The role of psychotherapy in treating psychiatric disorders.

Psychotherapy has shifted from long-term to short-term approaches, which have been found to be effective for the treatment of specific psychiatric disorders. These psychotherapy interventions (primarily behavior therapy, CBT, and IPT) have been found useful in presenting an educational framework for disorders and the treatment rationale for intervention programs. Short-term and maintenance empirical data support the effectiveness of using behavior therapy and CBT as adjunctive interventions with medications for bipolar I disorder and schizophrenia. In major randomized clinical trials, psychotherapy interventions (primarily behavior therapy, CBT, and IPT) have been shown to be effective as primary treatments (treatments of choice) for the major psychiatric problems of obsessive-compulsive disorder, panic disorder, and major depression as well as several other psychiatric disorders. The combination of psychotherapy and psychotropic medications is not always additive for acute treatment effects or especially for the maintenance of treatment effects so that the combination of psychotherapy and medications is not the most effective treatment for all psychiatric disorders. Badly needed, additional randomized controlled trials of psychotherapy, medications, and their combinations are under way in large, NIMH-supported studies of the treatment of several psychiatric disorders.