“Therapy Effectiveness? It’s the Relationship, Stupid” Comments, Page 1
You are currently browsing page 1 of comments on the article Therapy Effectiveness? It’s the Relationship, Stupid.
You are currently browsing comments. If you would like to return to the full story, you can read the full entry here: “Therapy Effectiveness? It’s the Relationship, Stupid”.
Interesting information about the ‘patient factors’ and that it is still unknown how therapy works. Some psychologists don’t hold to that however and insist that only their therapy can help you, so they must then be saying that they know fully how therapy works! (Sorry I’m on my ‘soap box’ again here, but I think it’s important).
I’ve commented before about a psychologist in the UK who stated to me that his research superceded any other research about disability and pain, and since his ‘new’ research was connected to an NHS pain clinic and was being promoted around universities; it seems that this research may end up dominating pain clinics around the country.
He originally offered unconditional therapy; 8 sessions in total, and during the first couple of sessions he seemed like someone I could trust and develop a good theraputic relationship with, but the second one in he said that unless I attended 2 full days a week for 4 weeks, which was impossible for me due to a disability, he would cancel my remaining therapy sessions; he said he couldn’t help me, but he hardly knew me!! He totally tried to manipulate me. Only his therapy would help me he said, so I challenged his ‘evidence base’ and told him that only people who are physically able to attend would complete the program, so the evidence of his success was actually skewed; he said that was not true, but I answered that other research concerning that contradicted him.
The point I’m making here is that a certain therapy is being promoted as the ‘only’ way forward in therapy, which seems to me to be rather dangerous and unethical, and really, why bother deciding to choose a ‘school’ if a national institution is being used to promote the idea that only one form of therapy is now relevant, which in turn means that they are stating that they know how therapy works.
I can’t help thinking that there is a connection to the commerciality of an idea here. Of course, I’m aware that psychologists write books, papers, run private clinics and so on, but when they start to say they can ‘make disabled people less disabled’ it has a serious affect on the disabled; consider the damage a particular UK psychologist has wrought on M.E. sufferers in the UK. He has made a lot of money out of promoting his theories, and his influence based on ‘evidence’ that the serious neurological symptoms these people suffer is ‘all in the mind’, has cheated hundreds of thousands of sufferers out of insurance payouts and disability benefits.
I think people like these bring the profession into disrepute and deter people from seeking out theraputic relationships in the future. The intimacy you share with a therapists is precious and therapists should not use the trust that develops to cajole a patient into a certain treatment regime for his or her own ends.
Thank goodness that there are many many good psychologists out there! I do hope that some of them will keep an eye on this issue.
Thanks for that Clare – a good reminder with the M.E. example, that people claiming to ‘know the one way which works’ can really, practically, economically damage people’s lives.
Could you say what the measure of progress in early sessions used by Michael Lambert is? I think early progress and therapy needing to be long term could be compatible (depending on how progress is measured).
could be, Evan, good point. The impression I got was that it was not so compatible, that progress usually gets made swiftly or not at all. I think Lambert’s work is well worth checking out. These are just points I found interesting from one lecture, so I don’t really feel qualified to go into any more detail.
Therapy is indeed a relationship – when TWO parties play equal roles. I personally believe that until and unless both the client AND the therapist sees this, therapy is hardly going to work…simply because you can’t cheat reality: one party can only contribute 50% to the overall success and not more!
For many clients (myself included), their distress comes from some sort of dysfunctions in relationships – one way or another. Be it abuse or bereavement, or bullying, relationship issues…the truth is that many of them have rather distorted templates when it comes to relationships.
And so a therapeutic relationship is extremely important in that it gives them a new and healthy template (corrective emotions), and though for some it might take a while to embrace it…healing comes when they begin to view the world as a less threatening one. And you’re very right – it’s not the school that the therapist comes from; but the therapist as a person. When I go into therapy, I don’t care as much about which approach my therapist uses (of course, that’s important too); but I care more about whether I can “connect” with her.
Bravo, Sarah, from across the pond. Your candor is refreshing and important. Too many therapists tend to dogmatism disguising uncertainty and projection (at worst) or treat their approach as nearly a religion (less bad, often works; that might be the ‘placebo’ you mentioned in ‘politics’). In the end, I couldn’t agree more with your title. I would add, perhaps, that for each patient it comes down to: ‘whatever works’. More exactly, drawing on whatever ‘trues’ (I find it in-apropos to use the word ‘truth’ in this context) from any or all the methodologies, one can use those insights for that particular individual as seems fit, helpful and useful. Since it’s the relationship and the personalities involved, I don’t see how any meta-analyses aren’t susceptible to being flawed and skewed by collecting skews, biases, inter alia.
Cheers, Daniel! I like the idea of “drawing on whatever trues” – adds another dimension to “whatever works”… seems likely to lead to more lasting and meaningful effects.