Answers “Folkeopplysningen”: psychotherapy works

Answers "Folkeopplysningen": psychotherapy works
  • Marit Rabu

    Professor of Clinical Psychology at the University of Oslo

The post author reacts to the latest episode of “Folkeopplysningen” with presenter Andreas Wall (pictured).

In general, it has a very good effect.

The debate
This is a discussion post. Comments in the text are the responsibility of the author.

In the latest episode Part of the program series “Folkeopplysningen” on NRK was directly misleading.

To address the basics first: psychotherapy works.

The program states that it takes seven people to treat one to recover, and the statistical effect size is 0.3. Based on several meta-studies in recent decades, the world’s leading researchers in this field Estimated effect size to about 0.7. See also Barkham and Lambert (2021).

This means that psychotherapy is generally very effective.

Complex phenomena

A premise made in the episode is that the same “disease” can be treated with the same “medicine”. It’s not that simple.

Psychiatric diagnosis is based on descriptions of symptoms and their number and grade. The same diagnosis can have different causes and manifest itself differently in different people.

Diagnoses and the sick-well dichotomy do not help to understand what the person is suffering from and how one can contribute to making something better.

Mental health and mental illness are complex phenomena that require multiple explanatory models.

Multiple perspectives

Psychology is about people’s thoughts, feelings, behavior, relationships, and brain functions, not how development might occur.

Relevant perspectives, for example, attachment theory. It is about how people get basic motivation to establish contact and maintain relationships.

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The psychodynamic perspective was introduced in the program in the old fashioned way. This perspective is about working with the relationship between the past and the present, and people have a tendency to repeat the ways they encounter others.

An existential and humanistic perspective includes attention to common human conditions such as vulnerability, mortality, and existential loneliness. Emphasis is placed on individual well-being and values.

An important goal in therapy is always to strengthen the patient’s hope and belief that he can live his life and deal with difficulties.

What is recovery?

Specific treatment modalities explain a relatively small portion when measuring the effect of psychotherapy. Also, the so-called “common factors” are at work. Regardless of the method, they relate to the fact that you meet a friendly therapist who engages with what the patient is struggling with.

Who the patient is as a person (“patient effect”) and who the therapist is as a person (“therapist effect”) are also of great importance.

It is also not clear what the improvement is. The effect of therapy is often measured by comparing the patient’s answers after the end of the therapy with the answers given at the beginning.

In studies that explored patients’ own recovery experiences in more detail, recovery was revealed to feel “more normal.” This means being able to participate better in daily life, be kinder to oneself, have more control over symptoms, find more positive ways to relate to oneself and others, and above all, care about what’s going on, name it. A few examples.

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Kilde som gegel metastudier: Barkham, M., & Lambert, MJ (2021). Effectiveness and efficacy of psychological therapy. I.M. Barkham, W. Lutz, & L. Castonguay (ed.), Bergin and Garfield’s Handbook of Psychotherapy and Behavior Change. 50th Anniversary Edition (s. 135-189). Wiley.

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