Balancing therapy and medication in behavioral health treatment

Behavioral health care is evolving, as providers are increasingly recognizing that a one-size-fits-all approach is no longer sufficient. For many patients, the most effective path to recovery involves a medication and therapy combination that addresses both the biological and psychological dimensions of mental health. As health care organizations and providers strive to deliver integrated, evidence-based care, understanding how to balance pharmacological treatment with psychotherapeutic interventions is vital.

Understanding the role of medication in mental health treatment

Medications play an important role in mental health care by helping to manage symptoms, stabilize mood, and support overall functioning as part of a comprehensive care plan.
 

Symptom stabilization

Symptom stabilization is a critical first step in effective mental health treatment. The process involves reducing the intensity and frequency of distressing symptoms such as anxiety, depression, mood swings, or psychosis, allowing patients to regain a sense of control and safety. Medications can be instrumental in this phase, helping to create the stability needed for individuals to engage meaningfully in therapy and other supportive interventions.
 

Therapy readiness

Therapy readiness refers to a patient’s ability to actively participate in and benefit from psychotherapeutic treatment. When symptoms such as severe anxiety, depression, or disorganized thinking are stabilized, often through medication, patients are better equipped to process emotions, reflect on experiences, and develop coping strategies. Achieving therapy readiness ensures that individuals can engage more effectively in sessions, leading to more meaningful and lasting progress.
 

Influencing brain chemicals

Many mental health medications work by influencing brain chemicals such as serotonin, dopamine, and norepinephrine. These chemicals play key roles in regulating emotions, mood, and thought patterns. By adjusting the levels or activity of these neurotransmitters, medications can help correct imbalances that contribute to conditions like depression, anxiety, or bipolar disorder. This biochemical support can reduce symptoms and improve overall cognitive and emotional functioning, making it easier for patients to engage in therapeutic work and daily life.
 

Types of behavioral health medications

Behavioral health medications include a range of types such as antidepressants, antipsychotics, anxiolytics, mood stabilizers, and anti-anxiety medications, each targeting specific symptoms and conditions to support mental and emotional well-being.
 

Antidepressants

Antidepressants are commonly used to treat conditions such as depression, anxiety disorders, and PTSD by helping to regulate mood-related brain chemicals like serotonin and norepinephrine. They often take several weeks to become fully effective and may be used alongside therapy for optimal results.
 

Antipsychotics

Antipsychotics are primarily used to manage symptoms of schizophrenia, bipolar disorder, and other conditions involving psychosis, such as hallucinations or delusional thinking. These medications work by altering the effects of neurotransmitters like dopamine to help stabilize mood, reduce agitation, and improve thought clarity.
 

Anxiolytics

Anxiolytics are medications designed to reduce symptoms of anxiety, including excessive worry, panic attacks, and physical tension. Often prescribed for short-term use, they work by calming the central nervous system, with some, such as benzodiazepines, producing rapid relief of acute anxiety symptoms.
 

Mood stabilizers

Mood stabilizers are commonly used to treat mood disorders such as bipolar disorder. They help to prevent extreme mood swings, including episodes of mania and depression. These medications work by balancing brain activity and stabilizing neurotransmitter functions to promote emotional steadiness over time.
 

Stimulants

Stimulants are often prescribed to treat attention-deficit hyperactivity disorder (ADHD) by increasing the levels of certain brain chemicals, such as dopamine and norepinephrine, that help improve focus, attention, and impulse control. When used as directed, stimulants can enhance cognitive functioning and support better daily performance in individuals with attention-related challenges.
 

Anti-anxiety medications

Anti-anxiety medications are used to alleviate persistent feelings of fear, worry, and nervousness associated with anxiety disorders. These medications can include fast-acting options like benzodiazepines for short-term relief, as well as longer-term treatments such as certain antidepressants that help manage chronic anxiety symptoms.
 

Medications as a foundation for managing serious mental illness (SMI)

For individuals living with serious mental illness (SMI), such as schizophrenia, bipolar disorder, or major depressive disorder, medications often serve as the foundation for effective symptom management. While therapy offers valuable support in building coping skills and fostering emotional insight, there are limitations to therapy when symptoms are too intense or disruptive for patients to meaningfully engage. In these cases, the benefits of medication for mental illness become clear, as they stabilize mood, in turn reducing psychotic symptoms, helping to restore a baseline level of functioning. By addressing the biological underpinnings of SMI, medication enables individuals to achieve the stability needed to participate in therapy and other aspects of comprehensive care.
 

Addressing the risks of overreliance on behavioral health medications

While medications play a vital role in treating behavioral health conditions, overreliance on them can present significant risks. Solely focusing on pharmacological treatment may lead to underdeveloped coping strategies, reduced patient engagement in therapy, and a lack of attention to the psychosocial factors contributing to mental illness. Additionally, long-term use of certain medications can result in side effects, dependency, or diminished effectiveness over time. A balanced approach that combines medication with therapy and other supportive interventions helps mitigate these risks, ensuring that treatment addresses both the biological and behavioral aspects of mental health.
 

Benefits of a medication and therapy combination

Combining medication with therapy offers a comprehensive approach to mental health care by addressing both biological and psychological factors. Medication can quickly reduce acute symptoms, while therapy builds long-term coping skills and insight. Together, they lead to patients experiencing faster improvement, better adherence, and more durable outcomes.
 

Improving medication adherence through long acting injectables (LAIs)

Improving medication adherence is a critical challenge in behavioral health, particularly for individuals with severe or chronic conditions. Long acting injectables (LAIs) offer a practical solution by delivering consistent doses of antipsychotic or mood-stabilizing medications over weeks or even months, reducing the need for daily oral intake. This approach can enhance treatment continuity, decrease relapse rates, and improve overall outcomes, especially for patients who struggle with remembering or choosing to take medication regularly. By simplifying the medication regimen, LAIs support better adherence and can play a key role in stabilizing symptoms and maintaining progress in long-term care plans.
 

The future of integrated behavioral health treatment

The future of integrated behavioral health treatment lies in a more personalized, coordinated approach that seamlessly combines medical, psychological, and social interventions. As care models continue to evolve, the role of medication is essential, especially when paired with therapy, digital health tools, and community-based support. Advances in pharmacogenetics and data-driven treatment planning are enabling more precise medication choices, while collaborative care teams are improving communication between prescribers and therapists. This integrated framework not only enhances outcomes but also respects the complexity of mental health by addressing both symptom relief and long-term recovery.
 

Case studies: Medications in behavioral health treatment

Carelon Behavioral Health’s programs have been very effective implementing medications in behavioral health treatment through the naloxone vending machine program, achieving a 96% success rate in naloxone saving the lives of individuals experiencing an opioid overdose, and the Changing Pathways program, achieving a 79% reduction in the rate of overdose through initiatives such as medications for opioid use disorder (MOUD).