Growing Trend: Increase in Psychotherapy Sessions and Decrease in Medication Use for Mental Health Support

Recent research conducted by Columbia University’s Mailman School of Public Health and Columbia University Irving Medical Center highlights a notable shift in mental health treatment approaches in the United States. The study, published in the American Journal of Psychiatry, reveals that outpatient mental health care increasingly favors psychotherapy over medication. Specifically, data from 2018 to 2021 shows that the proportion of adults receiving only psychotherapy rose from 11.5% to 15.4%, while those on medication alone declined from 68% to 62%. This trend indicates a move away from relying solely on psychiatric medications, such as antidepressants, antipsychotics, anxiolytics, and mood stabilizers, toward more psychotherapeutic interventions.

The study further reports a significant increase in psychotherapy visits and national expenditures, which grew from $31 billion to $51 billion. Additionally, fewer patients are seeing psychiatrists for psychotherapy, with their share decreasing from 41% to 34%. Instead, social workers and counselors are playing a larger role in delivering psychotherapy, and the average number of visits per patient has increased. Interestingly, there is also evidence of reduced early dropout rates, suggesting that more individuals are sticking with psychotherapy treatment.

Much of this change occurred before the COVID-19 pandemic, particularly between 2018 and 2019, implying other factors contributed to this shift beyond remote mental health services. The increase in outpatient visits for those with mild or moderate distress indicates a broader acceptance of psychotherapeutic approaches. These trends may be supported by recent policy changes allowing mental health counselors and licensed therapists to bill for psychotherapy, expanding access and options for patients.

Overall, the study highlights a positive trend towards diversified mental health treatment strategies, emphasizing the growing role of non-physician mental health providers and increased patient engagement with psychotherapy, reflecting evolving preferences and policies in mental health care.

Source: https://medicalxpress.com/news/2025-05-psychotherapy-outpatient-declines-medication-mental.html