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Therapy

Once-a-Week Therapy Is Not the Only Option

There is no magic bullet for wellness or single prescription for mental health.

Key points

  • The U.S. Preventive Services Task Force is recommending that doctors screen all patients ages 8 and older for anxiety.
  • Once-a-week therapy has long been the default for mental health treatment.
  • There are not enough therapists to meet the growing need, but there also isn't a one-size-fits-all approach to mental health.

For the first time, the U.S. Preventive Services Task Force is recommending that doctors screen all patients ages 8 and older for anxiety. The goal is for primary care clinicians to identify early signs of anxiety, which can go undetected for years.

As a clinical psychologist, I feel this recommendation is a long time coming. We should be screening for mental health needs as frequently as we screen for physical health conditions. In fact, mental and physical health are inextricably linked, and it is well-documented that poor mental health can worsen chronic physical ailments and vice versa.

But there is a bigger elephant in the room we need to address first. While this new standard could help people feel more comfortable talking about their anxiety and seeking help, it doesn’t solve the real problem: the lack of mental health clinicians. In fact, this could well open the floodgates to a system that isn’t prepared for the influx of need.

Unsurprisingly, people are facing high levels of anxiety these days. The percentage of adults reporting recent anxiety symptoms jumped from 36% to 41% between August 2020 and February 2021 alone, and global stressors have only continued since then. The company I work at, Modern Health, recently partnered with Forrester Consulting on research revealing that the economic downturn and stressful world events are major sources of anxiety for people today.

Once-a-week therapy has long been the default for mental health treatment, but as more people are tested and diagnosed, there are simply not enough therapists to meet the growing need. Already most individuals aren’t able to access therapists due to long waiting lists and lack of affordability of mental health services. Imagine what will happen when an influx of people are tested and diagnosed with anxiety.

People need and deserve access to mental healthcare, but it’s critical to remember that there isn’t a one size fits all approach. Studies show that a single 20-30 minute intervention can be effective in some cases, while other studies have found that sessions that occur more frequently than once a week have better outcomes compared to weekly sessions. Intensive Outpatient Programs are also gaining traction as a shorter-term alternative to weekly therapy.

Has weekly therapy become the norm, and if so, have we forgotten to pause and consider whether or not that is really the right approach to address our needs at a given moment in time? Each individual has particular needs that fluctuate over time, so the type of support they need will also vary. It is critical that we challenge the status quo and educate individuals on the different modalities of care available that take their individual preferences into account. For example:

  • Self-guided materials. There are numerous resources online that can help individuals create a self-paced mental health routine. Mindfulness, for example, combined with self-guided CBT techniques can help reduce stress, decrease symptoms of anxiety and depression, and improve overall quality of life.
  • Group therapy and support groups. Social support is a major contributor to mental health outcomes. Groups are one way that individuals can benefit from social support in addition to learning from others and a provider.
  • Coaching. Recent research has found that for individuals with mild to moderate symptoms of depression, working with a certified coach can be a helpful and more accessible option.

The recommendation to increase screening needs to be paired with a plan to increase access to mental health resources. Screening alone is like telling people it’s raining, but that there aren’t any umbrellas. We need to look for ways to expand and augment the limited pool of therapists, such as improving access to self-guided digital mental health tools, exploring alternative “dosages” of therapy, and training and supervising coaches and other paraprofessionals in delivering evidence-based interventions.

It's time to rethink the assumption that ongoing once-a-week therapy is the only or best option for most people. There is no magic bullet for wellness and no single prescription for mental health. We need to open ourselves up to consider all the resources at our disposal to meet the growing need.

To find a therapist near you, visit the Psychology Today Therapy Directory.

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