Within the psychotherapeutic community there has been some discussion of empirically-based psychotherapy, e.g.
Almost no comparisons of different psychotherapies with long follow-up times have been done.The Helsinki Psychotherapy Study is a randomized clinical trial, in which patients are monitored for 12 months right after the onset of study treatments, in which each lasted approximately half a year. The assessments are to be accomplished at the baseline examination and throughout the follow-up after3 and 7, and 9 months and 1, 1.5, 5, 4, 3, 6 and 2 and 7 years. The final results of this trial are yet to be published because follow-up evaluations continued up to 2009.
There is considerable controversy about which form of psychotherapy is most effective, and more specifically, which types of therapy are optimal for treating which sorts of problems. Furthermore, it really is controversial whether the form of treatment method or the presence of factors common to many psychotherapies best sets apart effective therapy from inadequate therapy. Common factors theory asserts it is precisely the factors common to the most psychotherapies which make any psychotherapy successful: here is the quality of the therapeutic relationship.
The dropout level is quite substantial; one meta-assessment of 125 studies figured that the mean dropout level was 46.86%. The top level of dropout has raised some criticism about the efficacy and relevance of psychotherapy.
Psychotherapy outcome research-where the effectiveness of psychotherapy is measured by questionnaires provided to patientsthroughout and before, and following treatment-has had problems distinguishing between the success or failure of the different approaches to therapy. Those who stay with their therapist for extended periods are more likely to report positively on what develops into a much longer-term relationship. This suggests that some "remedy" may be open-ended with concerns related to ongoing financial costs.
In one of the earliest studies of psychotherapy treatment, Hans Eysenck reported that two thirds of therapy patients improved significantly or recovered on their own within two years, whether or not they received psychotherapy
Many psychotherapists believe that the nuances of psychotherapy cannot be captured by list of questions-style observation, and prefer to rely on their own clinical experiences and conceptual disputes to support the type of treatment they practice.
In 2001, Bruce Wampold of the University of Wisconsin published the book The Fantastic Psychotherapy Debate. In it Wampold, a former statistician who proceeded to train as a counseling psychologist, reported that
psychotherapy is definitely effective,
the type of treatment is not a factor,
the theoretical bases of the techniques used, and also the strictness of adherence to people techniques are both not aspects,
the therapist's strength of belief in the efficacy from the technique is a factor,
the character of the therapist is a significant factor,
the alliance involving the patient(s) and the counselor (meaning trusting and affectionate feelings toward the collaboration, motivation and therapist of the buyer, and empathic response of the therapist) is a key factor.
Wampold therefore concludes that "we do not know why psychotherapy works".
Although the Fantastic Psychotherapy Debate dealt mostly with data on frustrated patients, subsequent articles make similar findings for post-traumatic stress problem and youth disorders. There have also been studies of Panic Disorder, in which treatment effectiveness is measured in the abatement of panic and anxiety attacks. Psychoanalytic psychotherapy has been found to be as effective as Cognitive Behavioral Therapy for immediate relief and more successful over the long term.
Some report that by attempting to system or manualize treatment, psychotherapists may be reducing efficacy, even though unstructured approach of many psychotherapists cannot appeal to patients determined to solve their difficulties by means of the application of specific techniques distinct from their past "mistakes."
Experts note that the passage of your time alone, without therapeutic treatment, often results in psycho-social healing. Social contact with other individuals is universally seen as beneficial for all humans and regularly scheduled visits with anyone would be likely to diminish equally severe and mild emotional trouble, critics of psychotherapy are skeptical of the healing power of a psychotherapeutic relationship.[36"> Because any intervention takes time.
Many assets available to a person experiencing mental distress-the warm and friendly support ofpeers and buddies, family members, clergy contacts, private reading, healthyexercise and research, and independent coping-all present considerable value. Pundits note that humans have been working with crises, navigating severe sociable problems and finding methods to life problems long before the arrival of psychotherapy.[38"> Of course, it may be something in the patient that does not develop these "natural" supports that will require therapy.
Further critiques emerged from discursive, feminist and constructionist sources. Key to these is the issue of power. In this regard there is a concern that clients are persuaded-equally outside and inside of the consulting room-to understand themselves and their difficulties in such a way that are consistent with therapeutic ideas. This means that alternative ideas (e.gfinancial, . and feminist spiritual) are sometimes implicitly undermined. Critics suggest that we idealise the situation when we think of treatment only as a helping connection. It is also fundamentally a governmental practice, in that some social ideas and practices are supported while others are undermined or disqualified. So, while it is seldom intended, the therapist-client relationship always participates in society's power relations and political dynamics.">