Lately I have noticed an increasing trend in the psychotherapy field in which the marketplace of ideas has become more crowded. Every day it appears that someone has invented a new theory, therapy, or technique that is then marketed as the latest and greatest breakthrough. A flocking of therapists to training programs on these new inventions has created thriving businesses for many. The good news is that the more these offerings are marketed, the more these new ideas can be heard and explored. The bad news (at least to me), is that it may create an idea that by learning just the “right” theory, therapy, or technique, we as therapists can increase successful outcomes. Some psychotherapy marketers have gone so far as to draw a line in the sand and declare that what they are offering is the cure to most of the emotional problems for which people come to therapy. Others have been more respectful and inclusive in their offerings.
I think it is important for us all to remember that, in spite of the best marketing efforts, research still shows that any one specific therapy application is not superior to any other when it comes to measuring outcomes. In an article in the journal “Clinical Psychology: Science and Practice”, Stanley Messer and Bruce Wampold found in the results of their research that there is no evidence that that any one therapy application provides the magic bullet for successful clinical work. They write:
“Such results cast doubt on the power of the medical model of psychotherapy, which posits specific treatment effects for patients with specific diagnoses. Furthermore, studies of other features of this model—such as component (dismantling) approaches, adherence to a manual, or theoretically relevant interaction effects—have shown little support for it.”
In fact, the most recent research on what really works in practice involves each individual client’s perceptions of the overall progress of treatment and the key determinant for success still comes down to the client-therapist relationship. Michael J. Lambert and Dean E. Barley, in an article titled, “Research summary on the therapeutic relationship and psychotherapy outcome” from the journal “Psychotherapy: Theory, Research, Practice, and Training”, found that factors such as warmth, empathy and the therapeutic relationship had a higher correlation with client outcomes than specialized treatment interventions. (For more on the factors which create success in therapy work, I highly recommend the work of Dr. Scott Miller: www.scottdmiller.com )
If it is true that specific theories, therapies, and techniques are not, as Bateson would say, “the difference that makes the difference”, then maybe this can free practitioners from any rigid allegiances in the constant changing psychotherapy marketplace. I still encourage people to create new models and techniques and expand our field; however, I think we all need to be aware that even the greatest technique may go nowhere if a client does not have trust and a solid connection with the therapist. Unconditional positive regard for clients and having a human connection should never go out of style.