Is talk therapy a thing of the past?

College students are turning away from talk therapy and toward medication for anxiety and depression, according to a recent study.

“The major finding of this review was that attitudes toward seeking mental health services have become increasingly negative, in more or less a linear manner, among American university students over the past 40 years,” according to the study published in the March issue of Clinical Psychology Review.

Researchers looked at published studies that used the ATSPPHS (Attitudes Toward Seeking Professional Psychological Help Scale) on a sample of American college students and conducted a cross-temporal meta-analysis, finding that “help-seeking attitudes have become significantly more negative over time.”

Those results were a surprise for researchers, says Corey Mckenzie, Ph.D., lead author of the study and a psychologist at the University of Manitoba, Winnipeg, Canada. “Previous studies showed attitudes becoming more positive,” he says over a Skype interview. “We found the opposite.”

Mckenzie says two reasons could be behind the negative results. Movements to remove stigma give the message that mental health problems are more of a medical issue and big pharmaceutical companies have increased direct consumer marketing by telling the public that depression and anxiety are biological issues that need medical treatment, he says.

“So what we think has happened is that people are starting to believe that depression and anxiety are biological problems that need biological treatment,” McKenzie says.

However, talk therapy does not appear to be a thing of the past as there are waiting lists for people to see therapists.

Abigail Blackburn, Psy.D., a clinical psychologist in private practice in Newton, Mass. believes that talk therapy is still in favor. “In my practice, I’ve been full. Everybody that I know in private practice is completely full and people are having trouble finding providers,” she says.

Blackburn, who treats a lot of college students in her practice, says most of her clients want to talk to her first about a medication consultation. “The clients that I see always need to really be prepped by me for a referral,” she says. “They are not crazy about the idea of taking the medication. A lot of them see it as a sign of weakness, particularly the male patients I work with. They worry about side effects and not being able to drink.”

Ethan Seidman, Ph.D., founder and director of Kendall Psychological Associates, in Cambridge, Mass. and a clinical instructor at Harvard Medical School, says he is not hearing this attitude in clients, but “patients who come in really wouldn’t be the ones who would voice it, right?”

He says he was surprised by the results considering popular culture accentuates the journey of finding your path in life. “There is so much emphasis on personal narrative as being important and meaningful that I am surprised people have negative attitudes toward psychotherapy,” Seidman says. “At the same time I am not surprised that college students today are less interested in pursuing deep questions about the meaning of life, are less interested in face-to-face interpersonal processes exploring growth. There seems to be less interest in meaning-making and more interest in performance.”

The results emphasize factors happening in society, says Seidman, such as public health destigmitization efforts of mental illness that “use the language of chemical imbalance and the language of genetic cases and disease,” making people think medication is the answer. Another factor is multi-million dollar marketing campaigns from pharmaceutical companies promoting antidepressants and antianxiety medications. “There is no ‘big therapy’ to sponsor counter-campaigns that market psychotherapy,” he says.

Seidman says psychologists could do a better job speaking the language of the brain to help combat these results. “We don’t talk enough about the ways in which we can use the mind and use the therapeutic relationship to help the brain [create] new structures that lead to contentment and equanimity and calm.”