There is extensive evidence demonstrating that psychotherapy can be an efficacious and effective health care service for a wide range of commonly experienced mental health and health conditions. This conclusion applies across the lifespan and is based on many hundreds of studies, including both randomized controlled trials and studies examining the impact of evidence-based psychological treatments delivered in typical clinical settings.Psychotherapy works for the treatment of depression. Contrary to popular belief, it works at least as well (if not better) for patients with severe symptoms as it does for those experiencing milder forms of depression. Psychotherapy is as effective as medication in treating depression and is more effective than medication in preventing relapse. For some patients, the combination of psychotherapy and medication will be more beneficial than either treatment on its own. Compared to the use of medication alone for the treatment of bipolar disorder, combining psychotherapy with medication leads to patients functioning better and having fewer relapses. Emerging evidence suggests that adding psychotherapy to medication results in better treatment adherence, reduced subjective burden of disease, and lower suicide rates.In the treatment of anxiety and related disorders, there is strong evidence to support the use of psychotherapy as a first line treatment. This holds across the lifespan for generalized anxiety disorder, social anxiety disorder, specific phobia, panic disorder, obsessive-compulsive disorder, and posttraumatic stress disorder.Although the strength of evidence varies considerably across the treatment of anxiety and related disorders, in general, psychotherapy and medication appear to be equally effective. For many of these disorders the rates of premature termination of treatment are lower for psychotherapy than for pharmacotherapy.Overall, for depression, anxiety disorders, and related disorders, the strength of psychotherapeutic effects is similar or superior to what is typically found with the pharmacological treatment of these disorders. In light of this pattern of results and the potential for negative side-effects associated with medication, many clinical practice guidelines encourage clinicians to consider psychotherapy as the first treatment option to offer to patients with these disorders.Psychotherapy reduces depression and anxiety in people with coronary heart disease (CHD)-an important finding given the psychological burden associated with these symptoms and the fact that depression has been shown to a risk factor for CHD. There is also some evidence that, when added to usual medical treatments for patients with CHD, psychotherapy significantly reduces cardiac-related death.Psychotherapy can be more efficacious in reducing smoking (another CHD risk factor) than the usual medical treatment of CHD.
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