The Power of Partnership
Bridging Therapy and Medication in Mental Health Care
In my early days as a psychiatrist, I often found myself caught between two seemingly contradictory approaches to mental health care.
On one hand, therapy embraces the idea that feelings like anxiety or sadness aren't inherently bad. These emotions, while painful, can provide valuable insights. That therapeutic approach often suggests that fighting against these feelings creates more suffering.
On the other hand, the medical model identifies conditions like Major Depressive Disorder as illnesses that can benefit from medication. This approach suggests that without proper medical intervention, people might suffer unnecessarily.
Beyond the False Dichotomy
This apparent contradiction can be complicated to navigate, even for clinicians. It’s no surprise that it’s even easier for clients to get stuck in one of the two extremes – diligently attending therapy but making limited progress because their symptom burden is too heavy for them to effectively apply the new insights and skills they're learning, or becoming over-reliant on medications to provide relief for their suffering.
“When you combine medication and therapy to treat depression there’s a 35% increase in response rate compared to either therapy or medication alone”
The truth is more nuanced: medication can reduce symptom burden to a point where therapy becomes more effective. Rather than competing approaches, they're complementary tools that work best in concert.
What Research Tells Us
The evidence strongly supports an integrated approach. Therapy or medication alone have similar response rates. But when you combine medication and therapy to treat depression there’s a 35% increase in response rate compared to either therapy or medication alone (Cuijpers et al., 2020). For anxiety disorders, combined treatment has demonstrated both higher recovery rates and lower relapse rates than either treatment alone (Bandelow et al., 2017).
A True Partnership in Practice
Getting the most benefit from a blend of medication and therapy isn't as simple as just doing both. The potential impact is much greater when an individual has a team working together in concert for their health.
“The potential impact is much greater when an individual has a team working together in concert for their health.”
Recently, a client who had been seeing her therapist for months was struggling with clinical depression and anxiety. Despite consistent effort, she wasn't making progress toward her goals. Her therapist digitally referred her to Care Nimble, and we provided evaluation, diagnosis and treatment options to her that same day. She was able to pick up her prescription before her next therapy session and got answers to her follow-up questions about side effects immediately. Three weeks later, she was doing well on her medication and making progress again in therapy.
In this scenario, a team-based approach combined medication management and therapy skillsets, resulting in the positive outcome we see over and over again in good clinical practice, which for many is far too uncommon to find.
Building Better Bridges
The most effective mental health care happens when:
Providers of varied skills are able to work at the top of their license to assist persons in getting unstuck in their recovery
Processes for coordination are streamlined, providing timely evaluation, treatment, and iteration
Communication flows both ways throughout treatment
The full team has access to data and client-based clinical outcomes
When we move beyond the false dichotomy between therapy and medication, we create space for what really matters: personalized care that meets each client where they are.
If you're a therapist with clients who might benefit from this integrated approach, I invite you to check out Care Nimble to learn more about our team-based approach to care, and start making digital referrals when your clients are in need.
Dr. Erik Vanderlip is a board-certified psychiatrist and Chief Medical Officer at Care Nimble, an online provider of psychiatric medical management, specializing in collaborative care.
