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Is One Type of Psychotherapy More Effective than Another?
If an individual is seeking the assistance of a competent therapist to work out a particular problem, the question of "which type of therapy is more effective"?, may come to mind. The success rates of different types of therapy has been put to the test time and time again. It's finding: No particular type of therapy is significantly superior to others. From an overall perspective, only slight differences emerged-for instance, psychoanalytic and person-centered approaches were approximately equal in effectiveness, and both were somewhat less effective than cognitive and behavioral therapies. Furthermore, whether therapy took place in individual or group settings, over the short term or the long term, seemed to have little impact on its effectiveness.
Research also indicates that the most effective psychotherapists are people who genuinely care about their clients and who are able to establish a warm, empathic relationship that helps to foster respect, trust, and the feeling of being cared for (Strupp, 1984 Williams & Chambers, 1990). A clinician who is reserved, aloof, and emotionally detached is not likely to provide the kind of warm, supportive atmosphere that is essential to therapeutic progress.
Efforts to assess the relative success rates of various forms of psychotherapy may diminish in future years, in light of the current trend toward integrating the many diverse theoretical frameworks underlying the practice of American psychotherapy (Goldfried et al., 1990 Jensen et al., 1990). This integrative movement is reflected in a growing tendency among psychotherapists to ignore the ideological barriers dividing schools of psychotherapy and to define what is common among them and what is useful in each of them (Beitman et al., 1989, p. 138). Between one-third and one-half of currently practicing American psychotherapists do not consider themselves to be aligned with one particular type of psychotherapy, preferring instead to view themselves as eclectic in their application of psychotherapy (Beitman et al., 1989 Jayaratne, 1982 Norcross et al., 1988 Prochaska & Norcross, 1983 Watkins et al., 1986). Eclecticism in psychotherapy involves the pragmatic application of clinical techniques from different theoretical systems without necessarily subscribing to the theories from which the techniques are derived. Research indicates that psychotherapists who are eclectic in their clinical practices tend to be older and more experienced. This finding suggests "with experience comes diversity and flexibility" (Beitman et al., 1989, p.139). Making evaluation even more difficult is the fact that a therapist’s theoretical orientation (psychoanalytic, humanistic, cognitive, or behavioral) does not necessarily ensure that any significant change in behavior is attributable to the perspective. For instance, just because a psychoanalyst discusses inner conflicts with a patient who later recovers does not necessarily mean that inner conflicts were indeed the cause of the disturbed behavior.
Common Features of Psychotherapeutic Approaches
Certain common features are shared by almost all styles of therapy. Researchers Jerome Frank (1982) and Marvin Goldfield (Goldfield & Padawer, 1982) have analyzed the commonalities of different psychotherapies extensively, and we explore some of their findings.
Combating the Client’s Demoralization People who seek the services of a psychotherapist are typically demoralized by anxiety, depression, and a poor self-image, and they often have little hope for escaping from their misery. By inspiring expectations of help, providing new learning experiences, and enhancing people’s sense of self-worth and efficiency, psychotherapists may be powerful morale builders. Virtually all effective psychotherapists, regardless of their particular methodology, tend to inspire in their clients a sense of hope and a belief that things will get better. These morale-boosting expectations may well contribute to a reduction in symptoms and an improved sense of well-being (Jacobson, 1968 Prioleau et al., 1983).
Providing a Rationale for Symptoms and Treatment Regardless of their theoretical orientation, virtually all therapists provide their clients with a plausible explanation for their symptoms and a logical scheme for alleviating them. As clients rethink the nature of their problems and possible solutions, they often acquire a new perspective on themselves as well as some fresh ideas about how to respond to their world more effectively. Acquiring a better understanding of oneself and one’s problems, along with developing possible solutions, may contribute greatly to the healing process.
Providing a Warm, Supportive Relationship Effective therapists are individuals who are able to establish a caring, trusting, and empathic relationship with their clients. In one study, clients rated their personal relationship and interaction with their therapist as the most important part of their treatment (Sloane et al., 1975). Another study demonstrated that even paraprofessionals (laypeople trained by professionals) who were versed in how to engage in empathic listening were quite effective in helping people overcome behavioral problems (Berman & Norton, 1985). Thus it would seem that the nature of the client-therapist relationship has much to do with the success of the treatment (Henry et al., 1986 Kokotovic & Tracey, 1990). The fact that most therapists attempt to establish a warm, confiding, and empathic relationship with their clients may account, at least in part, for the comparable success rate reported for each method.
Providing a Professional Setting Good therapy does not usually take place over a cup of coffee, in the room of a private home that does double duty as a family room, or over the telephone. Instead, it usually takes place in a dignified, professional setting in a mental health clinic, hospital, or private office. This kind of setting may contribute much to the therapeutic process. An office that is quiet and professional is likely to provide a sense of security and safety that people may not experience in an informal setting, where the possibility of being overheard or interrupted may inhibit spontaneity. In addition, such a setting is likely to enhance the therapist’s prestige and, by inference, to heighten the client’s expectations for effective treatment.
In view of the widespread and extensive nature of behavioral problems, it is likely that at some point in our lives many of us will think seriously about seeking professional help in the form of psychotherapy.
Dr. Virgil Davis is currently a full professor of psychology. Davis has published several articles and is co-author of the books "Understanding Psychology". (2 editions) Dr. Davis is owner of Davis Karate Studios, holds a 7th degree black belt in karate and is also a Reiki Master.
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