By Catherine A. Sanderson, Amherst College
Psychotherapy can be taken to mean an organized interaction between a trained professional psychologist and an individual who might be facing some mental, emotional, or psychological issues that seem to have little or no medical explanation. This interaction might happen over a period of time in different sessions that aim at identifying and treating the underlying issues. There are many different approaches to psychotherapy that also determine the goals and methods of the treatment.
What Research Tells Us
A fundamental question that often comes up is—Does psychotherapy work? This is obviously an essential question, and it’s frankly one that is pretty hard to do good research on.
Many participants strongly believe that psychotherapy is effective. An estimated 15% of all Americans seek some form of therapy every year, from seeing a therapist in a private office, to talking with a counselor at school or church, to calling a mental health hotline. And most people who go to therapy report they are satisfied, or even very satisfied, with the experience.
But it’s a bit hard to interpret these findings. After all, people typically go to therapy when they are in a pretty low spot and therefore are likely to get better even if they hadn’t gone. People responding to surveys also tend to be highly motivated to report the time and money they’ve spent going to therapy was a good investment.
People also tend to like their therapists who provide a listening ear and support at a much needed time. These factors make it somewhat difficult to rely merely on people’s own reports of the benefits of therapy for assessing its true effects.
Opinions of Clinicians
Similarly, clinicians overwhelmingly tend to think that therapy is effective. Therapists personally see clients who start therapy feeling pretty unhappy and leave feeling better, which leads therapists to believe their approach has been effective.
But of course these people might also have felt better naturally, as time passed. It’s also possible these people later relapse to their prior state but either seek out a new therapist or none at all.
Evaluating the Efficacy of a Therapy
So, what’s the right way to assess whether therapy actually works? The only completely convincing way is to use an experiment—specifically, a trial that is randomized and controlled—in which people who seek therapy are randomly assigned to either receive therapy immediately, or to be placed on a waiting list (the control condition).
But on a practical level, assigning some people experiencing psychological distress to wait before receiving therapy may not be viable ethically.
This article comes directly from content in the video series Introduction to Psychology. Watch it now, on Wondrium.
Comparison Model for Evaluating a Therapy
So, instead of no-therapy, what many clinical trials do to evaluate the efficacy of therapy is compare two different types of therapy. For example, the most commonly used approach for treating couples experiencing marital problems has been traditional behavioral couple therapy, or TBCT, which encourages couples to engage in more positive behavior with each other and teaches them communication and problem-solving strategies.
But in the 1990s, a newer form of couple’s therapy known as integrative behavioral couple therapy, or IBCT, was developed. This model includes a deliberate focus on helping people accept their partner’s problematic behavior, in part by changing their own emotional reaction to their partner.
Randomized clinical trials revealed that acceptance through changing their own reaction was in fact better than the traditional approach at increasing relationship satisfaction and preventing divorce.
Observations from Studies
What do randomized studies evaluating the overall effectiveness of therapy show? Generally that the average client who receives therapy ends up feeling better than about 80% of those who don’t. So, therapy doesn’t help everyone, but it helps many people.
It’s also important to remember that many different approaches to therapy provide some of the same benefits. A therapy’s effectiveness may therefore be more of a function of these common features than a particular therapeutic orientation or technique. For example, effective therapists, regardless of their orientation, provide an empathetic and caring relationship. They try to understand the client’s perspective, listen to their concerns, and offer reassurance and advice.
The importance of these features is clear given research showing that the quality of the therapist-client alliance, or bond, is often a more important predictor of positive outcomes than the specific therapy approach used.
Finally, and perhaps most importantly, therapy provides hope and a new perspective to people who feel anxious, depressed, and demoralized. The very act of going to therapy provides hope that things can and will get getter. This belief may go a long way toward reducing symptoms and feeling more optimistic about the future.
Common Questions about the Efficacy of Psychotherapy
Psychotherapy can be taken to mean an organized interaction between a trained professional psychologist and an individual who might be facing some mental, emotional, or psychological issues that seem to have little or no medical explanation.
Clinicians overwhelmingly tend to think that therapy is effective. Therapists personally see clients who start therapy feeling pretty unhappy and leave feeling better, which leads therapists to believe their approach has been effective.
Psychotherapy doesn’t help everyone, but it helps many people. Many different approaches to therapy provide some of the same benefits. A therapy’s effectiveness may therefore be more of a function of these common features than a particular therapeutic orientation or technique.
Most importantly, therapy provides hope and a new perspective to people who feel anxious, depressed, and demoralized. This belief may go a long way toward reducing symptoms and feeling more optimistic about the future.
