psychiatry, surveys the medical, psychiatric and psychological literature from 1984 to 2007 that is relevant to the cost-effectiveness of all kinds of psychotherapy. The volume explores the cost of providing psychotherapy in relation to its impact both on health and on the costs to society of psychiatric illness and related conditions.

Written for psychotherapists, psychiatric benefit providers, policy makers, and others interested in the cost-effectiveness of providing psychotherapeutic treatments, this book analyzes the burden of mental illness, particularly in the United States, and the enormous associated costs to society that constitute a chronic, insufficiently recognized crisis in the health of our nation. The authors point out that in the United States nearly 30% of the population over the age of 18 has a diagnosable psychiatric disorder and yet only about 33% of those treated receive minimally adequate care. In fact, most people with mental disorders in the United States remain untreated or poorly treated, leading to loss in productivity, higher rates of absenteeism, increased costs, morbidity and mortality from medical illnesses, and loss of life through suicide.

This book provides a systematic and comprehensive review of 25 years of medical literature on the cost-effectiveness of psychotherapy and discusses the: • Epidemiology of mental illness, including prevalence and treatment rates• Misconceptions and stigmas associated with psychiatric illness and the provision of psychotherapy and how they affect those most in need of care • Cost-effectiveness of psychotherapy for the major psychiatric disorders as well as savings that psychotherapy can yield in increased health, work productivity, lives saved, and medical and hospital related costs

For instance, in a review of 18 studies conducted from 1984 to 1994, psychotherapy was found to be cost-effective in treating patients with severe disorders, including schizophrenia, bipolar disorder, and borderline personality disorder, and led to improved work functioning and decreased hospitalization. Likewise, studies point to the enhancement of outcomes when psychotherapy is used in conjunction with medical therapies in the treatment of cancer, heart disease, and other prevalent, chronic diseases. Psychotherapy Is Worth It: A Comprehensive Review of Its Cost-Effectiveness concludes that studies confirm psychotherapy works for many conditions, is cost-effective, and is not over-used by those persons not truly in need. A treatment that is cost-effective is not "cheap"; rather, it can provide effective medical help at a cost acceptable to society, in comparison both to other effective treatments for the same condition and to medical treatments for other classes of mental disorder.

Product Details

ISBN-13:	9780873182164
Publisher:	American Psychiatric Publishing, Incorporated
Publication date:	03/11/2010
Sold by:	Barnes & Noble
Format:	eBook
Pages:	359
File size:	7 MB
Age Range:	18 Years

About the Author

Susan G. Lazar, M.D., is Past Chair of the Committee on Psychotherapy, Group for the Advancement of Psychiatry; Clinical Professor of Psychiatry at Georgetown University School of Medicine, George Washington University School of Medicine, and Uniformed Services University of the Health Sciences; and Supervising and Training Analyst at the Washington Psychoanalytic Institute.

Table of Contents

ContributorsAcknowledgmentsChapter 1. IntroductionChapter 2. Psychotherapeutic and Psychosocial Interventions in Schizophrenia: Clinical Outcomes and Cost-EffectivenessChapter 3. Psychotherapy in the Treatment of Borderline Personality DisorderChapter 4. Psychotherapy in the Treatment of Posttraumatic Stress DisorderChapter 5. Psychotherapy in the Treatment of Anxiety DisordersChapter 6. Psychotherapy in the Treatment of DepressionChapter 7. Psychotherapy and Psychosocial Interventions in the Treatment of Substance AbuseChapter 8. Psychotherapy for Patients With Medical ConditionsChapter 9. Psychotherapy for Children and AdolescentsChapter 10. The Place of Long-Term and Intensive PsychotherapyChapter 11. EpilogueSubject IndexIndex of Treatment Studies

What People are Saying About This

David Spiegel

As we redesign health care financing in the United States, Psychotherapy Is Worth It is a must read. It is a lucid, scholarly, tightly edited examination of the costs and benefits of psychotherapy for a wide range of psychiatric and medical disorders. Health care planners, psychotherapists, and physicians cannot afford to overlook this book.

Peter Fonagy

This is a long awaited essential piece of integrative work that finally communicates the value of psychotherapy using the most effective universal currency, money. The book is the best and most comprehensive compilation of information to date on the cost of and benefit from psychotherapy. It is authoritative and even-handed, informative and never shirks complexity. In addition, almost as a bonus, a massive body of information is presented in a highly accessible, readable and stimulating style. It is an essential resource for anyone trying to make a case for psychotherapy services, whether this is for an individual case, a local service or a national healthcare system. A true achievement!

Robert J. Ursano

In this volume, Dr Lazar and her authors move us forward toward our goals of evidence based, cost effective, available and destigmatized psychotherapeutic care for our patients.

William J. Coburn

In this much-needed, compelling, and well-researched volume, Dr. Lazar and The GAP Committee On Psychotherapy bring to light, in very accessible language, what psychotherapists witness first-hand and what the public-at-large, including policy-makers, needs to know about mental health and its startling connection to economics. Armed with scientific data about the efficacy of and necessity for psychotherapy, the authors underscore the ameliorative effects and, crucial in today's economic climate, the cost-effectiveness of engaging in psychotherapy in response to wide-ranging physical and emotional problems. This book is a must-read for anyone interested in reducing human suffering and the enormous fiscal toll that it perpetuates.

Editorial Reviews

Reviewer: Heather Huang, MD (University of Wisconsin School of Medicine and Public Health)
Description: This is a comprehensive review of the literature examining the cost-effectiveness of psychotherapy.
Purpose: By examining the aspects of psychotherapeutic interventions for major psychiatric diagnoses, the book aims to investigate their cost-effectiveness.
Audience: It is intended for psychotherapists, providers of psychiatric care, policy makers, and anyone else interested in the costs of providing psychotherapeutic treatments.
Features: A brief overview of the impact and prevalence of mental illness in society begins the book, with a discussion of the complexity of cost, providing a framework for understanding the multiple dimensions of cost and cost-effectiveness. Subsequent chapters summarize the literature as it pertains to the evaluation of cost-effectiveness of psychotherapy in various psychiatric diagnoses, including schizophrenia, borderline personality disorders, PTSD, anxiety disorders, depression, and substance abuse. Separate chapters address psychotherapy in patients with medical conditions, children, and adolescents, as well as the place of long-term and intensive psychotherapy. Several chapters use tables to summarize the important references.
Assessment: In an era of medicine dominated by cost considerations, emphasis on biologic treatments, and evidence-based medicine, psychotherapy has lost some centrality as a therapeutic treatment modality. This book comprehensively examines research literature that addresses cost-effectiveness of various psychotherapeutic modalities for a number of the most important psychiatric conditions. It touches upon the multiple ways that psychotherapy is used (supportive, educational, insight-oriented, behavioral, cognitive restructuring) for various illnesses. Through summarizing research literature of sound methodology, it overwhelmingly demonstrates the multiple ways that psychotherapy reduces healthcare costs (overall medical utilization, frequency of hospitalization, duration of hospital stay, and work days lost). Reviewing mostly positive studies, this book does not provide an in-depth summary of the negative or equivocal literature, although it does address equivocal studies in general.

Doody's Review Service

Reviewer: Heather Huang, MD (Rush University Medical Center)
Description: This is a comprehensive review of the literature examining the cost-effectiveness of psychotherapy.
Purpose: By examining the aspects of psychotherapeutic interventions for major psychiatric diagnoses, the book aims to investigate their cost-effectiveness.
Audience: It is intended for psychotherapists, providers of psychiatric care, policy makers, and anyone else interested in the costs of providing psychotherapeutic treatments.
Features: A brief overview of the impact and prevalence of mental illness in society begins the book, with a discussion of the complexity of cost, providing a framework for understanding the multiple dimensions of cost and cost-effectiveness. Subsequent chapters summarize the literature as it pertains to the evaluation of cost-effectiveness of psychotherapy in various psychiatric diagnoses, including schizophrenia, borderline personality disorders, PTSD, anxiety disorders, depression, and substance abuse. Separate chapters address psychotherapy in patients with medical conditions, children, and adolescents, as well as the place of long-term and intensive psychotherapy. Several chapters use tables to summarize the important references.
Assessment: In an era of medicine dominated by cost considerations, emphasis on biologic treatments, and evidence-based medicine, psychotherapy has lost some centrality as a therapeutic treatment modality. This book comprehensively examines research literature that addresses cost-effectiveness of various psychotherapeutic modalities for a number of the most important psychiatric conditions. It touches upon the multiple ways that psychotherapy is used (supportive, educational, insight-oriented, behavioral, cognitive restructuring) for various illnesses. Through summarizing research literature of sound methodology, it overwhelmingly demonstrates the multiple ways that psychotherapy reduces healthcare costs (overall medical utilization, frequency of hospitalization, duration of hospital stay, and work days lost). Reviewing mostly positive studies, this book does not provide an in-depth summary of the negative or equivocal literature, although it does address equivocal studies in general.

Doody Reviews