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Science and Psychotherapy

Most people closely associate medicine and science, but how many of us think of psychotherapy and science as being related? Maybe we don’t, but we should. A recent research article that has received significant media attention has drawn attention to this issue.

While it’s true that psychotherapy has little to do with scientific tools like Petri dishes and test tubes, the process of determining which types of psychotherapy are most helpful for specific problems is a scientific one. For decades, major universities and other research institutions have investigated whether some approaches to psychotherapy are more effective than others. Fortunately, after thousands of such rigorously conducted studies, we now possess scientific knowledge about whether specific psychotherapies are helpful for specific problems. Sounds like good news, right? It is! But here’s the bad news. There is no guarantee that a visit to your local therapist will result in your receiving the best-established type of therapy for your problem.

If you see your primary care doctor for advice on high cholesterol, you’re likely to be counseled on which changes to your diet might be helpful and which medications might be appropriate. You wouldn’t expect to be told to take up model boat building, however useful the physician might deem that to be. Why? Because early last century, medicine committed to the use of a scientific approach in selecting treatments. That means that if research shows that iron supplements are more helpful for anemia than, say, leeches, your physician will recommend iron (even if he is an amateur leech farmer).

Unfortunately, this approach has not been as widely accepted by psychotherapists as it has by physicians. Two important reasons for this involve therapist training and accountability. Many therapists attend training programs in only one type of therapy, and graduate from training thinking that this type of therapy is superior and appropriate for many (or all) types of problems. This represents a shortcoming of some therapy training programs. The other factor creating ambiguity around the standard of care among therapists has to do with accountability. If your doctor gives you penicillin for your melanoma, you can file a complaint with the state licensing board. You might even be able to bring legal action. However, therapists are typically not held accountable in the ways physicians are.

There are many reasons — some very good — for the different standards. For one, the consequences of applying the wrong treatment are typically different in psychotherapy than in medicine. Additionally, it’s often much clearer whether or not a broken arm is healing as opposed to whether someone’s depression has improved. So while it may be inappropriate hold therapists to the same standards we have for physicians, it is certainly reasonable to expect that therapists be cognizant of the research base for any type of therapy they provide.

Posted in Psychotherapy, Research. Tagged with , , , , .

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