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Psychotherapy: What The Research Says
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What does the research say about psychotherapy? There are several main conclusions. The major conclusion is that, in general, psychotherapy is effective. Here some major findings regarding the effectiveness of psychotherapy.
I. Psychotherapy Helps Clients.
About one-third of clients get significantly better and another third get somewhat better. Only one third make no progress or get worse.
II. The Healthiest Do Best.
The people who do the best in therapy are the ones who functioned fairly well before getting therapy. These are people of at least average intelligence, insightful and verbal, with no chronic mental illnesses or personality disorders.
III. The Briefer The Problem, The Better.
The less time a problem has existed, the easier it is to treat.
IV. Internal Problems Are Easier To Treat Than External Ones
Generally, problems that are mainly internal (feelings such as anxiety, depression, shyness, etc.) respond better to therapy than problems that are more external (aggressive behaviors, anger explosions).
V. The Therapist Matters Too.
As we can see from the above, it is the features of the client and the problem, not the therapist, that have the most impact on whether therapy works. But the therapist still has an impact on whether the client gets better.
And it is the personality of the therapist, not their techniques, that has the biggest impact. Research suggests that certain therapists just have more of a therapeutic personality -- they tend to be warmer, more empathic, and more confident in their abilities to help.
VI. The Client-Therapist Relationship Matters.
One factor that helps therapeutic success is the quality of the client-therapist relationship. Clients and therapists who like, understand, and respect each other tend to have better outcomes.
One factor that aids a good client-therapist relationship is an agreement about what interventions are likely to work. For instance, if a client believes that challenging irrational beliefs seems likely to help, then that client would do better working with a cognitive therapist. If a client believes that early childhood relationships are a key factor in the problem, that client might work better with a psychodynamic therapist.
VII. Interventions Matter as Well.
Despite all these other above-named factors, research has shown that certain techniques work (or don't work) with certain problems. For instance:
(A) We know that treating severe autism is very difficult but is more effective if started early.
(B) We know that treating obsessive-compulsive disorder usually works best if the therapist uses cognitive therapy combined with something called "Exposure/Response Prevention."
(C) We know that personality disorders are very difficult to change. Often, these disorders can only be managed, not cured, by therapy.
(D) Long-term research has emerged that suggests if your child is significantly hyperactive and impulsive, talk or behavioral therapy will not change those symptoms. Only medication can decrease significant hyperactivity and impulsiveness. However, therapy can help with many other aspects of the condition, such as oppositional behavior, lack of motivation, and poor organization.
(E) We know that panic attacks are often caused by people thinking that normal signs of anxiety are in fact signs of catastrophic events about to happen, such as heart attacks or fainting. We know that changing these misperceptions can reduce or eliminate future panic attacks.
(F) We know that the longer social skills training goes on, the more likely it is to succeed. Short-term groups (six-eight weeks) are often unsuccessful in changing social skills.
(G) Research has identified many different phobias that people can develop. I have treated phobias as diverse as fear of vomiting, fear of fainting, and fear of choking. It is often comforting for people to know that their phobia is experienced by others and has been successfully treated.
IN CONCLUSION
This is just a smattering of the important research that can guide therapists in their treatment decisions. In my view, it is important for therapists to know past and current research, as this research can and does suggest specific ways to intervene.
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