Changing Trends Seen in Psychotherapy in Outpatient Mental Health Care

May 09, 2025

THURSDAY, May 8, 2025 (HealthDay News) — From 2018 to 2021, the role of psychotherapy in outpatient mental health care increased, while psychotropic medication without psychotherapy became less common, according to a study published online May 1 in The American Journal of Psychiatry.

Mark Olfson, M.D., M.P.H., from Columbia University and the New York State Psychiatric Institute in New York City, and colleagues examined recent national trends in outpatient mental health care and psychotherapy using data from four representative surveys of the U.S. household population. The analyses focused on 17,821 adults with outpatient mental health visits, including 6,415 with psychotherapy visits.

The researchers found that for adults receiving outpatient mental health care, there was an increase in use of psychotherapy only (11.5 and 15.4 percent in 2018 and 2021, respectively), but there was no change in use of psychotherapy and psychotropic medication together (20.8 and 22.5 percent, respectively); a decrease was seen in use of psychotropic medication only (67.6 and 62.1 percent, respectively). Per psychotherapy patient, there were increases in psychotherapy visits (mean, 9.8 and 11.8, respectively) and in total national psychotherapy expenditures ($30.8 and $51.0 billion, respectively, in constant 2021 dollars); a reduction was seen in patients receiving psychotherapy from psychiatrists (41.2 and 34.2 percent, respectively).

“Psychiatrists provided psychotherapy to a decreasing percentage of all psychotherapy patients, which may have increased the need for psychiatrists to refer patients to and collaborate with non-physician psychotherapists,” Olfson said in a press release. “At the same time, social workers and counselors, but not psychologists, assumed a larger role in providing psychotherapy, and there was an increase in the average number psychotherapy visits per patient. A decrease in the fraction of patients with just one or two psychotherapy visits further suggests there was a decline in early drop out. Americans are becoming more willing to seek out and stick with psychotherapy.”

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