The healthcare industry favors psychotherapies that have been found effective in randomized controlled studies. Thus, cognitive behavioral therapies are typically covered while lengthier, more costly treatments such as psychodynamic therapy are often truncated or not covered. Reports suggest that roughly two-thirds of privately insured Americans are enrolled in plans that limit duration of treatment based on research findings.
Advocates of cognitive behavioral therapy call this a fortuitous confluence of evidence and insurance interests.
Opponents call it a ploy to cut down on costs, one that keeps many people from getting the care they need. They cite evidence that many patients need 20 or more sessions of the more traditional forms of therapy to respond to treatment.
The situation might change now that the Mental Health Parity and Addiction Equity Act has gone into effect, as of Jan. 1.
Passed as part of the federal stimulus package, the act requires that insurers provide mental health coverage that's no less restrictive than traditional medical coverage. In theory, the act should enable patients needing lengthier therapy to receive it. But skeptics point to several loopholes -- chiefly, that insurance companies are not required to cover mental health care at all.
The new law affects 113 million Americans whose states did not already have mental health parity provisions in place. California has followed a mental health parity law since 2000 and so will not be affected.