The Effectiveness of Therapy

The graph below comes from research that focuses on what makes therapy work. As you can see, the most important factor is in blue, and accounts for 40% of the change that happens when people enter therapy: ironically, things that happen outside of therapy, like getting a new job, having a divorce, starting yoga classes, taking a big vacation and so on, have a big impact on the course of treatment. The next most important factor, which accounts for 30% of therapy outcomes, has to do with the therapeutic relationship. For example: Do I feel safe and understood by my therapist? Do I feel connected to this person - are they are knowledgable and capable of helping me? The next factor, which is only half as important, is the therapeutic approach or techniques used and accounts for 15% of change in therapy. Psychologists get attached to certain models of therapy like CBT, EMDR, hypnotherapy and so on, but these models and techniques seem to matter less than the therapeutic relationship itself. Finally, the fourth factor has to do with a clients expectations and beliefs that therapy will work. The "placebo effect," as it's called, also accounts for about 15% of the change in therapy. In other words, if you think therapy will help you, it’s more likely that it will!

Note: it is important to remember that these are helpful generalizations; there can be big fluctuations between people and their experience of therapy. Although this “common factors” approach has been replicated, there are some who question its authority.

But does it work?

Although the four factors identified above may help explain how therapy works and what makes it work, the question still remains: does it work? And perhaps more importantly, will it help me? Fortunately, there has been a lot of research done in this area and the evidence is clear: yes, psychotherapy does work. A large poll seeking to understand the use of mental health services in America revealed that even though satisfaction with mental health treatment is very high, 1/3 of people that could benefit from therapy do not access the services.

Psychotherapy works very well

• 80% of clients benefit

• 50% of clients experience resolution of their problem 

Psychotherapy is efficient

• Improvement after a few sessions 

• Most clients benefit by 12-16 sessions 

Effects of psychotherapy last 

• Clients continue to get better after therapy 

• Outcomes last for 6 months and lifetimes 

Experiences associated with effectiveness

• Credible therapist, helpful explanation 

• Meaningful goals, useful solution 

Sources:

Therapy in America 2004, a new Harris Interactive(R) poll

Truscott, D. (2018). Improving Psychotherapy Outcomes: The Power of Potential Feedback. PAA & CAP Professional Development Day, Calgary, Alberta

Tasca, G. A., Town, J. M., Abbass, A., & Clarke, J. (2018). Will publicly funded psychotherapy in Canada be evidence based? A review of what makes psychotherapy work and a proposal. Canadian Psychology/Psychologie Canadienne, 59(4), 293-300.