In Brief

Plain and simple, empirical research shows behavioral treatments for substance abuse and depression help people. That and the importance of federal funding for mental health research and treatments were the messages of the day at a congressional briefing given by psychologists in May.

At the briefing, sponsored by APA, the Congressional Caucus on Addiction Treatment and Recovery and the Congressional Mental Health Caucus, psychologist David H. Barlow, PhD, director of the Center for Anxiety and Related Disorders at Boston University, explained the advances of the last 30 years in treating anxiety, panic disorders and depression. For example, he noted how far anxiety treatments have come since the early 1970s, when he visited a woman who hadn't left her apartment for 20 years because of her fear of panic attacks.

"We couldn't do much for people like that back then--we just talked with them about their anxiety," Barlow said. "But in the '70s we started to learn more, to get a better understanding of what causes anxiety and depression and how we could go about treating it."

Barlow has been a key player in that work--developing and testing cognitive-behavioral strategies for overcoming anxiety, panic and depression. He presented the results of empirical behavioral studies, just as rigorous as pharmaceutical research, that show the success of treatments like exposure therapy and cognitive-behavioral techniques that teach people how to think differently about their emotions.

"But now," said Barlow, "the major problem is getting treatments to people who need them."

Also since the 1970s, said psychologist William Miller, PhD, of the University of New Mexico, alcohol dependence has gone from being viewed as an unchangeable way of life to a highly treatable chronic illness. Miller's research points to the effectiveness of psychological treatments for alcoholism; 12 months after cognitive-behavioral treatment, a quarter of people are continuously abstinent, the remainder are abstinent at least 75 percent of the time, and there's an 87 percent overall reduction in alcohol consumption. "If you have to develop a chronic illness, this is not a bad choice because it's very treatable," Miller said.

Miller is also looking into ways to further improve the effectiveness of addiction treatments. He and his colleagues at the University of New Mexico's Center on Alcoholism, Substance Abuse and Addictions have added a motivational interview at the beginning of standard treatments for substance abuse and dependence. The interview, conducted by highly trained therapists, helps clients examine their own motivations and goals for change, Miller said. Both adults and adolescents showed roughly double the rate of abstinence when a motivational interview was added at the beginning of inpatient or outpatient treatment.

Psychologist Kathleen Carrol, PhD, of the Yale University School of Medicine, further described myriad empirical evidence that behavioral therapies work for a diverse range of addictions and populations, emphasizing their durability and consistency.

"If the overriding question for lawmakers is 'Is there evidence that these approaches are effective and cost-effective, and that they work in the real world?'" she said. "The answer is 'Yes.'"

--K. KERSTING