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Considering Therapy? Consider This...



I’m not sure therapy will help me,” is a frequently expressed sentiment by patients new to therapy or others who have “tried before,” with inconclusive results. How might one understand these patient expressions? Does their uncertainty speak of reluctance, resistance, a need for reassurance, genuine skepticism, curiosity, or a combination of factors? Regardless, ambiguity is significant for those about to embark on a process that has numerous demands (e.g., time, energy, money, exposure to parts of their mind that may not be all that comfortable, etc.).


Leaning on science may be one of several ways to grapple with questions about the utility and/or effectiveness of psychotherapy. Researchers have concluded that you are better off in therapy than without. Specifically, Smith et al., (1980) showed that those who engaged in therapy were better off than 80% of their sample that did not engage in therapy. Other findings have advocated for a preventative care model, pointing out if left untreated, minor ailments frequently escalate into more debilitating symptoms.


Knowing one may be better off utilizing psychotherapy is informative, but an additional question is “how long will therapy take?” This is difficult to answer straightforwardly; potentially adding to patient uncertainty. Several researchers have inquired about the time element of therapy. Howard and colleagues (1996) confirmed most patients responded positively to therapy within just a few sessions. Symptom relief and overall change further depends on the subjectivity of the patient and is additionally bolstered by frequent sessions. In fact, Howard and colleagues (1996) found that approximately 75% of patients showed significant improvement after 26 sessions of therapy and up to 82% showed improvement beyond 26 sessions. Confirming that continued doses of therapy correlated with improved patient outcomes, Smith and colleagues studied 475 therapy cases and established psychotherapy as a scientifically proven treatment for mental health.


Additional factors to consider about therapeutic effectiveness includes the quality of the therapeutic relationship, patient expectations, and unknown factors. For example, a myriad of studies corroborated that most effective psychotherapies are moderated by the quality of the patient-therapist dyad. Also, one should discuss at the outset what one’s expectations are. Symptom reduction as soon as possible? Behavioral change? Deep insight into the inner-workings of one’s mind? In other words, both therapist and patient should collaborate and examine their attitudes regarding where their therapeutic destination is headed along with how long that journey may take.


References

Howard, K. I., Moras, K., Brill, P. L., Martinovich, Z., & Lutz, W. (1996). Evaluation of psychotherapy. efficacy, effectiveness, and patient progress. The American Psychologist, 51(10), 1059–64.


Smith, M. L., Glass, G. V., & Miller, T. I. (1980). The benefits of psychotherapy. Baltimore, MD: John Hopkins University Press.


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