How psychotherapy works

The following questions were produced by the American Psychological Association.

by. Bruce E. Wampold, PhD,

How exactly does psychotherapy help people?

Patients often come to psychotherapy with explanations for their difficulties that leave them feeling that the distress will continue indefinitely. Every treatment provides an explanation for the distress that is adaptive — that is, the patient understands that he or she can do something to improve his or her situation. This leads the patient into healthy actions in that the psychotherapy improves some aspect of their lives, whether it is thinking more positive thoughts, creating better relationships, more appropriately expressing emotions, or enacting other positive changes. The critical aspect is not which treatment a person receives but rather that the patient believes this particular treatment is effective and works collaboratively with the therapist.

If I were a client seeking therapy for the first time, how would I know if someone is an effective caregiver and is offering appropriate treatment? How long should I expect to be in treatment for a given problem?

As a starting point, a patient should ascertain that the psychologist he or she is considering is licensed by the state where he/she practices. Ideally, a patient would have evidence that the therapist is effective — has this therapist helped patients in the past? Because this evidence is rarely available, consumers often rely on word of mouth — the testimonial of friends who have benefited from treatment from a particular clinician. After therapy begins, the best cue is the patient’s experience: Does this therapist understand me? Does the treatment plan make sense to me? Do I believe this therapist will help me? And most important — am I making progress? Patients typically experience a positive response to psychotherapy quite rapidly. If a patient is not making noticeable progress in several sessions, the patient should discuss this with the therapist (and similarly, the therapist should initiate this conversation with the patient if adequate progress is not being attained). Together, a patient and therapist determine when treatment should end and often, this happens relatively quickly. Of course, some problems require longer treatment.

Treatment length depends on the problems or disorder, patient goals, patient history and characteristics, events occurring outside of therapy (e.g., divorce, change in employment status), and therapeutic progress. Evidence indicates that therapy typically is terminated when the patient is functioning adequately