Psychotherapy

Presentation

For anyone who feels vulnerable or psychologically fragile to start looking for psychotherapy or psychotherapy may seem a particularly challenging. Of all the psychotherapies (more than 200 officially listed), there he more effective than others? Is that some problems lend themselves better? When and how should it be used? It is these questions that this data will attempt to answer, even if the answers are neither definitive nor absolute. The field is still young, evolving, and many controversies remain 1,2,28 .Several competing schools of thought. Moreover, researchers disagree on the notion of efficiency, that means precisely to improve, be cured, relapse? Fortunately, there are also many points of agreement. In the current state of knowledge, three main conclusions seem warranted: The majority of well-conducted psychotherapy give good results. The success of the therapy depend first and foremost motivation and commitment to the subject. The therapeutic alliance established between the patient and therapist would be much more important in predicting the outcome of treatment the particular technique used by the speaker.

The dodo effect: all psychotherapies work

Hundreds of research for several decades, and grouped summaries of studies and meta-analyzes have demonstrated unequivocally that psychotherapy can help to effectively treat several psychological problems such as depression, panic disorder, the anxiety disorders, food and various personality disorders.

Moreover, the intersection of these studies concluded that any psychotherapy done right, no matter the particular technique used, is likely to give good results. This hypothesis has been presented for the first time in 1976 in a study entitled Comparative studies of psychotherapies: is it true That "Everybody has won and all must have prizes"? (Comparative studies of psychotherapies: Is it true that "everyone won and that everyone should get a prize? "). The subtitle of the study from the book Alice in Wonderland , by Lewis Carroll, in which the dodo bird-judge declares that all those who participated in the race won.

The study concluded that all kinds of therapies are very different from each other, yet demonstrated comparable efficacy to face similar problems, we then hypothesized that "common factors" present in the majority of psychotherapy could be the origin of what is now called "  the effect dodo.

Since then, several syntheses of studies, meta-analyzes and literature have focused on the phenomenon, and although there is some disagreement, most researchers now agree on the validity of the dodo effect. However, it was noted that different approaches could actually be equivalent provided they are bona fide , a Latin phrase that literally means "good faith." For a therapy to be bona fide , the therapist should hold at least a master's degree or equivalent training, the treatment is based on psychological principles apply and the customer's problem can reasonably be handled by a psychotherapeutic approach.

Why does it work?
That the majority of psychotherapy can be effective well done does not mean that all psychotherapies are equivalent for everyone. We did a lot of research to find out what might be the famous "common factors" present in all psychotherapies, and how they determined the success. Most experts agree today on the four elements that are essential to predict the outcome of therapy, and their relative importance :

- The involvement and commitment of the patient in a proportion of 40%.

- The quality of the therapeutic alliance between patient and therapist: 30%.

- Confidence in the efficacy of the treatment (including placebo effect): 15%.

- The specificity of the preferred therapeutic approach 15%.

Common factors seem to be more important than factors specific to one approach or another. This does not mean that the choice of the technique is secondary. Indeed, if it does not match the expectations of the patient, this may have a negative impact on his personal involvement, the quality of the therapeutic alliance and the confidence felt, reducing the chances of success.

A study astonishing
Thirty people with depression were treated with cognitive therapy. The success rate of the therapy was evaluated according to three variables, one's own cognitive approach (emphasis on the links between thinking and depression), and the other two are common to all psychotherapy: the therapeutic alliance and client involvement. There was a clear correlation between these two common factors and the likelihood of success of the therapy, while the element specific cognitive therapy was not a good predictor of success. Researchers have even speculated that too much focus on a particular technique could reduce the quality of the therapeutic alliance and outcome of therapy.

The patient
The involvement and commitment of the patient: 40%. seems that the most important aspect of "involvement" of the client (a concept that encompasses both commitment and action) its sincere intention to collaborate in the therapeutic process . Goodwill, efforts and openness are crucial. One study has also demonstrated a strong correlation between "openness" and the patient's initial success in the short and long term therapy.
In a vast synthesis of studies, published in 2003, it was found that the patient's role is crucial to that will be a good therapeutic alliance. It was also noted that trust and collaborative spirit demonstrated by the therapist may have a positive influence on customer involvement. In addition, if the therapist clearly explain to the client that the process will of both sides to work with vigor and determination, it can positively influence treatment outcomes.
Among the responsibilities of the patient, mentioned in a publication of the Harvard Medical School, it is mentioned that it must be motivated to actively participate in treatment and be ready to deal with intense emotions.