Promoting student centred emotional well-being
What is "good" treatment?
In order to understand what might be the best treatment for you, it is helpful to know what research in psychotherapy indicates and
how to interpret research results. Research can help us to understand aspects of treatments which may be valuable, but has to
be interpreted within a clinical context, and cannot say which treatment is best for any individual.
There are serious limitations
to psychotherapy research that have to be kept in mind in evaluating any treatment modality.
- Research models in therapy need
to be standardized in order for the research to be valid. In other words, all the therapists need to be doing pretty much the same
thing with all the subjects.
- The subjects in the research need also to fit into distinct criteria. This means that often the people
that the research studies do not represent a typical outpatient population where it is hard to stick people into one distinct diagnostic
category. In many psychiatry research around 70% of people referred to the study will be excluded from the research. Among
the general public who may go for help, only 5-10% may be similar to study populations.
- The criteria used to indicate success may not
correlate particularly well with what an individual or therapist may deem a success. For example, in research, a 50% reduction in
symptoms on a validated scale is often used to indicate a success. The average difference on the scale between the studied treatment
and the control treatment or placebo may vary by only a few points around this 50% reduction; not enough to necessarily indicate a
true clinical difference.
- Research models often don't represent what expert practitioners actually do. Most psychotherapists do not
come home at the end of the day and say, "I treated three Major Depressions, two General Anxiety Disorders, one Obsessive-Compulsive,
and one Panic Disorder today". People who come for help generally come in with complex issues that they need to discuss, with
symptoms often being a secondary consideration. Some people have been convinced that symptoms are of utmost importance, or that
having a diagnosis is crucial in treatment or as an entry into treatment. Expert practitioners recognize that diagnoses are
simply guidelines.
- People in any form of therapy will tend to be influenced by, and wish to please, the therapist. This means
that if the therapist gives positive feedback if the client expresses more intense feelings, that the client will tend to be more
expressive. If the therapist gives positive feedback when the client reports a decrease in symptoms, then clients will tend to downplay
their symptoms. The results of research need to be interpreted with this in mind.
Understanding psychotherapy research
