Does therapy work?

[vellichoria]

Therapy these days seems to be offered for all sorts of concerns and issues that people have but I am wondering if it actually works in resolving fundamental issues for anyone and addressing the root causes or is it just a fad we are going through?

It absolutely works. There's different kinds of therapy for different kinds of issues. Depends what you want to work on

It depends.

I tried CBT a couple of months ago. I was only offered 5 sessions (through the NHS) because they thought I'd "improved enough" to not need anymore sessions, despite the fact that my catastrophisation had become much worse and I was having panic attacks almost every day.

I think it can be really beneficial for a lot of people, but CBT made me worse because they didn't understand that a lot of my anxiety is caused by my autism, and therefore they only gave me generic tips that I physically and mentally cannot act on when I feel a meltdown coming on.

TW post
Depends what for. I’ve learnt CBT techniques and they are helping me manage my depression together with drugs. Also another for intrusive thoughts It works by noting the thought and moving back to what you were thinking about before. it’s exhausting. at the moment so it hasn’t solved things as such.

One therapist just let me talk about my fears when I was having surgery, I actually went about social problems making friends. I felt at the time that she would allow me, or lead me to talk about the surgery as a diversion tactic from addressing my social issues. The therapy did not help me at all with getting more friends or social life.

These years later I think I probably needed to talk about the surgery with someone neutral and the therapist had worked that out.

It depends on the issues and the therapy.
And with most, you need to put the work in. You can't just show up to the sessions and expect a miracle.
My dad did CBT and said it did not help. He never did any of the homework.

I had therapy for 15 years, once a week with the same therapist to help me recover from childhood abuse and a subsequent abusive relationship. I am now happily married with happy, loved DC. I could only have achieved that through therapy.

It varies a lot, depending on how good the therapist is I think. I have had a lot of therapy in my past and some professionals really helped me with my issues and others didn’t.

What do you mean by 'work'?

It isn't a magic fix. It doesn't remove whatever has caused your difficulties. It can help you deal with the difficulties more constructively, put them in context, and reduce the negative impact on your life.

If it’s a fad it’s a pretty long-established one!

The talking therapy I had for an eating disorder didn’t really kick in until years later when I was in a place where I felt I was ready to recover.
It all made sense at the time but only later cold I put it into practice, and use it to this day.

When I trained the data suggested about a third of people will find therapy very helpful; a third will find it somewhat helpful; and a third will not find it helpful and some of those will find it actively harmful. The variables that contribute to those differences are many. However, the greatest predictor of good outcomes in therapy is the quality of the relationship between the therapist and the client. The different techniques/theories applied by different models of therapy only account for a small part of the outcome.

That's really interesting. I think I had a very good relationship with the psychologist who helped me most. When I saw a different one a couple of years later I stopped pretty quickly as we simply didn't click.

It certainly helped me, and is currently supporting my child who is benefitting from being able to process how they really feel without having to be concerned about how the words or thoughts affect the person hearing them.

@AttachmentFTW could you share the source for that?

The right type of therapy with the right therapist makes a life-changing difference.

Unfortunately, it's hard to find the right type of both for each individual.

It depends. I have had severe psychiatric problems, but it was a problem that runs in my family. Therapy wouldn't make much difference as my problem wasn't caused by anything -other than genetics. My psychiatrist said she would refer me to therapy if I wanted, so I went along. I found the whole process ridiculous. OTOH my friend is a therapist and I believe she helps a lot of people.

My experience is similar. The stuff CBT uncovered was absolutely no use for overcoming anorexia at the time. But now I’m a healthy weight the insights I gained from CBT help me in many aspects of my life.

lots of people have told me I should get some therapy as I’m struggling to cope after Dh left me after 35 years of marriage but having looked into it I just can’t afford it. I spoke to someone locally who said I would need to go 8 to 12 weeks and it was £70 an hour visit

Exactly this. It’s like when you go to the physio - it’s not going to work unless you do the exercises they give you.

Yes it can work, but there’s lots of variables. Is it the right therapy/ therapist. Is the person ready for help etc.
my teen dd has therapy for anxiety (around 12 sessions) and she’s doing amazing now.

I’ve heard cbt is less likely to work with people with autism and DBT is more likely to help.

Yeah. It was offered to me and I thought if I said no, they'd say I wasn't bad enough to need help. So I said yes. It was a load of bollocks for me, personally, though. It actually made me worse 😂

Edited to add: sorry, It was CBT that was offered to me. I'm not sure if I'm allowed to request a specific type of therapy through the NHS

@GooseyGandalf I've attached an image which is a widely used diagram about the the different factors influencing therapy. The client's extra therapeutic factors are things like their life situation; how much support they have; their motivation; access to money/resources to make change etc. It's taken from Michael Lambert's work from the 1990s which I appreciate is a bit old but I understand his findings have been born out in more recent research.

Having looked at the thing about thirds it's not from a specific study but is amore general observation made based on outcomes from lots of MH research from the 20th century; especially treatment for depression. It's called "the rule of thirds".

@GooseyGandalf here is the image

When I trained as a clinical psychologist (30 years ago) they used to quote that if you just stayed on the waiting list 1/3 got better, 1/3 got worse and 1/3 stayed the same.

There is / was a book called what What works for Whom by Roth and Fonagy. They did systematic reviews and looked at outcomes for different therapies and, although I cant really remember i think it said all therapies were about equal and theraputic alliance was most important - it was maybe the same thing as above.

This won’t be a popular view but I do think therapy can be a bit cult like in its language and attitudes. I don’t like the way that if it doesn’t work it’s somehow your ‘fault’ - you weren’t ready, you didn’t put the work in, etc.