Effectiveness of Psychotherapy
On a previous thread, the question of the effectiveness of Psychanalysis came up. Since then, I have done some research.
A recent article* summarized the results of three literature surveys, and the author came up with the following conclusions:
1. For major affective disorders, and major psychoses, psychpharmacological treatment works best.
2. For symptomatic anxiety based disorders, such as phopias, generalized anxiety disorders, panic disorder, obsessive complulsive disorder, and post - traumatic stress disorder, cognitive and behavioral treatments work best.
3. For personality disorders and complex comorbid disorders with an underlying personality disorder, long term relationship therapies work best. Among these theraputic types would be pscyhoanalysis.
So, in the history of theraputic intervention, psychoanalysis has gone from a cure all, to one method of several that can be called upon to help in category three above.
Misuse of psychoanalysis. Case 1. A woman with a phobia spent 10 years in psychoanalysis at a cost of $20,000 with no improvement. With cognitive/behavioral intervention she was cured in three months.
Case 2. A woman became severely depressed and was placed in a mental hospital at the age of 28, where she stayed for two months. Talking therapy did not help and this woman had reoccuring episodes for the next 15 years. At that point, lithium treatment for manic depressives was introduced. Once this woman was put on lithium, she never had another episode again.
* References provided upon request. I don't want to be accused of being a name dropper
I generally agree with that. Evidently we were arguing at cross-purposes before, talking about different areas.
What does cognitive and behavioral treatments consist of? Is t someone re shaping your thinking?
the simple answer would be that behavioral therapy focuses on your behavior (phobics would be slowly desensitized to the object of the phobia)
Cognitive therapy would focus on the understanding of the problem and ways to deal with it.
Both cognitive and behavioral therapies might have components of the other within the therapy but the main focus would be one form of therapy.
MY personal opinion is that for real long-term change to occur every person needs adequate and correct information about their problem. Part of any therapy should include the cognitive component - even for those who most benefit from the medications that can do wonders for those who need them.
Sadly not enough people are adequately informed of their problem or the possible recommended solutions.
As for reshaping your thinking - I would say the answer is YES it does. In the hands of an ethical therapist this is a good thing. Many problems that people have stem form incorrect thinking - like the assault victim who blames herself for the assault instead of blaming the perpetrator. This is the kind of thinking that would need to change.
Rejoice in the healing and not in the pain.
Rejoice in the challenge overcome and not in the past hurts.
Rejoice in the present - full of love and joy.
Rejoice in the future for it is filled with new horizons yet to be explored. - Lee Marsh 2002
Marilyn...as an occupational therapy student I am trained in cognitive behavioral therapy. It helps people change faulty thinking that is causing them anxiety, depression or other problems. It is really interesting. I have some more info, if you would like it email me....
Lady Lee and Wonderwoman, thanx for your responses. I am interested in getting more information about this. I live in Australia where therapists are often average at best. I don't want to talk too much about it here, but I would like to learn more. If either of you have more inforamtion email me on firstname.lastname@example.org
I think cognitive therapies are good as quick band-aids. Real growth requires you discover the constitutional underpinnings of your personality. You need to know what you want out of life and your preferred way of getting what you want. You need to know what you avoid in life and your preferred way of avoiding what you don't want.
You can never change this structure. You can only manage it - live around it.
You might also check at your library or book store for books by Albert Ellis and Wayne Dyer. The are propents of the cognitive approach.
I don't know if I would call it a band aid. When people are suffering, they feel great relief once they feel normal. Once they feel much better, then they can think and plan as you indicate.
Let me elaborate on a point I made. For an agoraphobic who is house bound as a result of their phobia, effective therapy releases them from a self imposed slavery, not of their choosing. That is why I say that effective treatment is far more than a band aid for those who are suffering.
Thank you for returning to this subject. I think the average person thinks the sum of therapy as talking. Talking is a great part of it, but if the patient will do it, the therapist can/will also recommend a variety of books to further insight into the patient's situation.
What's on the open market is not necessarily what's the most precise, correct, information available - at least 10 years ago. I asked my therapist about this (books dealing on boys being raped) - and her response was: "Books will be published for the general public what the publishers think the general public will absorb, or accept." At that time - the general public had a hard time accepting descriptive accounts of boys being raped either by males or females.
Different therapists, if they're good, will assess the capabilities of their patients also - what techniques the patient is currently using/not using for pain/comfort, what they feel the problems really are vs what the patient thinks they are, what they've read, what they believe, and their outlook on what they expect out of therapy.
I've known people who just say they went to therapists - and just *kinda* talked - turned into same ol' same ol' and they stopped going. Fortunately, the 2 out of 3 therapists I went to were very good. Virginia M. from Boca Raton was an RN educated (with training in family/alcohol), power-driven, female idiot.
A "band-aid" could be considered that - or it could be a life-saving tourniquet - absolutely necessary at that time, and necessarily must be applied correctly. Both apply pressure to a wound.
After twelve years of therapy, my psychiatrist said something that brought tears to my eyes. He said "No hablo ingles." Ronnie Shakes