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The human and societal toll of mental illness remains significant, despite advances in understanding and treatment. For all the optimism promised by the “Decade of the Brain” (Gabbard 1992), little evidence suggests that pharmacotherapy outcomes have improved substantially in the past four decades. As former National Institute of Mental Health director Thomas Insel noted at the conclusion of his tenure, “The unfortunate reality is that current medications help too few people to get better and very few people to get well” (Insel 2009, p. 704). Neither are psychological treatments a panacea, and too many patients are left with a burden of suffering, despite receiving skilled psychotherapy.
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