Does Therapy Work?

Therapy and counseling: Do they make you better? Let’s look at the evidence.  People want marriage counseling. They want help with anxiety and depression. They want therapy for their children and for their adolescents. But they also want to know whether therapy and counseling is scientifically proven to work.

Today, insurance companies will pay for some therapy, but they often limit what they will pay for. The question is, does therapy work in a scientifically proven way? And if so, what types of therapies work better than others?

How researchers test if therapy works.  It's important to note that scientists believe experimental evidence is needed to prove that therapy works.  For instance, new drugs are tested in so-called double-blind studies. Some people receive the experimental drug.

Other people receive a pill that looks like the drug but is made of sugar. And the people participating in the study don't know whether they are getting the real drug or the sugar pill. Researchers have used a similar method to see if therapy can be proven to work. The whole effort is to see which therapies are "evidence based." Their tool is to use randomized controlled trials.

What randomized control trials can show is if a given treatment has been beneficial to a wide range of people participating in the test. What it can't show is why a particular therapy works or doesn't work.

The "gold standard" in evidence-based therapies is cognitive behavioral therapy for treating people who are depressed.

Cognitive behavioral therapy, or CBT: proof that it works for depression. In a recent study of cognitive behavioral therapy, or CBT, half the patients who were given CBT therapy improved. So did about half the patients who were treated with medication. Only about one quarter of the patients who were given sugar pills improved.

This improvement took place over several months. Better yet, many of the patients who received CBT were given three additional sessions of therapy over the year, and they maintained their improvement over the year.

A member of the American Psychological Association, Dr. Hollon, says studies like this are "the gold standard" for showing what therapies work or don't work.  Talk therapy: it works if you have the right chemistry with your therapist.  Most people who come to therapy have multiple problems they want help with.

They may feel depressed, and they also want their relationship with their spouse and children to improve. They may feel uncomfortable with the amount of alcohol they consume. And they may have trouble sleeping due to thoughts that race through their head and make them uncomfortable.

That's why it isn't easy to just have someone get cognitive behavioral therapy because it may not help them with their other problems.

A trained and experienced therapist may use some cognitive therapy along with other types of therapy, including psychodynamics. The combination may help a client more than just CBT would.  It turns out that researchers have tried to find evidence for this type of more general talk therapy, or eclectic therapy.

So, does it work?  Evidence that talk therapy works:

Talk therapy has been hard for researchers to get their arms around because each therapist does things differently with each client.  To try to classify talk therapy and see if it works, Dr. Enrico Jones, University of California at Berkeley, developed a 100-item rating system, called the Process Q-set, to classify video-taped therapy sessions in an objective way.

Researchers discovered that talk therapy often involved cognitive behavioral techniques combined with other techniques.

Some therapists used a lot of psychodynamics. Psychodynamics examines the client's relationship with the therapist and uses elements of this to help the client examine unconscious conflicts in a new light. It turned out that therapists who used a lot of psychodynamics helped people the most in improving their depression!

So what does the research show? Therapists who combine multiple techniques according to their client's needs and their own experience can help a client work wonders.

By Richard Geller
Richard founded his first successful company at age 18. He is co-founder of a number of franchises and venture-backed companies including Amazing Media, an advertising technology company. He has written four business books and has given talks at the Washington Press Club, the Wharton Club of DC, and George Washington University, among others. He has been widely quoted in Entrepreneur Magazine, Investors Business Daily and other publications. He is currently co-CEO of a company that provides leads to professionals such as dentists, therapists and even dog trainers.  Contact Richard

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