Making Psychotherapy Great Again?

Psychotherapy never stopped being as "great" as other treatments. This column explores the evidence base for both psychotherapy and medications, using depression as a specific example. The limitations are comparable for psychotherapy and medication, with much of the evidence based on small degrees of "statistically significant" rather than "clinically meaningful" change. Our field's biomedical emphasis leads to a false assumption that most patients present with single disorders, when comorbidity is the rule rather than the exception. This false assumption contributes to limitations in the evidence base and in our ability to treat patients optimally.