When Therapy Isn't Enough: How Decision Science Can Improve Your Life

By Nika Kabiri

If therapy isn't enough, or doesn't feel right, what can you do? This book introduces a groundbreaking alternative to therapy rooted in Decision Science. You'll learn science-backed reasons why therapy isn't working for you, and you'll learn why a Decision Science approach can help you better. This quick read includes practice exercises to help you build the skills you need to make life-changing decisions. Also in these pages is the author's personal story of how she, after years of suicidal depression and failed attempts at therapy, turned her life around and learned to thrive, one decision at a time. 

• Language: English
• Publisher: Nika Kabiri
• Release date: May 25, 2024
• ISBN: 9798224435111

Nika Kabiri

Nika Kabiri (JD PhD) is a Decision Scientist who has spent 20+ years studying decision-making in a variety of contexts, from relationships to politics to business. She writes, speaks, and consults, helping people get real, move forward, and minimize regret. She has worked with clients like Amazon, Google, and Microsoft, and is a former University of Washington faculty member. Nika's work on decision-making has been featured in Fast Company and Yahoo, and she was recognized as a top decision coach in LA Weekly. She has been quoted in Time, the Washington Post and Gizmodo and has contributed to media sources like The Hill, Huffington Post, and Inside Sources. She is also co-author of the bestselling book Money Off the Table: Decision Science and the Secret to Smarter Investing. Nika earned her PhD in Sociology at the University of Washington, where she specialized in choice theory and institutional analysis. She also has a JD from the University of Texas. 

Book preview

Introduction

The first time I put a loaded gun to my head, I had been in and out of therapy for about seven years. Over that time, I’d seen at least three therapists and one psychiatrist. I’d taken a load of meds and been in and out of a mental hospital. I had learned a lot about myself and changed some behaviors for the better, but somehow, after so much time getting therapeutic help, I ended up wanting to end my life again. It’s made me wonder: as enriching as therapy can be, can it be everything for everyone?

Hear me out.

A lot of people are going to therapy. A lot more than ever before. In 2021, about 14.5 million more people sought mental health treatment than in 2002.[1] Between 2018 and 2023, the U.S. behavioral therapy market had grown an average of 7.3% per year, and earnings by behavioral therapists saw a compound annual growth rate of 8.2%.[2]

Despite the growth of this industry, things haven’t improved as much as might be expected. While 10.5% of the population experienced depression in 2015, 17.8% said they were depressed in 2023.[3] Suicide rates increased by 30% between 2000 and 2020.[4] And an August 2023 Time Magazine article points out that since 2002, the number of Americans getting mental health care has grown by 33%, but the proportion who say their mental health is excellent has fallen by 21%.[5]

Something doesn’t add up.  

I’m not saying that no one has ever been helped by therapy. Many people have. I have, and maybe you have. All I’m saying is that therapy may not be enough. And it may not be for everyone.

Yet when we’re going through a tough time, therapy is considered the solution. So, when it doesn’t work, the assumption is that we haven’t yet found the right therapist, or that we aren’t working it. In other words, therapy can’t possibly be the problem.

For those of us gung-ho about therapy, this is encouraging. We just need to keep pushing. But for others of us who’ve been left unfulfilled by it, or who simply feel uncomfortable with the idea of it, the notion that therapy is the only option can bring about a sense of hopelessness.

But fortunately, there is hope.  

In this guide, I’ll explain why therapy might be limited in giving everyone what they need to break out of a funk, get unstuck, and move toward the life they want. Next, you’ll learn the basics of Decision Science, an alternative if not complimentary framework for improving your wellness, one that has the power to help you when therapy may not be able to. Understanding what Decision Science is will prepare you for the remaining sections of this guide, which will explain the specific ways in which a Decision Science approach to life improvement can make you feel and live better.

Finally, you’ll read my personal story, not because I’m special, but because I’m not. Like many of us out there, I was once severely depressed and suicidal, and therapy only went so far. I felt hopeless. And aimless. Once I realized the power of good decision-making, I effectively ended my depression and built a beautiful life for myself. A life I never imagined was possible.

You too can have a life you never imagined was possible. You just need to choose to read on.

The Practice of Therapy

The human brain is fascinating. Research in psychology has given us so much insight into what makes us tick that it’s kind of unbelievable. The same can be said for research in neuroscience, behavioral economics, and sociology.

But the practice of psychological therapy... that’s another thing.

Here’s how therapy generally works. You make an appointment with a therapist, which usually lasts about an hour. You go to their office, sit across from them, and start telling your story. You tell them why you’re there, what you want to work on, how you feel. They