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Psychological Treatment

Effectiveness of Treatment

Biomedical Therapies

Seeking Treatment

Research has shown that many people with psychological disorders benefit from treatment. Effectiveness depends on the specific disorder being treated and the skill of the therapist.

Ways of Assessing Effectiveness

The effectiveness of a particular therapeutic approach can be assessed in three ways: client testimonials, providers’ perceptions, and empirical research.

Client Testimonials

Clients who get treatment for psychological problems often testify to their effectiveness. However, such testimonials can be unreliable for several reasons:

  • Regression toward the mean: People often go into treatment because they are in extreme distress. When their distress becomes less extreme, they may attribute this to the treatment’s effectiveness. But even without treatment, extreme distress tends to decrease. The tendency for extreme states to move toward the average when assessed a second time is called regression toward the mean.
  • The placebo effect: People often feel better after being in treatment because of their expectations that they will improve. (See Chapter 1 for more information on placebo effects.)
  • The justification of effort effect: People may believe that treatment was effective because they spent time, effort, and money on it. If people work hard to reach a goal, they are likely to value the goal more. This phenomenon is called justification of effort.
Providers’ Perceptions

Treatment providers can say whether a treatment is effective, but this can be unreliable for several reasons:

  • Regression toward the mean affects providers’ perceptions of success. They may believe that a client who entered treatment in crisis became less extremely distressed because of the treatment. However, such an improvement may have occurred without any intervention.
  • Providers’ perceptions may be biased because clients often emphasize improvements in order to justify discontinuing treatment.
  • Providers may also have biased perceptions because they continue to hear from past clients only when those clients were satisfied with treatment. They don’t often hear from clients who found treatment ineffective.
Empirical Research

Another way to assess effectiveness is through careful empirical research. Research has shown that some treatments are more effective for a particular problem than a placebo or no treatment. These treatments are known as empirically validated treatments. Researchers have to conduct two or more studies in order to conclude that a specific treatment is effective for a particular problem.

Research shows that psychotherapy works for many psychological problems. Although people who do not receive therapy also sometimes improve with time, people who do receive therapy are more likely to improve. Research also shows that all approaches to therapy are about equally effective, though certain kind of therapies do seem somewhat more effective for specific problems.

 
Specific Disorder Most Effective Treatment
Panic disorders Cognitive therapy
Specific phobias Systematic desensitization
Obsessive-compulsive disorder Behavior therapy or medication
Depression Cognitive therapy
Post–traumatic stress disorder and agoraphobia Exposure treatment

Who Benefits from Treatment?

Clients who are likely to benefit from therapy share some common features:

  • Motivation to get better
  • Family support
  • Tendency to deal actively with problems rather than avoid them

Clients who are less likely to benefit from therapy also share some features:

  • Hostility and negativity
  • Personality disorders
  • Psychotic disorders

Can Therapy Be Harmful?

Under some conditions, therapy can be harmful to the client. Clients may be harmed if:

  • Therapists engage in unethical behavior, such as by having sexual relationships with clients
  • Therapists act according to personal prejudices or are ignorant of cultural differences between themselves and their clients
  • Therapists coerce clients into doing things they don’t want to do
  • Therapists use techniques that research has not demonstrated as being effective
  • Therapists lead their clients to produce false memories of past traumas through careless use of techniques such as hypnosis or free association

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