What Works in Therapy  |  Douglas Behan, DSW, LCSW

Psychotherapy Models

Effective therapy requires more than expertly applying an evidence-based treatment.

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A treatment model is essential but research shows it is NOT the most powerful change factor.

Most therapists start out with the belief that effective therapy is synonymous with using a theory or an evidence-based treatment approach. However, research has shown that the theories and techniques only account for a modest portion of the change that takes place in therapy (Wampold & Imel, 2015).

 

Meta-analytic studies of the psychotherapy outcome research literature have determined that no one psychotherapy model is superior to the others in the treatment of the major psychological disorders (Lambert Chap 6 Bergin & Gar, 2013; Wampold & Imel, 2015). In a review of the psychotherapy research literature, Lambert (1992) estimated that theory-based techniques account for about 15% of the change in treatment.

What the Research Says...

What it Means for Therapists

Using a bona fide psychotherapy treatment model is correlated with improved outcomes (Lambert, 2013). Research has not found one model that is superior to others in treating mental health disorders. Research has shown that it is best to match a model and techniques to the needs of each individual client rather than asking clients to adapt to a single model preferred by the therapist (Norcross & Wampold, 2018; Owen & Hilsenroth, 2014; Stiles, 2009).

Key

Points

  • No one psychotherapy model has proven more effective than the others in treating the major psychological disorders.

  • However, a model is necessary for effective treatment. It provides structure and focus to the therapy.

  • The model provides a shared conceptual map for the client and therapist for why the problem exists and what will be done about it within therapy.

  • Therapists should be flexible and choose a model based on the client's characteristics and preferences.