(Part 1) The Ingredients of Effective Therapy
Studies of therapy improvement therefore
should include three independent measures: the client's
evaluation of the progress made; the therapist's evaluation;
and the judgments of people who know the client
well, such as family members and friends.
Another approach to evaluating the effectiveness
of therapy is to assess the resultant behavior change. Although
one of the goals of psychotherapy is enhancement
of the client's self-awareness and insight, most
people would consider therapy a failure if the person's
behavior remained the same. It is not enough to be a
source of insight.
Changes in overt behavior are easier to describe
and assess objectively than changes in attitudes, feelings,
and beliefs. But questions remain. To what degree
should behavioral change be used as a criterion? Who
should determine the kinds and amounts of change desired?
How lasting should the change be? How longstanding
and disabling has the patient's condition been?
It seems reasonable that criteria for success should be
related to the difficulty of the hurdle to be overcome.
Implicit in this conclusion is the recognition that criteria
that are appropriate in one case may be inappropriate in
others.
The Ingredients of Effective
Therapy
There is evidence that therapeutic effectiveness may be
more closely related to therapists' personalities than to
their theories. This suggests that we need to increase
our understanding of what clients and therapists do during
therapy sessions and how they react to one another.
The therapeutic situation merits investigation, regardless
of its measurable results, because each contact between
a client and a therapist involves a unique interest and
personal experience composed of complex, events. This
is true not-only in traditional psychotherapy but in the -newer
behavioral and cognitive therapies as well.
Research on the nature of psychological therapies
has explored the characteristics, attitudes, and behavior
of the client and therapist in addition to the therapeutic
technique used. What goes on in therapy sessions can
be characterized in terms of the operation of two sets of
factors. These factors are the procedures employed
by the therapist which mayor may not match the descriptions
of those procedures found in books and manuals.
Interpersonal factors refer to the social chemistry
of the relationship between the therapist and the client.
To minimize the effects of individual differences among
therapists, Freud struggled hard to establish technique
factors as the single most important therapeutic influence
in psychoanalysis. More recently, behavioral theorists
have also emphasized the need to specify the procedures
they employ. While it would be convenient if
technique factors were the only ingredients in therapy,
interpersonal factors not only are important but can be
decisive in influencing the outcome.
An example of the importance of interpersonal factors
is provided by a study that included groups of
trained and untrained therapists (Strupp and Hadley,
2009). One group consisted of experienced professional
psychotherapists; the other group of Vanderbilt University
professors who were selected on the basis of their
widely recognized interest in their students, their accessibility,
and their willingness to listen and help students
solve personal problems. None of the professors had
worked in the field of psychology or in any other "helping"
profession. The subjects were college students,
most of whom complained of anxiety. Each student was
assigned to either a professional or a nonprofessional
therapist. A third group of subjects constituted a control
group. Each control subject went through an assessment
procedure, but the start of therapy was delayed. (see next page).
should include three independent measures: the client's
evaluation of the progress made; the therapist's evaluation;
and the judgments of people who know the client
well, such as family members and friends.
Another approach to evaluating the effectiveness
of therapy is to assess the resultant behavior change. Although
one of the goals of psychotherapy is enhancement
of the client's self-awareness and insight, most
people would consider therapy a failure if the person's
behavior remained the same. It is not enough to be a
source of insight.
Changes in overt behavior are easier to describe
and assess objectively than changes in attitudes, feelings,
and beliefs. But questions remain. To what degree
should behavioral change be used as a criterion? Who
should determine the kinds and amounts of change desired?
How lasting should the change be? How longstanding
and disabling has the patient's condition been?
It seems reasonable that criteria for success should be
related to the difficulty of the hurdle to be overcome.
Implicit in this conclusion is the recognition that criteria
that are appropriate in one case may be inappropriate in
others.
The Ingredients of Effective
Therapy
There is evidence that therapeutic effectiveness may be
more closely related to therapists' personalities than to
their theories. This suggests that we need to increase
our understanding of what clients and therapists do during
therapy sessions and how they react to one another.
The therapeutic situation merits investigation, regardless
of its measurable results, because each contact between
a client and a therapist involves a unique interest and
personal experience composed of complex, events. This
is true not-only in traditional psychotherapy but in the -newer
behavioral and cognitive therapies as well.
Research on the nature of psychological therapies
has explored the characteristics, attitudes, and behavior
of the client and therapist in addition to the therapeutic
technique used. What goes on in therapy sessions can
be characterized in terms of the operation of two sets of
factors. These factors are the procedures employed
by the therapist which mayor may not match the descriptions
of those procedures found in books and manuals.
Interpersonal factors refer to the social chemistry
of the relationship between the therapist and the client.
To minimize the effects of individual differences among
therapists, Freud struggled hard to establish technique
factors as the single most important therapeutic influence
in psychoanalysis. More recently, behavioral theorists
have also emphasized the need to specify the procedures
they employ. While it would be convenient if
technique factors were the only ingredients in therapy,
interpersonal factors not only are important but can be
decisive in influencing the outcome.
An example of the importance of interpersonal factors
is provided by a study that included groups of
trained and untrained therapists (Strupp and Hadley,
2009). One group consisted of experienced professional
psychotherapists; the other group of Vanderbilt University
professors who were selected on the basis of their
widely recognized interest in their students, their accessibility,
and their willingness to listen and help students
solve personal problems. None of the professors had
worked in the field of psychology or in any other "helping"
profession. The subjects were college students,
most of whom complained of anxiety. Each student was
assigned to either a professional or a nonprofessional
therapist. A third group of subjects constituted a control
group. Each control subject went through an assessment
procedure, but the start of therapy was delayed. (see next page).
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If you are ready to schedule a FREE Consultation...
I encourage you to access this website
for the codependency treatment I recommend here:
http://www.TheLiberatorMethod.com/