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.
