Does Psychotherapy Work? One of the most asked questions about psychotherapy and counselling by perspective clients and certainly everyone that pays for is does it work. Secondly what is the best kind of therapy? There are many questions that those thinking of entering therapy and those who are in therapy have. Another question is often in the form of, "I have a psychotherapist but nothing is changing." Sometimes people say 'I am not crazy so why should I have therapy' or 'The only reason I can't change is that I can't find the right answer'. Why should I need therapy? The answer to these questions is never simple or easy. Let's have a look at some possible answers. I like what Allan N. Schwartz, LCSW, Ph.D. wrote in Jun 2009. He says ……."the answer is that it is not just "you who need therapy but, really, most of us." We live in a complex world where the individual gets lost in the masses of people. That makes it very difficult for [many of us] to feel as though [our] lives have any meaning. In a mobile world, where war is completely impersonal and includes fatalities among civilians including women and children; where neighbours live near one another for a couple of years and move; where {workers are treated as expendable], as though they are unimportant throw away cogs in a machine; in which marriages do not last and family seems to have so little meaning; it is common for people to suffer an existential angst whereby they wonder why they are on this earth and just what their lives are supposed to mean. If these are not enough reasons to seek psychotherapy I do not know what is." In response to the question, 'does therapy help everyone', the answer is that there is nothing in this life that is ever true of every person. There is just too much diversity of temperament, life style, economics, personal motivation, personality and so on, for any universal truth about therapy to fit all people. The other question about the best therapy is similarly vague. At the moment the U.K. government is promoting primarily CBT and psychological therapies that depend on the therapist providing a treatment in the same way as a physiotherapist would do for muscle/skeletal problems by doing something to the patient. The difficulty is that muscle/skeletal systems have a few hundred variables in how they are supposed to work compared to an almost infinitive number of variables in human behaviour. The road to mental wellbeing is varied and sometimes several paths have to be taken before finding the one that suits the individual and their circumstances. Having said all of this, let us take a closer look at some of the variables that influence a therapeutic experience and can determine its outcome. 1. A lot depends upon the motivation to change that a client brings to the therapy. When someone is strongly motivated to change because they feel unhappy and are ready to learn there is a lot of impetus to grow as a result of treatment. 2. Trust between the therapist and client is enormously important. Of course, trust does not develop immediately. Instead, as in any relationship, trusts take time to build. However, it can help a lot to see a therapist who has been referred to you by friends and acquaintances who know their work. Always see a qualified therapist who is registered with one of the national professional organisations. 3. A lot depends on how a particular therapist works, but, even so, certain facts should hold true: For example, it is important that the therapist, whether he is psychodynamic or cognitive behavioural, should be someone a client feels comfortable speaking to. Some people prefer a more formal therapist while others prefer someone is warmer and more familiar. Nevertheless, it is important that the client feels treated with respect and dignity. 4. The work has to be useful in the client's current situation. Sometimes the route to the current situation is to go back to the point in development in which the defence originated. 5. Part of working in the "here and now" is focusing on the relationship between client and therapist. After all, it is that relationship in which all the client ways of thinking and interacting get repeated. That is why it is important for both to focus on the real relationship in the therapy office. It is always vital that the therapist not be critical or judgmental of the client. There may be disagreements and areas of tension and they need to be discussed and clarified. However, the role of the therapist is not to be the judge. Naturally, some people may enter psychotherapy expecting or fearing judgment but that, too, should be clarified and worked through in the treatment. A few comments about cognitive behavioural therapy: While a CBT may rest more on changing patterns of thinking, especially automatic thoughts into more helpful thoughts, it remains my opinion that client feelings and transference issues come into play anyway. Those issues, it seems to me, need to be addressed, especially if a client remains in treatment for a long time. Length of time: Psychotherapy is not meant to be a lifelong pursuit. In fact, if a client finds that they are still in therapy for more than two or three years, they really need to discuss that with their therapist. Ultimately, the goal of therapy is to finish and leave. Often individuals will enter psychotherapy to solve a current problem and then decided to enter into an analysis which can be seen as a reformation of the basic assumptions of 'being'. How does a client know if therapy is finished? When someone finds that they are feeling better, functioning at work, has improved relationships at home and has a social life, there is a very good assumption that they have completed their work. It is then important to discuss this with the therapist. In fact, some therapists may raise this issue to the client. Whoever raises the issue of completion first, the main idea is that it is discussed and a finishing date be selected. No, therapy does not help "everyone," but, there are all the variable to consider before deciding that therapy is for you or not. Today, we have the advantage of using medications in those serious situations where it is called for, to help make therapy more beneficial and available for those individuals who need that. I would rather make an error on the side of believing a certain therapist or type of treatment is not for me than to simply conclude that it cannot help me. The only way of know if psychotherapy will work for you is to have an assessment. This should given you a sense of what it would be like to be in therapy both from the way the person doing the assement works and to get your questions answered.