Is Therapy Really Effective?

This is the question many of use want to ask... Is therapy really effective? If I go and see a psychotherapist, will I get anything out of it? Can I really be 'fixed?'

Well, this all depends on who you want to ask, and how far you want to go back as to when this question was asked and an expectation formulated as to the empirical efficacy of psychotherapy. Roughly 60 years ago, the German psychologist Hans Eysenck (1952) stated that "The figures fail to support the hypothesis that psychotherapy facilitates recovery from neurotic disorder" (p. 323). 

Speaking from his practice-based experience over the span of 45 years American psychologist Paul Clement (2013) stated that "68% of my patients have improved, 31% have not improved, and 1% have gotten worse" (p. 37).

In an interview with Clinton Power of the Australia Counselling Directory, psychologist Scott Miller ran through some of the statistics surmising the efficacy of psychotherapy. I shall be brief, but cover some of the most astonishing results as outlined through his brief dissertation (if you're interested in pursuing more from Miller, you can see some findings presented by him and some others here).

Miller cites that when we compare the counselling profession with the medical profession we can observe a much less troublesome side-effect profile in the former. What's that mean? After one sees a therapist there are infinitely less side-effects than whether one might see a GP and be prescribed some medication for their ailments.

What else can we see? Well, Miller asserts that very, very few people will die from psychotherapy. When you see a counsellor, you usually exist without dropping to the floor as your heart stops. One might leave contemplative, another might leave with a sense of direction, still others might leave with an elevated sense of meaning and purpose assigned to their life - very few would feel a need to 'croak' as they say. Where does this lead to? Well, naturally you can say that most people leave better as a result of therapy. Much research has supported this (see for example the exhaustive research undertaken in showing the effectiveness of cognitive behaviour therapy [CBT] for clients; Beck (2011) showing a Table outlining the effectiveness of this approach on psychiatric disorders such as Major Depressive Disorder, Generalised Anxiety Disorder, and Substance Abuse; psychological problems such as couple and family problems; and medical problems with psychological components such as chronic back pain, cancer pain, and obesity), and little would feel the urge to deny these findings.

Miller goes on to cite that 40 years of research on the effectiveness of psychotherapy has shown that when one compares a treated sample of participants with a non-treated sample, those that have undergone some form of psychotherapy are better off than some 80 percent of those in the non-treated sample! That's no small number - therapy is, in fact, effective!

Comparing the effect size (i.e. the term given when the strength of a phenomena is measured and put into a computation) of the outcomes of those that have undergone psychotherapy with the effect size of the effectiveness of fluoride on the prevention of caries we find that the former is four times great than the latter! That is, when we compare the effectiveness of counselling and the persons outcome, and when we compare the use of fluoride with the prevention of dental carries, we can see that when one attends psychotherapy, they are four times more likely to benefit (if speaking in terms of probability) than if one uses fluoride increase dental hygiene!

Comparing the effect size of psychotherapy outcome and the use of aspirin in the prevention of heart disease and stroke, we see an effect size 27 times greater(!) for the former. Those aren't low numbers!

Another interesting finding was when one compares the effect size of psychotherapy outcome with that of coronary heart bypass surgery. What do we find? We find an effect size for psychotherapy outcome that is on par with that of coronary heart bypass surgery!

So why is it that we're so quick to use fluoride to improve our dental health but discount psychotherapy for our mental health? Why is it that we'll much quicker turn to aspirin than we would to counselling? Why is it that when we have heart issues that have gotten so bad that we'd have the required surgery, but when we're debilitated because of our daily stresses and depressions we won't turn to counselling?

I don't know...

I have an inkling though. I think stigma (though the awareness of the importance of maintaining or improving our mental health has significantly increased from even a few years ago) has a part to play. I think personal pride has a part to play. I think laziness has a part to play. I think the fear of burdening others has a part to play. 

There are so many factors that are stopping us from seeing someone from the mental health profession to help us fix our own failures or negative aspirations that we can't just pinpoint one. What must happen is to continue to try and  lift the stigma. To alert others that mental illness isn't something that we should cover up and hide, it's something we should acknowledge and seek help for!

If we've got a debilitating pain in our abdomen we don't just cover it up for the sake of not bringing attention to ourselves; we go and see a professional so that we can get it looked at and treated! This is what must also happen within my lifetime for those with a mental illness. Or those that have found themselves ruminating more and more on the negative at the expense of the positive. It's got to happen for those that quality of life is impaired because of their battle with anxiety, depression, obsessions, compulsions, substance use and abuse, and all in between.

I hope that this brief post has made a difference in your mental formulations of how you now perceive both mental illness, and the effectiveness of psychotherapy. This was my aim!

References

Beck, J. S. (2011). Cognitive behavior therapy. New York, NY: The Guilford Press.

Clement, P. (2013). Practice-based evidence: 45 years of psychotherapy's effectiveness in a private practice. American Journal of Psychotherapy, 67(1), 23-46.

Eyesenck, H. J. (1952). The effects of psychotherapy: An evaluation. Journal of Consulting Psychology, 16, 319-324.

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