Ph.D. Psychologist and Therapist

Psychologist and Therapist, Individual and Couples Therapy,  Bellevue, WA

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The Effectiveness of Therapy: Research Shows Very Beneficial Effects

One of the most important questions you may be asking as you consider going to a therapist is simply this: Does therapy work? It's a complicated question, because all different kinds of people go to different kinds of therapists with different kinds of problems. The simple answer is, yes, therapy usually works. Now let me tell you about some of the best research available that backs up that claim.

In 1994 Consumer Reports magazine teamed up with some researchers to study whether therapy helps people. In their annual survey of all their readers, in which they ask about car repair histories, and satisfaction with appliances, they also asked about therapy. They asked people a number of questions, including what kind of therapists they went to, how long they went, how bad they were feeling when they started, and how much they felt it helped them.

This was the biggest study of its kind ever done, and it is particularly relevant because it is done from the consumer's point of view: Are people being helped? Are they getting what they pay for? Are they satisfied with the results? The findings came out strongly in favor of the effectiveness of therapy. About 50% of the people, including may of the ones who felt quite bad when they started therapy, felt that therapy helped them a great deal. Another 40% said that therapy had helped them somewhat.

Here are some of the other main findings: (The study was written up in the November 1995 issue of Consumer Reports, and in the December 1995 issue of American Psychologist. If something below is in quotes, it means I'm quoting directly from one of those articles.)

Since this study is the largest and most comprehensive of its kind, I'll spend some time explaining why the findings are important. One of the main reasons this study is so important is because it looks at how people use therapy in the "real world." Most research on therapy is done in very controlled, somewhat artificial conditions, using small numbers of people who get predetermined, short-term treatments. For example, a study might look at whether 12 sessions of a certain kind of cognitive therapy is helpful for panic disorder. Laboratory findings like this are important, because they demonstrate that under controlled conditions, therapy can work. But in the real world, therapy isn't so controlled. Knowing that "laboratory therapy" can work doesn't really tell you how well "real world" therapy works. The real world question is, do people get help when they come to all kinds of therapists with all kinds of problems. It is very encouraging that Consumer Reports came back with such a positive answer to that question.

The study is also important because it helps settle an old debate about the effectiveness of different types of therapy. The two primary approaches to therapy that are used in the United States are Cognitive/Behavioral and Psychodynamic. In addition to this there are "Humanistic" approaches to therapy, and there are Family Systems approaches, which are most relevant to work with couples and families. There are a number of variations on each of these approaches, and there are some other less common approaches.

Cognitive and Behavioral therapy have always been more closely tied to academic research settings than Psychodynamic, Humanistic, or Family Systems approaches. In addition, cognitive therapy is easier to standardize, and easier to research. Because of that, there have been many "laboratory" studies showing that cognitive therapy works, especially for certain things like depression. Psychodynamic therapy, which tends to focus on understanding things that are unique about each individual, is harder to standardize, and doesn't lend itself as well to laboratory research. As a result, for many years, if one counted up the laboratory studies supporting each approach to therapy, cognitive therapy has had the longer list.

The Consumer Reports study found that in real world circumstances, in a large sample, looking at all kinds of problems, psychodynamic therapy performed just as well as cognitive behavioral therapy. In fact, based on the ratings of the therapy consumers, no single type of therapy helped them more than the other types. A number of other smaller research studies over the last few decades have come to the same conclusion.

What that means for the typical person seeking therapy is this: The choice of which approach to use should probably be based on which approach seems like the best match for a particular person, and for the kind of issues that person is wanting to work on. There is another finding worth mentioning, that has come out of a number of studies over the years: Therapy is more effective when the therapist and client are well-matched with each other, have a good rapport, and form a positive working relationship. In other words, your best bet is to find a therapist who seems like a good match for you.

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