Does therapy work

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Does therapy work? So far, we have looked at what therapy is and had a brief rundown of the types of therapy and some of the ways you can access it.  This week, we ask the question: Does therapy actually work?  

I’m Jennifer Rose, a UK counsellor, psychotherapist and Mental Health Recovery worker.  My blog is not intended to be a substitute for professional advice, diagnosis, medical treatment, or therapy. Always seek the advice of your physician or qualified mental health provider with any questions you may have regarding any mental health symptom or medical condition.

For week three of my blogging adventure, I am continuing to answer some of the questions I had when I first discovered the world of therapy. But first, I want to ask - do you have a favourite book? It was Book Lovers Day on the 9th of August, and while I was a student counsellor and psychotherapist, my go-to book was Mick Cooper’s ‘Essential Research Findings in Counselling and Psychotherapy’. It answers so many questions anyone interested in therapy should be asking -

Does therapy work? Yes, for many people and most issues – and Mick Cooper presents the research evidence for the effectiveness of therapy.

Some examples of the evidence are:

· There are over 400 studies those receiving psychotherapy had better outcomes than those who did not (Smith and Glass, 1977).  

This has been consistently supported by hundreds of subsequent meta-analyses demonstrating the clear clinical benefits of psychotherapy (Wampold and Imel, 2015).  

· Psychotherapy is not only effective in addressing most mental health issues, but is also at least as effective as medication in doing so (Hollon et al, 2006; Cuipers et al, 2013). 

·   The effects of psychotherapy have been found to be longer-lasting than those of medication (Hollon et al., 2016) (Although this study has been retracted, the UK Council for Psychotherapy still state this).

·  Relapse after psychotherapy is unlikely after the treatment ends (Nordal, 2010). 

·  There is also evidence to suggest that longer-term psychotherapy is more effective than shorter-term psychotherapy (Howard, Kopta, Krause, & Orlinsky, 1986). 

There is some evidence to suggest that specific forms of psychotherapy are more effective than others in addressing certain issues. This is often reflected in clinical guidelines, such as those produced by NICE. 

·       Psychodynamic therapy has been linked to good outcomes for people with depression or a diagnosis of personality disorder (Fonagy, 2015).

·       Family and systemic therapy has been linked to good outcomes for people with substance misuse issues (Liddle, 2016).

·       Cognitive behavioural therapy has been linked to good outcomes for people who are experiencing panic attacks (Otte, 2011).

Is it the type of therapy or is it the therapeutic relationship?

While there is evidence that some types of psychotherapy may be better suited to particular issues, there growing evidence to suggest that it is the relationship between the therapist and client that has the biggest impact on how well the therapy works. For example:

·         A review of the current research showed that in twenty studies, nineteen of them found therapist effects were critical (Johns et al, 2019).

·         Exploration of fifty years of psychotherapy revealed that strong therapeutic relationships are vital to the success of treatment Orlinsky, Rønnestad, & Willutzki, 2004). 

·         The differences between established models of psychotherapy do not significantly alter outcomes supports the suggestion that the therapeutic relationship is more important (Seligman, 1995; Tasca et al, 2019).  

 

I hope this has helped answer the question 'Does therapy work?' 

 I wonder if thas started to make you think about some of the assumptions you had about therapy?  Let me know in the comments.

Jennifer Rose
P.S: If there are any questions you would like me to address, please do let me know.  In the meantime, why not follow me on my socials?


Click here to go to the Socials page of my website, where you can find the links to all my social media.

Sources

Cuijpers P, Hollon SD, van Straten A, et al. BMJ Open 2013;3:e002542. doi:10.1136/bmjopen-2012-002542
Fonagy, P. (2015) The effectiveness of psychodynamic psychotherapies: An update. https://doi.org/10.1002/wps.20235

Hollon SD, DeRubeis RJ, Fawcett J, Amsterdam JD, Shelton RC, Zajecka J, Young PR, Gallop R. Effect of cognitive therapy with antidepressant medications vs antidepressants alone on the rate of recovery in major depressive disorder: a randomized clinical trial. JAMA Psychiatry. 2014 Oct;71(10):1157-64. doi: 10.1001/jamapsychiatry.2014.1054. Retraction in: JAMA Psychiatry. 2016 Jun 1;73(6):639-40. PMID: 25142196; PMCID: PMC4315327.

Howard, K. I., Kopta, S. M., Krause, M. S., & Orlinsky, D. E. (1986). The dose–effect relationship in psychotherapy. American Psychologist, 41(2), 159–164. https://doi.org/10.1037/0003-066X.41.2.159
Johns RG, Barkham M, Kellett S, Saxon D. A systematic review of therapist effects: A critical narrative update and refinement to review. Clin Psychol Rev. 2019 Feb;67:78-93. doi: 10.1016/j.cpr.2018.08.004. Epub 2018 Aug 25. PMID: 30442478.

Liddle, Howard. (2016). Multidimensional Family Therapy: Evidence Base for Transdiagnostic Treatment Outcomes, Change Mechanisms, and Implementation in Community Settings. Family Process. 55. 10.1111/famp.12243.

Nordal, K. C. (2010, November 1). Where has all the psychotherapy gone? Monitor on Psychology, 41(10). https://www.apa.org/monitor/2010/11/perspectives

Orlinsky, David & Rønnestad, Michael Helge & Willutzki, Ulrike. (2004). Fifty years of psychotherapy process-outcome research: Continuity and change.

Otte C. Cognitive behavioral therapy in anxiety disorders: current state of the evidence. Dialogues Clin Neurosci. 2011;13(4):413-21. doi: 10.31887/DCNS.2011.13.4/cotte. PMID: 22275847; PMCID: PMC3263389.

Seligman ME. The effectiveness of psychotherapy. The Consumer Reports study. Am Psychol. 1995 Dec;50(12):965-74. doi: 10.1037//0003-066x.50.12.965. PMID: 8561380.

Smith, M. L., & Glass, G. V. (1977). Meta-analysis of psychotherapy outcome studies. American Psychologist, 32(9), 752–760. https://doi.org/10.1037/0003-066X.32.9.752

Tasca, Giorgio & Angus, Lynne & Bonli, Rupal & Drapeau, Martin & Fitzpatrick, Marilyn & Hunsley, John & Knoll, Megan. (2019). Outcome and progress monitoring in psychotherapy: Report of a Canadian Psychological Association Task Force.. Canadian Psychology/Psychologie canadienne. 60. 10.1037/cap0000181.

Wampold, B.E., & Imel, Z.E. (2015). The Great Psychotherapy Debate: The Evidence for What Makes Psychotherapy Work (2nd ed.). Routledge. https://doi.org/10.4324/9780203582015

 

 

Life doesn't always follow the path we expected. Grief, loss, anxiety, change, and life's unexpected challenges can leave us feeling uncertain, overwhelmed, or wondering where to turn next. I created the Therapy Roadmap as a gentle way of making sense of these experiences. Rather than seeing therapy as simply solving problems, the Roadmap uses familiar landscapes—such as rivers, bridges, forests, and quiet places to rest—to explore the emotional journeys we all encounter at different times in our lives. Wherever you find yourself, each place offers an opportunity for understanding, reflection, and growth. Through these articles, I share compassionate insights, practical guidance, and reflections inspired by the Therapy Roadmap, with the hope of helping you feel a little less alone and a little more confident about the next step on your own journey. Whether you're simply curious, seeking support, or considering counselling, you're warmly welcome here. Take your time to explore the path ahead, and if you feel ready to take the next step, I'd be honoured to walk alongside you.

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