Effectiveness of Therapy

Modified: 2024-07-28 8:25 PM CDST

• Therapy works, but no one therapy seems to work much better than another.
  • Therapy is better than no therapy.
• How can such a pattern exist?
  • Many variables contribute to the effectiveness of therapy:
    • the match of diagnosis to treatment,
    • the therapist,
    • the client,
    • the therapeutic alliance.
  • Obviously, a correct diagnosis is vital to effective therapy.
    • Therapists, being human, also differ widely.
    • So, two therapists using the same therapy may use it differently.
  • Clients, too, vary widely.
    • Clients who want to change will obviously be more likely to.
    • Another rule of thumb in therapy that emphasizes the role of the client is that clients who ask for help are more successful in therapy than clients who are "helped" without their asking for help.
• Finally, the notion of a "therapeutic alliance" or a combined effort by the therapist and the client is very important to successful therapeutic outcomes.

• The Effectiveness of Psychotherapy
  • Full text of Martin Seligman's American Psychologist (1995) article on efficacy vs. effectiveness studies of psychotherapy.
    • The abstract reads:
      • Consumer Reports (1995, November) published an article which concluded that patients benefited very substantially from psychotherapy, that long-term treatment did considerably better than short-term treatment, and that psychotherapy alone did not differ in effectiveness from medication plus psychotherapy. Furthermore, no specific modality of psychotherapy did better than any other for any disorder; psychologists, psychiatrists, and social workers did not differ in their effectiveness as treaters; and all did better than marriage counselors and long-term family doctoring. Patients whose length of therapy or choice of therapist was limited by insurance or managed care did worse. The methodological virtues and drawbacks of this large-scale survey are examined and contrasted with the more traditional efficacy study, in which patients are randomized into a manualized, fixed duration treatment or into control groups. I conclude that the Consumer Reports survey complements the efficacy method, and that the best features of these two methods can be combined into a more ideal method that will best provide empirical validation of psychotherapy.