Very cool you considered being a clinical psychologist but ended up doing something different that’s helping millions of people in a different way. I also started out on a psych path but ended up pivoting to audiology and eventually a resilience instructor in the military. The psych foundation has stayed with me though and influences everything I do.
Very cool. I have been a therapy skeptic and am happy to be proven wrong. Anecdotally, it does seem however, that a good fraction of patients don’t have a specific condition that they’re trying to address, as opposed to some miscellaneous personal problems. I wonder what therapy does for them.
Interesting article, thank you. There is increasingly good evidence for Mentalization Based Therapy (MBT) for people with a diagnosis of BPD. This provides group MBT sessions alongside individual sessions.
Yep, clinical significance and statistical significance are very different things. The larger effect sizes are likely to be clinically significant; not so sure about the smaller ones.
I have the same impression about the worried well vs. those with more serious problems. That’s one reason I changed my mind about going into clinical psychology.
Most of the studies in the meta-analysis were on CBT, as there’s more research on CBT than any other form of therapy. Interestingly, though, the authors didn’t find any evidence that CBT is more effective than other therapies.
Also, I’ve learned that this is because therapies are therapist-relative. It fits the personality of the therapists. I’ve watched sessions where person-centered (Carl Rogers) works just fine. The therapist felt confident in this theory.
I use a person-centered technique to start sessions and move to CBT and REBT. It’s just up to the therapist.
I wonder if there's a potential confounding variable of more structured, focused, behavioral therapies that tend to get used with anxiety-based diagnoses vs the greater variety (and often less behaviorally focused) of therapy types that would be used for the other diagnoses? Of course, that would not count for everything because there is a significant difference in the severity of some of these diagnoses, but maybe an interesting thread to pull on and investigate more?
Right. Other therapies try to be as structured as possible, but they’re not in the same league as systematic desensitisation. That would add noise to the system,
Behavioral therapies like the ones typically used in anxiety based disorders, often have more clearly defined goals and outcomes that produce better data on their efficacy
As a therapists in training and long time pastoral counselor, I felt like that was the case before I decided to get clinically trained. It just seemed to be the case.
My population is men, couples, and parents. So I don’t usually dive too deep into psychopathology, though I’m being trained in it. This is good to know to understand how much effort should be put into various disorders.
Very cool you considered being a clinical psychologist but ended up doing something different that’s helping millions of people in a different way. I also started out on a psych path but ended up pivoting to audiology and eventually a resilience instructor in the military. The psych foundation has stayed with me though and influences everything I do.
Great stuff as always
Interesting! And thanks, Kyle - I appreciate the kind words!
Very cool. I have been a therapy skeptic and am happy to be proven wrong. Anecdotally, it does seem however, that a good fraction of patients don’t have a specific condition that they’re trying to address, as opposed to some miscellaneous personal problems. I wonder what therapy does for them.
It’s an interesting question. I’m hoping to do a deep-dive into this topic at some point in the future. Stay tuned!
Interesting article, thank you. There is increasingly good evidence for Mentalization Based Therapy (MBT) for people with a diagnosis of BPD. This provides group MBT sessions alongside individual sessions.
Hadn't heard about that - thank you!
I am curious how strong the effect was. A therapy can be statistically significant without making a big difference.
It is my belief that therapy can help the “Worried Well” somewhat, but not so much those who really need the help.
I am curious whether CBT was tested. It was my impression that this was one of the few types of therapy that actually had proven positive effects.
Yep, clinical significance and statistical significance are very different things. The larger effect sizes are likely to be clinically significant; not so sure about the smaller ones.
I have the same impression about the worried well vs. those with more serious problems. That’s one reason I changed my mind about going into clinical psychology.
Most of the studies in the meta-analysis were on CBT, as there’s more research on CBT than any other form of therapy. Interestingly, though, the authors didn’t find any evidence that CBT is more effective than other therapies.
Also, I’ve learned that this is because therapies are therapist-relative. It fits the personality of the therapists. I’ve watched sessions where person-centered (Carl Rogers) works just fine. The therapist felt confident in this theory.
I use a person-centered technique to start sessions and move to CBT and REBT. It’s just up to the therapist.
I wonder if there's a potential confounding variable of more structured, focused, behavioral therapies that tend to get used with anxiety-based diagnoses vs the greater variety (and often less behaviorally focused) of therapy types that would be used for the other diagnoses? Of course, that would not count for everything because there is a significant difference in the severity of some of these diagnoses, but maybe an interesting thread to pull on and investigate more?
Yeah, that could be a factor. You’re thinking of highly structured practices like systematic desensitization, I assume?
Yes
Right. Other therapies try to be as structured as possible, but they’re not in the same league as systematic desensitisation. That would add noise to the system,
Behavioral therapies like the ones typically used in anxiety based disorders, often have more clearly defined goals and outcomes that produce better data on their efficacy
As a therapists in training and long time pastoral counselor, I felt like that was the case before I decided to get clinically trained. It just seemed to be the case.
My population is men, couples, and parents. So I don’t usually dive too deep into psychopathology, though I’m being trained in it. This is good to know to understand how much effort should be put into various disorders.