Looking for Evidence That Therapy Works

[TM99]

1. I don't agree with all of it but still an excellent article.

First, mindfulness styles used in psychotherapy are all forms of CBT so if a therapist is using it, then yes, they are doing a type of CBT therapy.

Second, CBT is the current technique that is getting studies done in its effectiveness and nothing else is being studied. It is the 'technique de jour'. Before CBT, it was brief therapy. Before brief therapy it was expressive therapies. Before that, it was Gestalt forms of therapy. In another 10 years, there will likely be a new form that is touted as the only effective form of therapy.

The irony is that really any form of psychotherapy is cognitive behavioral therapy. It seeks to assist clients in changing habituated patterns of cognition and self-talk and the concurrent behaviors that cause them distress and emotional turmoil.

With that said, as a professional in the field, I can criticize the fact that more and more therapist are of the school of whatever the client wants, give it to them. No one really wants to see unconscious motivations. No one really wants to see that they are causing much of their own misery. No one really wants to hear that they must exercise will in order to make lasting change. Habits take time to form not only bad ones but also good & healthy ones.

Therapists must be willing to challenge clients who believe they know what is best for themselves. I use MBCT (Mindfulness Based Cognitive Therapies) with great success, however, I must convince clients that while not always easy, the rewards are great. It is not a quick fix either. Take a drug for four weeks, and anyone will feel different. MBCT (as well as other CBT's) can take months of daily practice before benefits are gained and lasting change begins to set in.

I do completely agree with them that evidence-based structured therapies have in my own clinical experience been far more successful than 'therapy as an art' (it isn't one!) or 'the relationship is all that matters' (it doesn't!). It is extremely important as a therapist to keep reading the science and learning about the field - what works & doesn't work, what is popular and what is not, and advances in companion fields like neuroscience, philosophy, religion, etc. I still use other techniques and tools that are not evidence-based as no one has taken the time to test their effectiveness. I must rely on my own empirical observations and those of my trainers and teachers there.

The other problem is, and I don't think it was clearly stated in the article, is that most therapists do not know when a client is 'better' and often believe that therapy never ends. I disagree. I want my clients to accomplish their goals, feel better, think more constructively, and have happier relationships with themselves and others. Once they learn how to accomplish that, I am pleased as punch to see them 'graduate' from therapy with me.

While I don't agree with all their points, it is a good springboard for discussion with lots to still agree with. Thanks for sharing it.