Thousands of studies have shown that, on average, psychotherapy has a moderate positive effect on psychological problems. Most of the research examined cognitive behavioral therapy, but other bona fide therapies tend to work also. Why does psychotherapy worK? Here are some possible answers, most of which originated in a class work. “Persuasion and Healing,” by Jerome Frank:

1. Psychotherapy usually increases hope, or in more modern terms, self-efficacy for overcoming the problem. This effect leads to a great feeling of relief and to extra efforts to overcome the problem. Effort often translates into benefits.

2. Psychotherapy usually leads to reinforcement for taking actions to overcome the problem. Going to a psychotherapist is a bold action. If the client feels better at the end of the first session (because of increased hope or enjoying the interaction, for instance), the feeling better can reinforce taking bold actions to overcome the problem. The person therefore takes more bold actions to overcome the problem and may start an upward spiral of improvement, where actions lead to benefits, which serve as reinforcement for further actions to overcome the problem.

3. Psychotherapy usually involves a professional healer accepting clients as they are, while trying to help them overcome a problem. Humans are such social creatures that this acceptance and the formation of a goal-directed team can lead to powerful positive effects on motivation and emotions.

4. Psychotherapy can lead to positive changes in thinking and behavior of clients and can lead them to improve key situations, usually involving important relationships. These changes can have beneficial psychological effects, thereby reducing the level of the problem.

How do you think that psychotherapy works? If you agree with any of points 1-4 above, what does the point suggest that you do as a psychotherapist to maximize your effectiveness? Could you apply the same insight into your behavior as a parent? As a friend?

John Malouff, PhD, JD
Associate Professor of Psychology