Re: thoughts on psychotherapy

From: Scott Badger (w_scott_badger@yahoo.com)
Date: Thu Jul 06 2000 - 12:39:41 MDT


Whew, there's a lot of ideas flying around on this
topic. I'll confess up front to being a psychologist,
though I rarely do therapy. But I would like to add a
few comments here.

Eliezer wrote:

"Psychotherapy is bunk.

Experiment demonstrates that psychotherapy produces
results slightly worse than a control group in which
patients just talk to a random person for an hour."

And how does that make you feel? ;-D

Seriously though, I'd also like to see your source.

J Reeves wrote:

"I believe it was Timothy Leary (pre-LSD) that did the
original study and found that of people that received
psychotherapy roughly a third got better, a third
stayed the same, and a third got worse - exactly the
same as a control group which did not receive any
therapy"

That's a really old study. There's been tons of
research since then. My notes are buried in the closet
somewhere but, as you might imagine, this is not the
first time that therapists have been accused of being
ineffective. Consequently there have been many
outcome studies conducted to address this very point.
A few years ago, Bergin (I believe) conducted a
meta-analysis study which reviewed and integrated a
large number of those studies. The exact numbers
escape me but the results indicated that therapy is
more effective than no therapy on the average, but not
by much. It also demonstrated that the theoretical
orientation used (cognitive therapy, Gestalt,
Psychopdynamic, etc) made no difference. (BTW, Freud
is NOT a cognitive psychologist). There's a ton of
research that cognitive therapy is well-suited to
depression. So are meds. And the two together are
better than either alone.

There's a good article on effectiveness by a quite
famous psychologist (Martin Seligman) at:

http://www.mentalhelp.net/articles/seligm.htm

Can anyone do therapy? Well, it has been shown that
Ph.D.s are no more effective than Master's level
counselors. Are trained counselor's better than your
Aunt Jane? Probably, although there are a lot of
natural-born counselors out there. Empathy and
reflective listening skills don't come easy to a lot
of people, though. Plus, maybe you don't don't want
to talk to Aunt Jane (or your preacher) about your
sexual hang-ups.

When I did do therapy for a community mental health
center, I noticed that many client's problems were
already resolved to a considerable degree by the time
they showed up for the appointment. This was because
just knowing that they had an appointment got them on
a therapeutic track. Sorta like cleaning the house
before the maid shows up. It always boiled down to
whether the client was motivated to take action and
improve or take no action and blame someone/something
else.

I do have a problem with Pop Psychologists and the
marketing of self-esteem/self-love. The only thing I
ever heard Dr. Luara say that I liked was when her
caller complained of having low self-esteem and Laura
replied with, "Well, have you done anything lately to
deserve feelings of self-esteem?" TRhe caller was
stumped. I personally think it's more important to
foster and facilitate a genuine sense of
self-efficacy. The rest will follow.

I recently watched Mumford, a movie about a guy who
pretends to be a psychologist and everyone loves this
guy. They think he's a great therapist. When the
other therapist in town asks him what his theoretical
approach is, he says he doesn 't really have one
because people's problems are too complex and
ingrained by the time they come to him. All he said
he did was listen and encourage them to talk about the
problem and he found that they often found at least a
partial solution.

Nigel talked about how sophisticated strategies
developed by advertisers might be useful. I recall a
book titled the Psychology of Persuasion. Might want
to check it out.

http://www.amazon.com/exec/obidos/ASIN/0688128165/o/qid=962908340/sr=2-1/102-8320433-0480129

He mentioned how people are good at small decisions
and not so good at big decisions. That's a
no-brainer, isn't it. The big decisions are perceived
as a lot more relevant and so the decision making is
often mucked up by stressful emotions. My dissertation
was on decision-making, specifically Career Indecision
and the degree to which various affective states
interfered with effective decision making processes.
My theoretical grounding came from Personal Construct
Psychology.

http://www.centrepcp.ndirect.co.uk/

Best regards,

Scott

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