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WHAT MAKES MIND THERAPY WORK


Techniques and other factors

*For an explanation of the term 'functional mental disorders', see the page
 The Nature of 'Mental Illness'

Because the medically-categorised functional mental disorders* are conjectural clusters of symptoms, none is more responsive to particular  theories of mind therapy than  to others.   Despite the claims made by some 'schools', no particular set of techniques – such as psycho-analytic interpretations, systematic desensitisation, dream analysis, guided imagery, hypnosis, relaxation exercises, role playing and biofeedback – is more efficacious than others.(1)

'Non-Specific' Factors

 

 

*See: Saul Rosenzweig: 'Some implicit common factors in diverse methods of psychotherapy' pp 412-415 American Journal of Orthopsychiatry 6 (1936) and 
G. Watson: 'Areas of agreement in psychotherapy' pp 698-709 American Journal of Orthopsychiatry 10 (1940)

'Without your help, I could never have made it this far'. ©Hallmark Cards Inc.Since 1936 at least, therapists have recognised that the most important factors in beneficial mind therapy are 'non-specific' and  common to all the 'schools'.   These include clients' belief that the therapy will help them, the quality of the client-therapist relationship and concentration by client and therapist on the client's objectives.*
Another major factor is the readiness of clients to help themselves.   Therapists are there to provide the right kind of help and encouragement; but their efforts will prove futile if clients merely talk and listen without trying to put into practice what they learn in the consulting room.

'Client factors'
 

The willingness of clients to help themselves may well depend on: their particular circumstances; the support they receive from family, friends, colleagues and so on; their natural resilience to setbacks and being prepared to alter their circumstances or themselves in some way.(2)   In fact, according to M. J. Lambert, 'A substantial number of outpatients (on a waiting list for their initial appointment) improved without formal psychological intervention'.(3)  

The therapist factor

A therapist's ability to foster a conducive working relationship, or 'therapeutic alliance' is also very important.   This largely depends on their interpersonal, or 'people', skills — such as the ability to:

get to know the real person behind the 'mask' of status, appearance, manner and beliefs;

imagine themselves in the client's situation;

understand and show they understand what a client is struggling to communicate;

dedicate themselves to the task in hand;

provide emotional support as appropriate.

 

'The attitude of the psychotherapist is infinitely more important than the theories and methods of psychotherapy'. Carl Gustav Jung(4)
'Experience has taught me to keep away from therapeutic 'methods' as much as from diagnoses ... everything depends on the man and little or nothing on the method.' Carl Gustav Jung(5)
'.. however much therapists may focus on the technical aspects of their procedures, an increasing body of evidence suggests that it is the personal relationship between themselves and their patients which is experienced by the latter as the most potent therapeutic force.' David Smail(6)
'Some years ago I formulated the view that it was not the special or professional knowledge of the therapist, nor his intellectual conception of therapy (his 'school of thought') , nor his techniques which determine his effectiveness. I hypothesised that what was important was the extent to which he possessed certain personal attitudes in the relationship.' Carl R. Rogers(7)
'... the crucial factor in psychotherapy is not so much the method, but rather the relationship between the patient and his doctor or, to use a popular expression the 'encounter', between the therapist and his patient.   This relationship between two persons seems to be the most significant aspect of the therapeutic process, a more important factor than any method or technique.' Victor E. Frankl(8)
'Experience provides clinicians with a special sense of what should be done next in (psycho)therapy: on a deep level, this special sense reflects a very complex decision-making process that is informed by dozens, perhaps hundreds, of bits of data related to the client, the therapist and the context.' John D.W. Andrews, John C. Norcross & Richard P. Halgin(9)
'If any single fact has been established by psychotherapy research, it is that a positive relationship between patient and therapist is positively related to therapy outcome.' Irvin D. Yalom(10)
'A psychoanalyst's personality is his major therapeutic tool.' Henri F. Ellenberger(11)
'If I can only be myself in the relationship, not a professional expert, not a "psychologist", not a "psychotherapist", just me in that relationship, that's helpful.' Carl R. Rogers(12)
'... we are only more helpful than the average layperson because of our greater experience of people in distress ... rather than because of our extensive knowledge of psychodynamic/humanistic theory and practice ...   By simple virtue of being professionals, we may be seen as knowing best — and we may come to believe in this myth ourselves, perhaps setting great store by psychodynamic formulations rather than being a fellow pilgrim with our clients ...' Gill Edwards(13)
'There is growing evidence that effectiveness in therapy is primarily dependent on the quality of the relationship between therapist and patient and that that, in turn, depends on the quality of the therapist.   The results of psychotherapy are, however, difficult to assess, especially since many or most of the conditions treated naturally improve with time.   There can be little doubt that many people can benefit greatly from wise and considered counselling by an educated and experienced life-guide.   Whether there is any school of psychotherapeutic training which can produce such qualities is another matter.' Robert M. Youngson(14)
'... it is becoming increasingly obvious that the (psycho)therapist's personality is a more decisive factor than the school to which he belongs. Arthur Koestler(15)
 

References:

(1) L. Luborsky, B. Singer & L. Luborsky: 'Comparative studies of psychotherapies: is it true that "everybody has won and all must have prizes"?' pp 995-1008 Archives of General Psychiatry 32 (1975)
D.A. Shapiro & D. Shapiro: 'Meta-analysis of comparative therapy outcome studies: a republication and refinement' pp 581-604 Psychological Bulletin 92 (1982)
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(2) Michael J. Lambert 'Psychotherapy outcome research' pp 94-129 in Handbook of Psychotherapy Integration [John C. Norcross & Marvin R. Goldfried (eds)] Basic Books, New York 1992
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(3) 'Spontaneous remission in adult neurotic disorders: a revision and summary' pp 107-119 Psychological Bulletin 83
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(4) p. 281 Modern Man in Search of a Soul. Routledge & Kegan Paul, London 1933
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(5) 'The Realities of Practical Psychotherapy' p. 329 in The Practice of Psychotherapy Routledge & Kegan Paul, London 1966
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(6) p. 49 Illusion and Reality. J.M. Dent & Sons, London 1984
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(7) p. 81 Person to Person (co-author B. Stevens). Souvenir Press, London 1973
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(8) p. 137 Psychotherapy & Existentialism. Penguin, Harmondsworth 1973
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(9) 'Training in psychotherapy integration' pp 576-577 in Handbook of Psychotherapy Integration [John C. Norcross & Marvin R. Goldfried (eds)] Basic Books, New York 1992
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(10) p. 401 Existential Psychotherapy. Basic Books, New York 1980
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(11) The Discovery of the Unconscious. Basic Books, New York 1970, p. 48
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(12) Interviewed by Tony Hobbs ['The Rogers Interview' Changes vol. 4, no 4, 1986, p. 255]
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(13) p. 22 Changes vol.3, no 1 (1984)
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(14) p. 670 Encyclopedia of Family Health. The Royal Society of Medicine, London 1995
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(15)  p. 248 The Act of Creation Hutchinson & Co., London 1964
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Suggested Reading:

D.M. Stein & M.J. Lambert: 'On the relationship between therapist experiences and psychotherapeutic outcomes' pp 1-16 Clinical Psychology Review 4 (1984)

Hans Strupp & Suzanne Hadley: 'Specific versus non-specific factors in psychotherapy' pp 1125-1136 Archives of General Psychiatry 36 (1979)

The Heart and Soul of Change: What Works in Therapy by Mark A. Hubble, Barry L. Duncan, Scott D. Miller. American Psychology Association, Washington DC 1999

The Great Psychotherapy Debate by Bruce E. Wampold. Lawrence Erlbaum Associates, Mahwah, New Jersey 2001

The Heroic Client: A revolutionary way to improve effectiveness through client-directed, outcome informed therapy  by B. Duncan, S. Miller, J. Sparks, G. Jackson, R. Greenberg, K.Kinchin. Jossey Bass, San Francisco 2004

  Back Next

What Mental 
Illness Is
Mind Therapy 
and Health
Mind Therapy 
Introduction
Employing a 
Mind Therapist
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For more information, without obligation, telephone: 01773 833267 (24 hours). All calls are confidential.