How Effective is Psychotherapy in Forensic Cases?

Mental illnesses such as major depressive disorder and posttraumatic stress disorder are increasingly becoming a serious public health issue worldwide. Left untreated, these disorders can create significant impairments in daily functioning and cause extreme suffering in everyday life for many individuals. Aside from treating mental disorders with pharmacotherapy (medications and drugs), psychotherapy (talk therapy) is the treatment of choice for many psychological conditions, especially for those clients who are involved in forensic cases and are suffering from severe stress as a result.   

When a client needs psychological help in a forensic case, the question remains: How effective is psychotherapy in helping a client regain their mental health? 

Research tells us that psychotherapy is an effective option, and sometimes even more effective than medication, in treating a client with a mental health disorder (Butler et al., 2006). Large-scale meta-studies have found that Cognitive Behavioral Therapy, also known as CBT (changing thoughts from negative to positive) has proven effective in treating depression (more effective than medication), generalized anxiety disorder, panic disorder, social phobia, posttraumatic stress disorder, and childhood depressive and anxiety disorders. In addition, Cognitive Behavioral Therapy (CBT) has proven to have success in treating marital distress, anger, childhood somatic disorders, and chronic pain.  

Brain imaging studies demonstrate that clients who undergo CBT have decreased activity in the medial prefrontal cortex—the executive center of the brain—dealing with negative thoughts and self-consciousness.  In addition, CBT clients have increased activity in the hippocampus (memory center), which is known to be affected in depression (Yoshimura et al., 2014). In addition, other forms of psychotherapy, including psychodynamic therapy (dealing with unconscious and conscious motivation), have been linked to changes in brain activity in the limbic system (emotional center) and regulatory regions in the prefrontal cortex (thinking center) (Buchheim et al., 2012).

Furthermore, meditation and mindfulness-based practices (awareness in the present moment) have also been shown to have a significant impact on decreasing mental illness (Walton, 2017). Studies have found that meditation is as effective as medication in reducing depression, anxiety, and pain. Brain imaging research has also shown that mindfulness-based practices have an impact on key areas of the brain known to be affected in depression and anxiety. Also, mindfulness practice by clients has been shown to create changes in certain regions of the brainstem (regulate bodily functions) that synthesize neurotransmitters (brain chemicals that can elevate mood).

The good news is that science is now able to provide concrete evidence that psychotherapy is an effective approach to reducing mental illness. Not only do psychotherapy patients report that they feel better, but we are now able to see the impact of psychotherapy on the brain through brain scans and other assessment (testing) methods. Combined with pharmacotherapy, psychotherapy can be a useful treatment approach to help forensic clients reduce their mental illness symptoms–enabling them to recover their mental health and pursue fulfilling and productive lives.

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