Director of Research - CNRS - University of Bordeaux
The Evaluation of Psychotherapy Efﬁcacy in France: History of the INSERM Report
Before 2004, no government in France had ever evaluated the efﬁcacy of psychotherapy (unless one considers the evaluation ordered by King Louis XVI over two centuries ago concerning Mesmer). However, the cost today of mental disorders can be counted in billions of euros per year and many of these syndromes are ranked among the top 20 most handicapping conditions according to the World Health Organization. Following the insistence of several national associations for the rights of patients in psychiatry in 2002, the French government solicited the expert center of INSERM to conduct a thorough evaluation of the efﬁcacy of three different forms of psychotherapy: psychodynamic or psychoanalytic therapy, cognitive-behavioral therapy, and family therapy. The results of this two-year investigation revealed that cognitive-behavioral therapy was far superior to psychoanalysis in terms of the number of disorders for which efﬁcacy had been demonstrated (with family therapy ranking between the two other forms). These results were immediately and vociferously contested by members of the psychoanalytic community, resulting in the removal of this report from the ofﬁcial website of the Ministry of Health. INSERM, however, refused to remove the report from their ofﬁcial website and defended its scientiﬁc validity and the rigor of its methods. This presentation will discuss the debate surrounding this report, the criteria used by INSERM for the evaluation of psychotherapy, and the implications of its results for the promotion of quality mental health care in France.