Sampling/Summary of Research Supporting Effectiveness of Psychotherapy
The American Psychologist Journal (vol. 50: No. 12, 1995) published the results of a Consumer Reports survey, asking approximately 7,000 people about the mental health treatment they’d received. Respondents tended to be educated, middle class, about one half were women, with a median age of 46 years. The majority were “highly satisfied” with their psychotherapy, and almost all said that their lives were improved and relationships felt more “manageable”.
Some key findings:
- People who received only psychotherapy improved as much as those who received psychotherapy with medication.
- Almost ¾ of the respondents went to a mental health professional (rather than clergy, family doctor, etc.).
- The longer people stayed in therapy, the more they improved; those who stayed for a minimum of six months progressed the most.
- People who started therapy feeling the worst reported the most progress.
- No specific modality or type of therapy did better for client improvement.
- Clients whose length of therapy or choice of therapist was limited by insurance or managed care did worse.
- Active “shoppers” did better than passive clients, e.g. those who sought out a therapist for themselves, rather than rely on a significant other to set up the initial appointment
Though this is a self-report measure and has inherent flaws, researchers agree that the survey merits serious consideration because it complements the traditional efficacy methods.
Additional findings on the effectiveness of psychotherapy include:
- Journal of American Psychoanalytic Association (52:1163-1184, 2004) reports that clients who had completed therapy had a “statistically significant reduction in symptomatic suffering”, they improved on sub-scales measuring self-esteem, intimacy, frustration tolerance, body image, and sexual satisfaction, among other measures. Overall, “their capacity to handle crucial aspects of life was improved”.
- A 2008 study published in the Journal of Consulting and Clinical Psychology (vol. 76 (1), 116-124) evaluated therapy effectiveness for treating adult clinical depression. It indicated major improvements in functioning for all indices: mood, motivation, concentration, appetite, fatigue, and sleep.
- A 2006 article in the Journal of Psychotherapy: Research Practice, Training (vol. 43 (2) 216-231) studied clients with predominantly anxiety symptoms. Clients’ responses to varied therapies were measured and compared; essentially, clients achieved “significant gains” and made changes from all theoretic orientation – cognitive/behavioral, psychodynamic, and interpersonal. They also maintained progress at a six month follow-up.
- A 2008 Oxford Journals (Abbass, Joffres, and Ogrodniczuk) published an article studying the effectiveness of short-term dynamic psychotherapy. The interviews and inventories post-therapy revealed statistically significant improvements: one third required no further treatment; seven clients stopped medication; two clients returned to work.
- The 2006 edition of Research on Social Work Practice (vol. 16, no. 2, 166-175) investigated whether or not clients improve, and if so, what therapeutic variable is efficacious. The results suggest not only that therapy is effective, but that the specific modality studied – psychodynamic interpretation – helped clients achieve their goals.
These research findings are a fraction of thousands of available studies . . . with all this compelling research on the utility of psychotherapy it is reasonable to ask: when does psychotherapy not work?
This is a good question because I don’t want to glorify the practice of psychotherapy, extolling its virtues without fairly critiquing it. In fact, we do have evidence for when therapy does not work: the 2001 issue of Psychotherapy: Theory, Research, Practice, Training (vol. 38 (2), 171-185), reports a review of psychological literature from 1988 to 1999, examining therapist’s personal attributes and in-session activities, negatively influencing therapy alliance and outcome. Therapist’s qualities contributing negatively are: rigid, tense, distracted, hurried, distant, and critical. Techniques such as over-structuring the sessions, inappropriately using silence and self-disclosure, making transference interpretations in an unyielding, dogmatic fashion; these proved not conducive to a positive therapy outcome and created or exacerbated problems with alliance.