First of all, does psychotherapy really work?

I can imagine it might be difficult for you to invest your time and energy in receiving psychotherapy without a clear answer about this question.  I would be skeptical too.  Since psychotherapy is a service, you don’t receive anything tangible from me such as medications or surgery.  When you come to my office for therapy, you might wonder whether you will feel better afterwards. 

Many studies have been conducted to assess the effectiveness of psychotherapy since the inception of the field. The good news is that, indeed, psychotherapy is significantly effective according to this 2017 meta-analysis (1) in comparison to no-therapy control groups. 

Then, you might wonder what would determine the effectiveness of psychotherapy?  Would it be the experience of the therapist, types of therapy (e.g., CBT, DBT, psychodynamic), etc.? There have been decades of scientific studies conducted on this inquiry, which reached the same conclusion: in general, no single type of psychotherapy is more effective than another.  (Wampold and Imel, 2015) (2)

According to Wampold and Imel (2015) (2), the psychotherapy approach is different from the medical model that identifies a particular treatment model for specific diagnoses such as treatment A for disorder Z.  (Exception to this, there are a few psychotherapy modalities that are a better match for a handful of particular mental health illnesses. For example, DBT is effective for treating Borderline Personality Disorder). This means, when you look for a therapist for treating mental illnesses such as depression, anxiety, and panic attacks the type of therapy modality would not influence the effectiveness and outcome of your therapy.  So, you don’t need to worry too much about choosing the right type of therapy modality such as CBT, Narrative, Psychodynamic, etc.  Rather, you could choose any type of therapy that speaks to you and that you feel comfortable with. 

That’s the reason why I don’t use one type of therapy modality for all my clients’ situations. Rather, I offer different therapy modalities for my clients to choose from depending on their issues in that moment.  So, in one session, I might be using different interventions from CBT, Narrative, and Solution-focused therapy, etc. Therefore, what I offer is personalized therapy based upon your needs and utilizing cutting-edge science. Your care is not constrained by the type of therapy modality.

Do psychotherapists improve with time and experience?

You might wonder if it would be better to see a therapist with a lot of experience in order to achieve better therapeutic outcomes.  Interestingly, there have been many studies conducted on this topic and resulted in the same conclusion:  there is no superior outcome for more experienced clinicians compared to trainees or less experienced clinicians. (Goldberg et al., 2016) (3) Goldberg’s longitudinal study stated that therapists on the whole become slightly less effective over time. Furthermore, therapists over 15 years of experience tend to overestimate their effectiveness and often fail to recognize failing cases. 

After learning about this information, I felt humbled and therefore will remind myself not to overestimate the effectiveness of my therapy as I gain more experience. I plan to continue to seek regular consultation, and to invest in my training and continual growth while also aiming to bring the best care that I can offer to my clients. Most importantly, I will frequently check in with you, my client, to see how you feel about your therapy and adjust it accordingly.  

What ultimately influences the outcome of therapy? 

If a certain type of therapy, or the number of years of the therapist’s experience don’t make much of a difference in terms of the effectiveness of the therapy outcome, you might wonder what you could use as a basis for choosing a therapist? 

In 2018, the American Psychological Association Task Force on Evidence-Based Relationships and Responsiveness conducted a meta-analytic study including 96,000 clients (4). They found  these factors below which have demonstrably effectiveness over successful therapy outcomes:

  • Alliance (most influential factor) – Building an effective relationship with you the client
  • Goal consensus – Fostering agreement on the goal(s) and expectations of therapy
  • Collecting and delivering client feedback – Using client’s feedback to measure how therapy is working for the client and to tailor treatment accordingly
  • Positive regard/affirmation – Being your cheerleader 
  • Collaboration – Working together with the client on the treatment process 
  • Therapist’s Empathy – Sensitive understanding of the client’s feelings and struggles; seeing things from the client’s point of view

Based upon this large-scale research, I have incorporated those factors into my therapy approach in order to maximize the chance of successful therapy outcomes for my clients.  Together with my client, we create goals and agree on the treatment approach. I frequently check in with my clients to see how the therapy is going and what I need to change (if anything). In this way, clients can let me know what their bottlenecks are, how much progress they have made, and what else they would like to work on. So, each client is indeed in charge of her/his/their own healing journey.  Also, this approach seems to help my clients determine for themselves when to graduate from therapy, since they know best when they have achieved their goals. 

When you are choosing a new therapist, take advantage of a free initial consultation that most therapists offer.  Listen to yourself to assess whether you feel comfortable with the therapist, and the therapist seems to work collaboratively with you.  You could ask questions about their therapy approach, as well as how it would look like when the therapist would help you with your particular issue. 

It takes time to find the right fit.  So, you might want to interview several therapists.  Even after starting a few sessions with a new therapist, if you don’t feel comfortable, it’s ok to change your therapist.  Therapists are very understanding of this, and you don’t need to worry about saying no to your therapist. It’s better for you to find the right therapist for your needs.

Please remember that the type of therapy modality and length of the therapist’s experience do not determine the successful outcome of your therapy.  The biggest determining factor is the quality of your relationship with your therapist. So please trust your intuition! 

I hope I will have a chance to meet with you during the 30-minute free consultation.  

Best wishes to you to find the right therapist for your healing journey. 

  1. Dragioti E, Karathanos V, Gerdle B, Evangelou E. Does psychotherapy work? An umbrella review of meta-analyses of randomized controlled trials. Acta Psychiatr Scand. 2017 Sep;136(3):236-246. doi: 10.1111/acps.12713. Epub 2017 Feb 27. PMID: 28240781.
  2. A Wampold, B. E., & Imel, Z. E. (2015). Counseling and psychotherapy.The great psychotherapy debate: The evidence for what makes psychotherapy work (2nd ed.). Routledge/Taylor & Francis Group.
  3. Goldberg SB, Rousmaniere T, Miller SD, Whipple J, Nielsen SL, Hoyt WT, Wampold BE. Do psychotherapists improve with time and experience? A longitudinal analysis of outcomes in a clinical setting. J Couns Psychol. 2016 Jan;63(1):1-11. doi: 10.1037/cou0000131. PMID: 26751152.
  4. Norcross, J. C., & Lambert, M. J. (2018). Psychotherapy relationships that work III. Psychotherapy, 55(4), 303-315.