Custom Search
|
|
How Change Works In Therapy
believed that results in therapy are attributable to a specific treatment choice. The education received by mental health professionals, including psychologists, stresses on the use of precise, empirically validated interventions. However it just isn’t possible to receive instruction in all the thousands of excellent therapy modalities available, especially when exciting new ones regularly emerge. Some approaches have been favoured due to the sheer quantity of data supporting their validity; in particular Cognitive Behaviour Therapy (CBT) and Interpersonal Process Therapy (IPT) are prime examples. The decades’ of therapy outcome research concludes that all therapy does actually work, but the evidence of one modality’s ascendancy over another is equivocal. In fact the famous “dodo-bird outcome” whereby “Everyone has won and all must have prizes” after Lewis Carroll’s “Alice in Wonderland” was announced in a extensive review of psychotherapy outcome studies (Luborsky et al., 1985). If all psychotherapies are equivalent, a more persuasive alternative was necessary to explain how successful change comes about and a review of all the research conducted since 1970 determined the existence of four common change factors (Hubble et al.,1999). The common factors are listed as follows: Client Factors (40%) By far the most important causes of change are client factors and these make up 40% of the variance observed in successful therapeutic outcomes. The strengths and resources that clients bring into psychotherapy are what make the most significant difference. These resources can be physical, spiritual, instrumental, social or psychological, such as good health, friends and a sense of humour. The effectiveness of therapy is exponentially increased when therapists encourage clients to use and develop what they already own in great quantity. Clients are often astonished when they realise how resourced they actually are and benefit from having their focus redirected towards their abilities and away from their failures. Therapeutic Relationship (30%) At least 30% of all change is accounted for by therapists’ capability to develop a strong, positive bond with their clients. Doctors know this as a skilled “bedside manner”. A quality therapeutic relationship has the following traits: => The therapist’s capacity for compassion, caring and empathy => Loving and liking the client => Mutual confirmation between client and therapist => How much the therapist can promote the client to take risks and develop mastery => Facilitating self-responsibility => Actively collaborating with a client instead of a “therapist knows best” method. Placebo or Expectancy (15%) At least 15% of the change observed occurs because a client expects the change to occur; this is known as the placebo effect. Clients who believe their psychologist to be trustworthy, competent and experienced are more likely to know positive change. Model or Technique (15%) Even though the particular type of treatment modality only depicts 15% of observed change, university training centres around modality-specific education. The over-reliance on intervention manuals creates a possibility that mental health professionals become mere technicians distributing a treat-by-numbers approach rather than therapists who treat the whole, unique and complex human being Therapists who are unable to tap into the four common factors are likely to be ineffective agents of change, even if they are highly effective in using exact therapy modalities. Therefore therapy will succeed if the four common factors can be exploited to their total potential. There are a number of important traits to look for in a therapist, including the ability to sensitively be in sync with you and speak the truth, patience, compassion, intelligence and experience. Of vital importance is that you like each other and get on well! References Hubble, M. A., Duncan, B. L., & Miller, S. D. (1999). The Heart And Soul Of Change: What Works In Therapy. Washington, DC: APA Luborsky, Singer & Luborsky. (1985). Therapist success and its determinants. Archives of General Psychiatry, 42, 602 – 611. Article Directory: http://www.articledashboard.com Dr Henshaw is a highly experienced clinical psychologist in Perth who can help you work through your depression and anxiety. To learn more, visit: www.henshawconsulting.com.au |
|