Be Your Own Therapist

This is not good news for the therapy business. At least, for those who provide the cognitive-behavioral treatments that have now been shown to be the most effective in treating a variety of mental health issues.

A recent study has shown that a patient can do just as well using a self-help book or a computer program. Since cognitive therapy is about retraining the mind through an exercise program, it makes some sense that the person of the therapist does not much matter.

Olivia Goldhill reports on the research:

Seeking out the perfect therapist can feel as significant and difficult as finding a romantic partner. A study on the effectiveness of trained therapists versus self-help treatment, though, suggests that therapists are not as important as they seem.

A meta-analyses of 15 studies, published in this month’s volume of Administration and Policy in Mental Health and Mental Health Services Research, found no significant difference in the treatment outcomes for patients who saw a therapist and those who followed a self-help book or online program.

The researchers, led by Robert King, psychology professor at Queensland University of Technology in Australia, evaluated the outcomes of 723 patients who were treated for a variety of mental health conditions, including anxiety, PTSD, OCD, and depression.

All 15 studies involved a form of Cognitive Behavioral Therapy (CBT) treatment, and patient outcomes were evaluated by various mental health diagnostic scales, rather than self-assessment.

Contrary to the researchers’ hypothesis that therapists would provide stronger results (though with greater variability), the results showed that therapists were neither more effective nor more variable than self-help options.

As soon as the world’s therapists get over gnashing their teeth, they can also see these results as a confirmation of the fact that their treatment is more scientific. After all, when you receive a medical treatment, does it matter whether it is administered by Dr. X or Dr. Y or Nurse Z. If the effect of the treatment depended on the person of the provider, it would be less about science and more about… a placebo.

Of course, there are other forms of psychotherapy. I try to follow them on this blog, especially those that appear weekly in New York Magazine. Those are Ask Polly and Lori Gottlieb. The so-called insights offered in these two columns are occasionally correct, but they are more often off the mark. With Polly, in particular, a former therapy patient seems compelled to offer up her own experience, with therapy and in life, as a means to show the proper amount of empathy for the letter writer.

I find this to be an especially useless technique, an admission that the columnist cannot get out of her mind to focus on the letter writer’s problems.