If you are considering beginning psychotherapy you may be wondering whether there is evidence that psychotherapy is effective.
To answer this question, first note that there are at least two ways people seek to benefit from therapy.
The first is in terms of the relief of symptoms and other kinds of psychological distress which reduce quality of life. To know whether therapy helps people in this way, we need to measure their distress before and after therapy. If their distress goes down, then we need to show that this likely happens because of the therapy, rather than for some unrelated reason. Many research studies have sought to measure and understand such changes. Some of the results are described below.
The second way in which people seek to benefit from therapy differs from the first. This type of benefit has to do with self-knowledge. To know whether a person has benefitted from therapy in this way, he or she needs to reflect on questions like the following: “Has being in therapy helped me to know more about myself and my life?” And “has this knowledge helped me to live a more fulfilled life?” For many people, getting to know themselves better is an important reason to pursue therapy. And many people have found that therapy helps them to make crucial gains in self-knowledge. However, this type of benefit is harder to measure using numbers than the first type of benefit. Still, something can matter even if it is not easy to quantify.
Often, people will be looking to gain in both of these ways by being in therapy. A troubling symptom can be a strong motivation to start. But once therapy has started, the interest in knowing oneself better becomes stronger.
When it comes to the kinds of benefits of therapy that can be readily quantified, we can look to a number of widely cited reviews of research studies. The results of these studies lead us to believe that therapy is an effective way to treat common psychological problems.
There are three kinds of reviews that are noteworthy, which we’ll now describe:
- Reviews of studies on the use of therapy and medications. Reviews of studies suggest that therapy can often be used instead of medications. It can also be helpful along with medications.
- Reviews concerning short-term cognitive behavioral therapy (CBT) and short-term psychodynamic therapy (PT).A recent review of studies suggests that different short-term therapies demonstrate similar effectiveness.
- Reviews concerning short-term vs. long-term therapy. A review of studies found that long-term PT showed significant advantages over short-term therapies
1. Psychotherapy and medications. One topic that has been studied is what happens when medications are used along with psychotherapy. Cuijpers et. al reviewed studies focusing on adults with depressive and anxiety disorders. In total, 52 studies were reviewed. They concluded that combined medication and therapy treatment makes a clinically meaningful difference.
Another topic that has been studied is whether psychotherapy can be used instead of medications. Imel et al. reviewed studies comparing psychotherapy and medication treatment in unipolar depression and dysthymia. They reviewed a total of 28 studies. They found the following. (1) Psychotherapy and medication were not significantly different at post-treatment. (2) Psychotherapy showed a significant advantage over medication at later follow-ups. The further in the future the follow-up occurred, the greater the advantage of therapy over medication. This led them to conclude that therapy may offer a prophylactic effect not provided by medication.
2. Short-term psychotherapies. Some studies have compared two widely used approaches. These are cognitive behavioral therapy (CBT) and psychodynamic psychotherapy (PT). One key difference is that CBT is a psychoeducational approach. PT is more of an exploratory approach.
CBT is a short-term therapy. There is also a short-term versions of PT (STPP). Leichsenring reviewed 6 studies of the treatment of patients with depressive symptoms. The review compared STPP with CBT. No significant difference was found between the two treatments.
3. Long-term psychotherapy. PT has traditionally been offered as a long-term therapy. This is an important way in which it is different from CBT. A question this raises is whether there is any reason to pursue a long-term therapy like PT. A review by Leichsenring and Rabung examined 23 studies of long-term PT. The studies included 1053 patients. The therapies lasted for at least a year or 50 sessions. The authors found that PT showed significantly higher outcomes in different areas than shorter therapies. These include overall effectiveness, target problems, and personality functioning.
Overall, there is good reason to think that therapy is an effective form of help for many. It can bring about increased self-knowledge – which many people find intrinsically valuable – and it can improve symptoms and functioning in various areas of life.
