Saturday 27 July 2013

Is it really important what kind of therapy modality you take?


Is it really important what kind of therapy modality one should take?

(By Meir Stolear, 27/07/13)

Dr. Bruce Levine (24/05/13), don’t think so. In his article “Why a Great Therapist Probably Beats a Great Antidepressant” (http://www.takepart.com/article/2013/05/24/best-therapy-for-depression-counseling-or-antidepressant), he used the following evidence.

Bruce Wampold (2010) examined hundreds of studies and found that outcome effectiveness doesn’t depend on the specific techniques of psychotherapy, but instead on the alliance between a therapist and their client, as well as the client’s confidence in the therapy (e.g., CBT) and in the therapist. In other words, what matters is finding a great therapist you like and trust.

Michael Lambert estimates that the factors responsible for “client improvement in psychotherapy are as follow:
40% of improvement can be explained by independent positive changes in the client life.
30% can be explained by therapist individualities (e.g., empathy, acceptance, warmth, and encouragement).
15% can be explained by “expectancy” or the placebo effect (i.e., patient believes that their therapist is extremely credible and trusts them).
15% can be explained by the techniques used in talk therapy; specifically, if the therapist and client believe in a technique, like CBT, that might be more important than the technique itself.

However, in my 20 years of clinical experience, I have learnt that CBT (specifically REBT) are by far more efficient way to help people to get better. What could be completed in 6 to 12 months, using a traditional counselling or psychotherapy, can be accomplished in 8 to 20 weeks of CBT/REBT treatment (preferably done by an experience therapist). However, I do agree that it is the constructive therapeutic alliances, which will determine a successful therapy outcome.