Therapy is effective...but...


Several decades of research have shown that therapy works. It’s been shown beyond doubt that, overall, therapy is effective and those effects are usually lasting. If you’re interested the research you’ll find more detail in Getting better outcomes where I try to provide as jargon free a summary as I can.


The 'but..' is about what factors make therapy effective.  It’s upon the evidence for these, together with my own experience of them, that I base my approach. What the evidence says is this: 


  • There is no evidence of a difference in outcome between different types of therapy – they are all are broadly equivalent in their outcomes
  • Some types of  therapy, for example CBT, have a greater weight of evidence (i.e. sheer number of studies) in clinical trails than others
  • The key elements that appear to make a difference to therapy outcomes apply across all types of therapy. These ‘common factors’ include the therapeutic relationship, the hope and expectation of change, and the effectiveness of the therapist
  • As many as 50% of clients may drop out of therapy early, presumably because they do not feel it is helping. Evidence shows that therapists find it hard to predict which clients will drop out
  • There is evidence of considerable variations in effectiveness between therapists, even those working within the same setting or service
  • Two factors have been shown by research to be strong predictors of a positive outcome to therapy: early signs of improvement, and the client’s rating of the therapeutic relationship
  • Using measures of outcome and the working alliance as therapy progresses has been shown to reduce drop out and significantly improve outcomes. Despite this evidence, however, most therapists continue to rely solely on their judgement to assess progress

My approach draws on this evidence and my experience to make you an active partner in the process, to build a strong alliance between us, and to actively monitor the way that we work together and our outcomes. Read more in My approach



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© 2011 Barry McInnes