Talk therapy provides enduring relief from depression years after treatment, study finds

From PsyPost on 07/19/26

Talk therapy provides lasting relief from depression, with the benefits persisting for several years after treatment ends. A new, large meta-analysis evaluating tens of thousands of patients tracked these mental health improvements over time, mapping exactly how long people feel better. The research was published in the journal World Psychiatry.

For more click here.

A few note worthy points:

1. Talk therapy may be more helpful than medication.
2. Talk therapy benefits are long lasting over several years.
3. In general, maximum benefit is achieved at about 3 months.
4. "Talk therapy" is professionally referred to as "psychotherapy" and colloquially as "counseling."]
5. "Psychotherapy" is much different than simple conversation because the therapist knows the most helpful questions to ask to explore areas that will be most helpful to the client and is ethically bound to put the client's needs ahead of their own.

MAID, Medical Assistance In Dying, available in New York State as of 08/05/26

On 07/18/29 I took an online CEU course from the Wurzweiler School of Social Work at Yeshiva University on “Understanding Medical Aid In Dying: Clinical, Policy, and Caregiver Perspectives.” There are 14 jurisdictions that now allow MAID with New York State’s more recent law taking effect on August 5, 2026. MAID is also legal in Canada and many other countries.

Self administered end of life chemicals is not called “suicide” by people in the field. Terms such as “death with dignity” are preferred. Also, MAID is not euthanasia. Euthanasia is ending life by another and it is illegal in all jurisdictions in the US although allowed in some other countries.

Here is a brief YouTube video about Barbara Goodfriend’s MAID experience on CBS Eye On America broadcast on January 28, 2025.

This the first in a series of article on MAID which will be tagged MAID.

Psychotropic medications and human functioning.

There is a very good book entitled “The Social Worker and Psychotropic Medication” by Kia Bentley, Shannon Hughes, and Joseph Walsh which attempts to cover what Social Workers should know about psychotropic medications.

When I graduated with my MSW in 1972 psychotropic medications had not yet been formulated and used in the treatment of symptoms of mental health problems. Psychodynamic oriented psychotherapies and custodial care were the predominant treatment strategies. The bio-psycho-social model of assessing problems in functioning was not described until 1977 by Dr. George Engel at the University Of Rochester. The Social Work knowledge base has always focused on what Social Workers called the “person in situation” model. 

Over the course of my 58 year career as a Psychiatric Social Worker I have learned about psychotropic medications and their effects on human functioning from “on the job training” and reading journal articles and books. It is interesting how the predominant treatment of symptoms of mental health problems has shifted from the psychological to the pharmacological. Some of this shift has been beneficial and some of it has been harmful. A good Social Worker is aware and educated about both.

The key question from a Social Work perspective is “How do psychotropic medications affect human functioning?” A corollary question is “what professional discourse is most helpful in assessing how psychotropic medications enhance or detract from human functioning?”

Monitoring effects of psychotropic medications.

As a Psychiatric Social Worker, and not a physician, I still spend a lot of time and energy discussing with my clients their medications, especially their psychotropic ones with them. 

Knowing about the power of the placebo effect I am very cognizant and curious about what my clients think about their medications. Do they think they will help, are skeptical, or have mixed feelings? Will they be compliant and take them as prescribed or “forget” to take them or abuse them?

There is a fine line between medical and psychological effects of taking medications. Many of my clients expect medications to be a “silver bullet” and a “magical key” to ameliorate their symptoms and improve their experience of their quality of life.

Whether medications “work” has as much to do with psychological expectations as well as the pharmacological actions. Whose job is it to monitor the efficacy of the use of medications: the prescriber, the psychotherapist or both? 

Throughout my career as a Psychiatric Social Worker I have increasingly found that it is my job if I want to help my clients improve their functioning. I find myself surprised at the lack of supervision by the prescriber on the psychological dynamics of prescribing medications. They don’t seem to have the time for it or an interest or competence in this aspect of their patients' treatment. They leave it up to the psychotherapist if the patient has one.

For more on this topic click here.

Does availability of mental health services make a difference?

I asked myself  last week what I had to show for my work after 57 years as a Psychiatric Social Worker in New York State. I decided to investigate further and here is part of what I found. New York is ranked as #1 in mental health and well being among all the US states according to Mental Health America in 2025. There are seventeen indicators that are measured to determine these rankings one of which, is “thoughts of suicide in the past year.” New York is ranked third lowest suicide rate in the nation after District of Columbia and New Jersey. 

In my career I have estimated I have done over 15,000 suicide/homicide evaluations most of them in large urban emergency rooms after an attempt was made or the person was bought in with a mental hygiene arrest. How many lives working as part of a mental health system team have been saved? Compared to other states, very many.

The national average suicide rate stands at 13.7 deaths per 100,000 people. However, individual state rates vary dramatically—ranging from a low of 5.7 to a high of 29.7.

In general, the highest rates are concentrated in the Mountain West and Alaska, while the lowest rates are primarily found in the Northeast and California. The rate in New York is 8.3 far below the national average. 

If mental health professionals were to build a mental health system that prevented deaths from suicide what elements in that system would be beneficial to that goal?

The glaring discrepancy in suicide rates is rarely recognized and acknowledged let alone addressed. For example the suicide rates in the worst states: Alaska 29.7, Wyoming 27.8, Montana 26.8, Oregon 20,0 and the best states: New Jersey 6.7, New York 8.1, Massachusetts 8.3, and Rhode Island 8.9 is very significant with the rates in the worst states being three times higher than the best states.

One of the biggest factors in suicide rates is the quality of the infrastructure that supports personal functioning. In other words, does a person have a place to turn when they are down and out? Is there help available? 

Mr. Rogers said that his mother told him, “Freddie, if you are in trouble look for the helpers.” Mental health professionals are a type of helper. The concern is that they are available  to meet needs of ultimate desperation. In some states that are more available than in others. The public health data of suicide rates is one way of measuring the difference their availability makes in the health and life of a population,

Lula Dean's Little Library Of Banned Books

 I noticed this morning, July 2, 2026,  that Kirsten Miller's book, Lula Dean's Little Library Of Banned Books, kindle version, is on sale for $2.99. I read it a couple of months ago and it is very enjoyable and illuminates the dynamics of book banning in our current society.

How it works: Small talk is beneficial

When it comes to small talk it is the process not the topic that provides benefits to the participants.

An interesting study asked people to predict how satisfied engaging in small talk about things like the weather, current events, traffic, etc. People prior to the small talk conversations rated the satisfaction as being low, but after the conversations rated their satisfaction much higher. Why the discrepancy between predicted and actual satisfaction? 

One explanation is that people based their prediction of satisfaction on the topic not the dynamics of the social interaction.

Is it worth engaging in small talk with people? The research finds that yes for most people it is. Observe your own experience and report your findings in the comments. I would like to know what the results are if you intentionally observe your experience.

For more click here.

Good work noted: Mental Wealth project at University of Sydney

 

Mother Teresa said that the US while the wealthiest nation on earth is also the most spiritually impoverished. The Beatles sang "Money can't buy you love."  Americans are very focused on money as the measure of success. The Stoics taught that the development of virtue is the proper measure of success.

How it works: Conspiracy thinking

 

Conspiracy thinking considered from a cognitive developmental model is immature and based on an egotistical desire for security in what is perceived as a confusing and threatening world. People who engage in conspiracy thinking should be approached with compassion without condescension and a passive non threatening friendly suggestion to consider other optional understanding of the phenomena under consideration.

How do systems work?

One of the obstacles to satisfying and fulfilling functioning is the lack of understanding of how systems work. Most of the systems that comprise modern life are complicated and thus confusing, frustrating, anxiety inducing, and can seem overwhelming. As a Psychiatric Social Worker I spend a lot of effort and energy in helping clients navigate the various systems that can provide the resources for them to meet their needs and are requiring some degree of compliance, cooperation, and behavior. This assistance requires that the Psychiatric Social Worker understands how these systems work. This understanding requires education and experience. This understanding of how systems work is a major component of Social Work competence.

The assistance in navigating systems is sometimes referred to as “empowerment.” Empowerment involves three activities: providing information, teaching skills, and providing opportunities to use that information and those skills.

What are the major systems that people function within in our current society? Some of them are education, health, legal, economic, recreational, media, social welfare, and political. Within these domains there are multiple subsystems.

Here on Markham’s Behavioral Health we will be exploring how these various systems work and how they can best be navigated to obtain what resources they provide to improve a person and their family’s functioning.

The overarching question is how do these systems affect a person and community’s mental health?

Michel Foucault called these systems “discourses.” Discourse analysis involves several components of the discourse: knowledge, skills, values, expert representatives of the discourse. One of Foucault’s great contributions was to analyze discourses historically and trace their development in society over time usually involving a couple of centuries or more. Understanding discourse development historically gives the student a better understanding of how the discourse’s knowledge, skills, values, and expertise evolved and came to be what they are today.

The first discourse to be described on Markham’s Behavioral Health is the health care system in the United States which is, compared to other first world countries, very dysfunctional and increasingly difficult to navigate to get one’s health care needs met. It is hoped that by better understanding the system one can better manipulate it to get one’s health care needs met and to help change it to a system that better meets the needs of the American people.

People learn poor interpersonal skills from their parents in their first 6 years.

From The Conversation 06/09/26, "Kids learn to bully from adults’ threats, manipulation and criticism – a child psychologist explains how parents can model better tactics"

Think about all the ways you can get someone to do something that’s undesirable to them, especially if you have power over them. You can use positive tactics, such as direct encouragement, incentives and praise. You can try negative tactics, such as threats, manipulation and force. Some – asking politely, saying please and thank you each time – work better than others, such as nagging or pleading.

Children learn which tactics work and are acceptable by seeing how adults, who hold power over them, employ them.

On one extreme, observing aggression between parents increases risk for children’s heightened aggression and violence in their own social relationships. Stanford psychologist Albert Bandura’s seminal 1961 “Bobo Doll Study” found that preschool children who saw an adult hit and kick a life-size inflatable figure were more likely to be aggressive toward that figure when frustrated.

In my own research, I focused on children who were exposed to domestic violence between parents as early as in infancy. As adults, these now-grown children were more likely to be both victims and perpetrators of violence with their romantic partners. People were particularly likely to be violent as adults if they were exposed to domestic violence when they were in preschool, as opposed to later in childhood, suggesting early childhood is a particularly important time for parents to model healthy conflict resolution.

Parents and other authority figures teach young children better by what they do, how they behave, than by what they say or as the aphorism is stated, "Actions speck louder than words." 

At age 80 I reflect on how my ex-wife and I modeled conflict resolution for our 9 children and I realize now that it was pretty dysfunctional and had a negative influence on our children. There is not much to be done about it now but admit our mistakes and ask for forgiveness.

The key skill children learn is how to use power in their interpersonal relations. Sometimes this is described as "control issues." There are things that children want to do that they are told they can't, and things that children don't want to do that they are told they have to. These conflicts lead to power struggles. The interesting thing to observe is who is going to win and how do they do it, and what are the consequences of getting one's way?

Are there better ways of resolving these conflicts than others? Yes. What are they?

Community programs mitigate opioid deaths significantly.

David Wazana has written a great article for the Rochester Beacon entitled, "Rochester joins effort to raise naloxone awareness." which was published on June 12, 2026. 

Rochester’s Neighborhood Ambassador Program, a city-funded, community-driven program, seeks to address the opioid epidemic by recruiting and training neighborhood ambassadors in opioid crisis interventions. NAP also distributes naloxone kits, which contain naloxone nasal sprays and strips to test for fentanyl and xylazine.

According to preliminary data from the Centers for Disease Control, 2025 saw an almost 14% decrease in overdose deaths; New York, along with Rhode Island, North Carolina, Alabama, and Vermont, saw the largest decline, with 25% fewer overdose deaths in 2025 than in 2024.

_______________________

In Monroe County, opioid-related overdose deaths dropped from 433 in 2023 to 216 in 2024, a decline of 50%, according to recent data from the county medical examiner. The decline mirrors a national trend, which researchers and advocates like Klee attribute to harm-reduction efforts and increased access to Nalaxone, as well as growing awareness of the dangers of opioid use.

In 2023, at the height of the nationwide opioid epidemic, opioid overdose deaths peaked at 79,000 before beginning a steep decline, which has continued since then.

I have known many people professionally and personally who have died from opioid overdoses. I also know of people who have been saved from dying by the quick administration of naloxone.

Deaths from naloxone overdoses are devastasting for families and communities. In attempting to counteract these loses it is important to know, support, and utilize harm reduction strategies. The data indicates that they work saving lives and improving the health of individuals, and the well being of families and communities.

As a side note, David Wazana's article is a great example of solution oriented journalism. Kudos to him for his good article and for the Rochester Beacon for publishing it.

The Platinum Rule

As a child, I greedily absorbed the many books I read as visions of alternate lives. Now, still capable on occasion of the same sort of greedy absorption, I am also aware of books as structures of language and of specific problems that they set out to address.

Spacks, Patricia Meyer. On Rereading (p. 46). Harvard. Kindle Edition. 

As a Psychiatric Social Worker I have been taught and learned that the skill of empathy is essential to good Social Work practice. In order to become skilful in empathy a person can practice the “platinum rule” which is to do unto others as they would have you do unto them. To practice the platinum rule one must know how others, especially those different from oneself, want to be treated. How does one learn this? The easiest way is through reading and rereading. As Spacks puts it, to experience “visions of alternative lives.” In reading books and working with people from different cultures, religions, generations, etc. I often feel like a voyeur. This is one of the reasons I enjoy my profession so much. I am endlessly curious about other people’s lives and experiences.

Intolerance of ambiguity can be a problem creating more problems

Some people tolerate ambiguity better than others who tend to see the world in black and white. The intolerance of ambiguity results in psychiatric symptoms of control, anxiety, depression, irritability, and compulsive behaviors such as drinking and drugging, pornography abuse, over working.

My mother used to call people who overthink things "worry warts."

How can people who have difficulity tolerating ambiguity and uncertainty be helped? The easy strategy for symptom relief is medication whether licitly subcribed by a health care professional or self administered having been obtained "off the street."

People who have difficulty with ambiguity have what is sometimes called an "insecure attachment style." Trust is a big challenge since negativity and pessimism are predominant thought processes. It helps if the person has relationships in which partners are reliable, honest, predictable and "there for them." The partner being non anxious, secure, and able to tolerate ambiguity is reassuring and soothing and the insecure person is able to "lower their guard" a bit and take a few bricks out the wall that they have surrounded themselves with to protect and defend themselves from the threat of future hurt.

People with difficulty tolerating ambiguity often are over controlling, rigid, stubborn, have a need to be right about everything, and insist that things be just so as they expect and demand. People they are in relationship with and trying to control often object to this style of interaction and the very things the controlling person was afraid of happening, happens. The attempt at controlling, and the other person objecting, rejecting and abandoning the person, is the very thing the person was trying to avoid by being so controlling in the first place and so there is a vicious cycle with the interaction escalating unitl a rupture occurs. In the extreme this interative pattern can lead to intimate partner violence, IPV.

Medications will not change the interpersonal activities engaged in this problematic situation. Often outside therapy individually and sometimes with couples and families can be helpful. The person with difficulty tolerating ambiguity needs help in managing their anxiety generated by uncertainty so they can manage their individual and interpersonal functioning in a more satisfying and fulfilling manner.

For more click here.