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Does Psychotherapy Work?
Here are some interesting tidbits pulled from a review of American Therapy by Jonathon Engle in the 12/21/2008 NY Times Book Review.
A survey published in the early '70's found that 59% of people visiting a professional psychotherapist for mental distress reported having been "helped" or "helped a lot", but the same survey reported that 78% of the people seeing a clergyman, 76% of people seeing a physician without any psychological training, and 77% of those seeing a lawyer(!) reported the same thing.
In a study conducted at Vanderbilt University in 1979 30 patients were divided into two groups with half being treated by trained psychotherapists and the other by humanities professors with no psychological training. The two groups reported the same improvement rate.
Engle concludes, "Effective psychotherapy seemed to require little more than a willing patient and an intelligent and understanding counselor who met and spoke regularly with confidence."
A survey published in the early '70's found that 59% of people visiting a professional psychotherapist for mental distress reported having been "helped" or "helped a lot", but the same survey reported that 78% of the people seeing a clergyman, 76% of people seeing a physician without any psychological training, and 77% of those seeing a lawyer(!) reported the same thing.
In a study conducted at Vanderbilt University in 1979 30 patients were divided into two groups with half being treated by trained psychotherapists and the other by humanities professors with no psychological training. The two groups reported the same improvement rate.
Engle concludes, "Effective psychotherapy seemed to require little more than a willing patient and an intelligent and understanding counselor who met and spoke regularly with confidence."
Replies to This Discussion
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Permalink Reply by Gary Baker on -
I think we need to take those findings with a very large pinch of salt! First of all, both studies are from the 70's, and so were no doubt psychodynamically based, or pyschoanalysis, both of which have been largely discredited as effective interventions these days, compared to behavioural or cognitive behavioural therapy.
Secondly, the measurements used were both subjective and vague. Although self-reporting is often a necessary measurement, a measure such as "helped" is pretty vague. Most people will find some relief in just talking about a problem, and would probably report it as having helped, but that doesn't alleviate it completely.
Thirdly, it appears the presenting issues were unclear. What is "mental distress"? And how were the various groups divided? It sounds like people were just randomly put into groups, with no control for actual problems. If that's the case, how can the different groups be compared? Surely everyone should be at the very least suffering from the same "distress", and preferably at the same level, so an accurate comparison can be made?
Psychotherapy works. CBT for example has extensive research proving this. Engle's conclusion is effectively what Rogers said was "necessary and sufficient" for successful therapy, but that is now generally dismissed as not being sufficient.
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Permalink Reply by John Sannicandro on -
Before you turn this into a bashng psychotherapy thread be sure you consider what issues that each of these subjects presented with. Clergy aren't likely to see anywhere as severe or debilitating problems as a psychotherapist. Primary care physicians also refer to therapists all the time if it is an issue that is out of the scope of their expertise.
If you are suggesting that a clergyman or a lawyer is as effective as a therapist dealing with major emotional problems and even minor ones then I'd say you are mistaken. An understanding listener is critically important, but there are a lot of other skills that are involved as well.
Please do not be dismissive of psychotherapy. There is plenty of room in the helping professions for hypnosis and psychotherapy to coexist.
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Permalink Reply by Michael Ellner on -
The Book Review is worth reading, if only to notice that that indeed there has been a transition from psychoanalysis to cognitive approaches-- This major change in theory and practice has not been reflected in the hypnotic models that were based on the old and ineffective psychoanalytical theories...
You can read it here:
Book Review - 'American Therapy - The Rise of Psychotherapy in the United States,' by Jonathan Engel - Review - NYTimes.com
http://www.nytimes.com/2008/12/21/books/review/Stossel-t.html?_r=1&...
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Permalink Reply by Michael Ellner on
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Hey John--
Before who turns this into a bashing psychotherapy thread?
On the other hand, there is a sub-group of psychotherapists who bash and discount certified hypnosis practitioners every chance they get -- I hope that you stick up for us in those conversations as quickly as you jumped into this one...
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Permalink Reply by John Sannicandro on
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Michael:
Absolutely agree that psychotherapy has a bigger problem with hypnotherapists than vice versa.However I don't think that the statistics you are quoting tell the whole story. If that was not John Bittner's intention then I stand corrected.
I think hypnosis is an extremely valuable tool for a psychotherapist.And Michael I do stick up for us as I am a licensed psychotherapist and a certified hypnotherapist. I also got my training from a so called "lay hypnotist" and the training was exceptional. The training offered by schools for psychotherapist is extremely lacking or non existent.
I believe everyone psychotherapists, clergy, MDs, and hypnotists should work within their range of competence and in some states their area of licensure to insure proper client care.
No harm intended. I don't like the bashing either way.
Perhaps John Bittner could clarify his thoughts on this?
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Permalink Reply by Michael Haifleigh on -
I found the first four sentences evocative and satisfying - I haven't read the balance of the article yet.
Does psychotherapy work? Depends on what you mean by “psychotherapy.” And by “work.” The answer matters.
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Permalink Reply by John Bittner - Ocotillo Hypnosis on -
Hello John:
My intent was simply to open a discussion on the subject. I sited the source of the article so that those interested in joining the discussion could evaluate the information in the context in which it was presented. I wonder if you had the opportunity to that before concluding that my intent was to bash a profession?
I prefer to be purposely vague when starting threads as I enjoy seeing the direction they take. What I'm primarily interested in here is people's thoughts on quote that ends my initial post.
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Permalink Reply by Jaime Nichols on -
Charles Barber wrote another review of this book for the Wilson Quarterly. His final paragraph reads as follows:
"But Engel does show that throughout this long, strange trip, psychotherapy has truly mattered in America. Has it served as an antidote to American individualism? Have we used it to refute F. Scott Fitzgerald's assertion that there are no second acts in American lives? Who knows. What we can conclude from American Therapy is a truth more universal than it is American: There has always been something unutterably and mysteriously healing about the unburdening of one's soul to another person."
Personally, I think there's more to therapy (brief or otherwise) than simply holding the space in which the client can lay their burden down, but that doesn't diminish the importance of this quality in a skilled therapist. I like Stephen Gilligan's model of the three energy archetypes that both clients and therapists present themselves with: tenderness, fierceness, and playfulness. More on using this model for sponsorship can be found here.
As to the effectiveness of psychotherapy, I would suggest the curious take the time to read Dr. Martin Seligman's assessment of the 1995 Consumer Reports study on the effectiveness of psychotherapy. I haven't read the actual Consumer Reports study, which apparently concludes that long-term therapy is more effective than briefer interventions, and as hypnotists, we would have several axes to grind regarding how those conclusions were made. Still, one of the general conclusions of Seligman's paper is that therapy does improve patients' lives overall, although no one specific modality is more or less effective in making a change.
Where does this put the working "lay hypnotist?" Hard to say. I would like to think that most of us practice within an ethical and responsible framework wherein we let the client know we are not psychotherapists. Furthermore, those that rely heavily on techniques like regression to cause should understand the potential for playing in a minefield of past trauma and be prepared both for abreaction and referral to a qualified mental health professional. Given that perspective, it's hardly fair to "slam" the effectiveness of professionals whom we may rely on to help clients that we cannot.
--Jaime
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