Tuesday, February 15, 2011

Proving psychotherapy works

Surprisingly, talking cures are having a good recession, though the cash seems mostly destined for cures of the cognitive kind. No doubt, they do much good, though personally, I'm drawn to the more knotty therapies - the psychodynamic - which raises the question of whether they are even talking cures? It's a big issue: can psychotherapy be proven scientifically; put crudely, does it work? Research is and clearly should be done, but it's worth remembering the ways in which statistical evidence can't prove everything.

Partly, it depends what you mean by 'works'. Getting so many thousand off sick pay is a measurable result. Allowing someone to see how patterns repeat in their life is harder to demonstrate en masse. As is sometimes noted, statistics don't see individuals - which is why psychotherapists prefer to discuss case histories not population studies.

This is not to say there aren't general principles in psychotherapy, manifest in different therapeutic schools, that can be assessed. Put a bunch of psychotherapists in a room and try stopping them! But when discussing efficacy, statistics may prove limited, because the change psychotherapy seeks is found in the particular contours of individual lives. The aim is not to get you back to work, though that may happen. It is, say, to deepen self-understanding.

There's a related issue. Psychodynamic therapies aim to help the client engage with the unknown in their lives - what's unconscious. Further, it can be important that the unconscious dynamics impacting them remain not well resolved during periods of therapy, so they can be fully worked through. The therapist that raises something to the level of tidy awareness too quickly may well limit the full impact of the work by, in effect, curtailing it. Research questionnaires, then, that ask about tangible benefits, and that work well for cognitive treatments, are questionable in psychodynamic work, at both a methodological and an ethical level.

- Mark Vernon

1 comment:

  1. I thought that given as Freud was the father of the 'talking cure', psychodynamic theorists would be pro not anti talking cures? Or is modern psychodynamic psychology moving away from talking? If so, moving towards what?