7.06.2012

Studying Psychotherapy


From time to time one of my former students comes to see me when he or she is in Portland. It is one of the great pleasures of my life, especially when they go on to achieve the kind of success that the person who came to see me a few weeks ago day has.

Professor Jeffrey Berman was one of the first students who studied with me at Reed. I guided him on his senior thesis and Jeffrey was able to publish the results. Since then he has conduced a large number of influential studies on the effects of psychotherapy.

A great many therapists resist the experimental scrutiny of their practice. Nevertheless, Jeffrey forges on. He always has a new study to tell me about and no doubt it is a controversial one, in spite of its methodological rigor. In most cases, his research takes issue with one of the many current myths about psychotherapy.

Much of his research involves comparing the outcomes of different types of therapy, say behavioral, cognitive, humanistic, psychoanalytic, or “undifferentiated” counseling, etc. In the study we discussed in detail he compared the therapeutic effects of trained (professional) and untrained (paraprofessional) therapists.

Training programs are almost naturally assumed to be necessary for clinical success, that a trained therapist is bound to be more effective than an untrained one. Most of the prior research confirmed this assumption. However, Jeffrey found they were based on inappropriate comparisons and statistical analyses.

To avoid those problems he carried out a more selective comparison with stiffer methodological requirements. Unlike the previous studies he found that professional (trained) and paraprofessional (untrained) therapists were generally equal in client outcome effectiveness.

Further, there were no outcome differences for patient problems or for type of treatment or, finally, for treatments carried out individually or in groups. In a word, on these measures, trained therapists were no more effective than those who were untrained.

Of course, these findings are no better than the previous studies upon which they were based. And while they were chosen with great care, they were not original studies carried out by Jeffrey, research that is extremely difficult to conduct now. So in the end he had to fall back on a second order comparison, known as meta-analysis that has become the standard method of summarizing research findings but to some commentators has its own inherent limitations.

Nevertheless, his findings both surprised and pleased me; one more myth about psychotherapy falls by the wayside to empirical analysis. Of course, I was also pleased to hear about his research and how provocative it continues to be.

Recently, he has been returning to Reed each year, ostensibly for his annual class reunion. But I know it also reflects how much his years at Reed, his many friends, the great spirit of the place means to him. It is an ailment for which there is no cure, one that affects most graduates of this very special college.

2 comments:

crofter said...

How interesting. I know nothing about the subject, but I would thing the communication skills of the person would maybe have a bigger effect on the degree of success that the patient experiences. If the patient is comfortable with the therapist would determine the ultimate outcome.

Great post!

Richard Katzev said...

As long as you trust the other person and you find him or her congenial, it seems to me it doesn't much matter if they have been trained or not.

All we have to do is drawn on our personal experiences.

Thanks for your comment.