Here\u2019s a question that I \u2013 much to my surprise – never get asked by any of you:<\/p>\n
\u201cDoes therapy actually work?\u201d<\/em><\/p>\n There can be many reasons why you don\u2019t ask me this. For example: you may have done some research yourself before you come and see me; you may have discussed it with your GP; you may figure that I\u2019m the wrong person to ask as I\u2019m hardly likely to say no; or you may be so distressed that you are willing to try anything to soothe the pain (history is full of desperate people buying snake oil in the hope that it would heal them).<\/p>\n Whatever the reason let me answer the question that you haven\u2019t asked:<\/p>\n \u201cDoes psychotherapy actually make people better?\u201d<\/em><\/p>\n Yes, the empirical evidence overwhelmingly shows that therapy is highly effective for a wide range of mental health problems.<\/p>\n So, given that psychotherapy works, the next logical question is:<\/p>\n \u201cHow does it work?\u201d<\/em><\/p>\n Short answer: we don\u2019t really know. The brain is a very complex organ.<\/p>\n To date there has been 20 studies using neuroimaging assessing brain changes following psychotherapy for depression. Together these studies suggest that psychotherapy alter brain function in people suffering major depression. We still don\u2019t know the exact brain circuits involved but the prefrontal cortex and the amygdala have been suggested.<\/p>\n All right, so we know that psychotherapy work, we\u2019re beginning to gain an understanding of the brain changes underlying this, another question that springs to mind is:<\/p>\n \u201cOf the many various forms of therapy (e.g., cognitive behavioural, psychodynamic, interpersonal, dialectic behaviour therapy) which ones have been shown to be the most effective?<\/em><\/p>\n Well, that depends to some extend on the disorder but if we\u2019re talking about depression a recent study compared the benefits of 7 different forms of psychotherapy and concluded that none were more effective than the others.<\/p>\n So, if it isn\u2019t the actual form of therapy that predicts how well people are doing the question, of course, becomes:<\/p>\n \u201cWhat predicts positive treatment outcome?\u201d<\/em><\/p>\n The therapist. More specifically, how good is he or she at building, maintaining and enhancing the therapeutic relationship.<\/p>\n In summary, therapy works, it changes the brain, there is no difference between the various forms of therapy (at least for depression) and the crucial factor in successful therapy is the therapist.<\/p>\n Which makes me want to reiterate the last point of \u201cBad therapy\u201d: be choosy and trust your gut feeling when picking a therapist (the person you\u2019re working with is more important than their theoretical orientation).<\/p>\n So, rather than recommending a specific therapist or type of therapy (who may or may not suit their personality) pass on the above advice to anybody you know who\u2019s contemplating commencing therapy \u2013 you\u2019ll be doing them the favour of allowing them to trust their instinct.<\/p>\n","protected":false},"excerpt":{"rendered":" Here\u2019s a question that I \u2013 much to my surprise – never get asked by any of you: \u201cDoes therapy actually work?\u201d There can be many reasons why you don\u2019t ask me this. For example: you may have done some … Continue reading