Because many of them had started treatment feeling suicidal or on the edge of needing hospitalization, they couldn’t afford to get worse. And at least 10 percent were deteriorating. A quarter or more of my clients dropped out without explanation a few weeks or months into treatment. Still, I couldn’t help but notice that, at my first training site, many of my clients remained stuck in neutral despite our best efforts together. You can’t quantify personal growth.” I hadn’t really understood what he’d meant at the time, but meeting with him over a period of years had helped me considerably when I was depressed, angry, and anxious whatever he did, it worked.Ī decade and a half later-after many adventures and odd jobs in my 20s and early 30s-I entered graduate school with this same perspective on psychotherapy: that it was an art too nuanced and complex to be measured. “Psychotherapy,” he once told me, “is a relational art. My introduction to the field came from my own therapist, who’d helped me greatly during my troubled teens. Kraus found that clients of the lowest-performing therapists were significantly worse off in the areas of violence and substance abuse at the end of treatment. On the other end of the spectrum, a study led by the psychologist David R. One study, led by John Okiishi of Brigham Young University, compared clinical outcomes from 91 therapists and found that the highest-performing among them helped clients improve 10 times faster than the overall average. However, after Grace died, I found myself more open to different approaches-to anything that might help me fix my blind spots and weaknesses.Ī small mountain of clinical research shows that therapists-that is, anyone who provides talk therapy, from psychologists to social workers-vary widely in effectiveness. Psychotherapy is unlike any other field, I’d thought, with the arrogance that comes from being untested. The very idea seemed too hypothetical, too academic, and almost insulting to the profession.
I’d had little interest in this topic when my professor first mentioned it. He showed us promising preliminary research, but also noted that many therapists were skeptical. He had read the book Moneyball, which described the Oakland Athletics’ revolutionary use of performance metrics, and he was curious whether psychotherapy could also benefit from more data and analytics. The episode sparked a crisis in me: What could I have done differently? How could I become a more effective therapist?Ĭasting about for solutions, I recalled an idea that one of my professors had discussed in class a year earlier. “I’ve just got to stay positive,” she said.Ī few months after relapsing, Grace died of a drug overdose, and her son was sent to foster care. Through it all, she insisted she could do it. I tried every therapeutic technique I could find, but nothing stuck. Yet she came faithfully to therapy, so I had a front-row seat to her painful unraveling. She lost her job and her boyfriend, and kept going back to drugs. Over the next several months, everything she had built fell apart.
When she finally reappeared, she had relapsed on heroin. Soon thereafter, Grace no-showed for three straight therapy appointments.
Thought field therapy doesnt work full#
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