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  • Dr. Lauren Fontenot

Beyond the Couch, Part I: Why going to therapy should be as trustworthy as seeing your Primary Care



Historically, we’ve been taught that therapy was about lying on the couch while someone deciphers your dreams to unlock your inner conflicts. While therapy looks quite different from the 1890s, that sense of “mystery” remains. However; today, I’m going to make the argument that seeing a psychologist should feel more like seeing your doctor than sitting down with Freud.

How going to therapy is like seeing your PCP:


Let’s say you’re under the weather (we’ll avoid pandemics for now). You go into your PCP; he or she checks out your symptoms and concludes you have a sinus infection. Your doctor quickly concludes that you need Antacids. Wait! Antacids? You’ve been sick before; you have an idea of how to get better. Knowing this, you’d probably question your doctor’s plan – maybe get a second opinion. In this scenario - you wouldn’t take medication that hadn’t been proven to work – so you probably shouldn’t do therapy that hasn’t been proven to work either.

This is the beauty of Cognitive Behavioral Therapy (or, CBT). Yes, you want to find the right provider for you – the right personality fit, caring, compassionate, thoughtful, but you also want someone who knows their stuff. I’ve discussed differences in training amongst different providers (LINK). Today, we’re focused on confidence in treatment - and as a provider, I’m just as confident in CBT for psychological difficulties as I am in amoxicillin for a sinus infection. That confidence comes from the fact that CBT has been tested and proven to successfully treat a variety of psychological disorders – in the same randomized controlled trials as those required of medications. The research looks different, but the results are just as trustworthy. Studies are done in different research labs to reduce bias and results are combined to show how effective the treatments amongst different individuals with different backgrounds and difficulties are. Even better, many of these research trials can tell you just where CBT stands when compared to no therapy, supportive therapy, and medications.

While results vary depending on type of difficulty and specific treatment, the resounding take away is these treatments are just as effective, if not better than, medication alone. With results like that, why not try treatment? However, just like a PCP, it’s important to ensure that your provider 1) knows the research, 2) is trained in the particular treatments you’re interested in, and 3) does the treatments as intended. The results of CBT are results we can put our trust in and feel confident about. You’d demand evidence-based treatment from your doctor. It’s time to also demand the same from your mental health provider.

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