Some believe that evidence-based therapies are the most effective. It seems that therapists who practice these methods can provide step-by-step instructions or a “magic pill” that will quickly and reliably alleviate suffering. But there is no universal solution that works for everyone all the time. The success of therapy depends primarily not on the method, but on the therapist-client relationship. How does this work, and what myths surround it?
Myth 1: Evidence-based methods are better than others
Just because a method has an evidence base doesn’t mean it’s more effective than others. Scientists often study treatment models without taking into account the role of the individual. They measure how well a protocol alleviates symptoms, but don’t evaluate how the client’s overall quality of life improves—for example, their ability to interact with others.
Let’s say a person has learned to build close, secure, and harmonious relationships in real life—that’s one reason to consider therapy successful and complete it. However, this result isn’t directly related to a decrease in anxiety or the frequency of obsessive thoughts, and most studies will only measure these factors.
The “evidence-based” nature of a treatment is often used as a marketing tool. ****In Western countries, where psychological care is typically covered by insurance, this impacts funding and the medicalization of the process. Therapists are required to adhere to strict protocols, follow standardized procedures, as in medicine, and achieve results quickly. This saves budget funds and offers clients an enticing solution that requires virtually no personal responsibility.
But this approach does not allow a person to receive the help they truly need—the experience of meaningful and often long-term contact, rather than mechanical intervention.
Myth 2: Pills are more effective than therapy
Sometimes therapists prescribe drugs instead of psychotherapy, rather than in combination with it—and this is another, literal example of medicalization.
Medication may temporarily suppress symptoms, but the problem remains. For some conditions, pharmacological treatment is unavoidable, and its absence significantly reduces quality of life. However, it’s important not to view medications as a “magic pill” or as a solution to all problems.
Myth 3: Success depends on the method
Research shows that the primary tool for change in psychotherapy is the relationship between client and therapist. American academic Mary Lee Smith, in her work “The Benefits of Psychotherapy,” based on data from over 400 studies, concluded that different types of psychotherapy are virtually equally effective. This result prompts her to ponder: “If technical approaches differ so greatly, yet the differences in effectiveness are so small, what are we to make of the volumes that detail the differences between psychotherapy styles? And what about the serious disagreements and hostility between different schools of psychotherapy?”
The answer to this question was substantiated by American psychotherapist and researcher Bruce Wampold in over 100 articles. He demonstrated that the effectiveness of psychotherapy is directly linked to the interpersonal skills the therapist demonstrates toward the client. These include warmth, acceptance, caring, empathy, trust, and sincerity. The client feels understood and believes the therapist is capable of helping them.
“The success of psychological treatment can be predicted by the strength of the alliance between the client and the psychologist,” says Wampold. He notes that a working alliance is especially difficult to maintain when the therapist’s attention is focused on the client’s problem or symptom: “The psychologist often reaches a level of emotional depth that can cause pain for the client, where something important threatens to be destroyed within.”
This once again proves that a reliable and trusting psychotherapeutic relationship, as well as concern for the client’s safety, are of crucial importance.
Myth 4: Protocols guarantee 100% results
Statistically, therapists who deviate from established protocols achieve better results than those who strictly adhere to protocol. Often, rigid protocols prevent psychologists from establishing a productive working alliance with clients.**
In her article “Conditions for Effective Psychotherapy,” researcher Anna Sokolova demonstrates that therapeutic change occurs when a psychologist, together with the client, explores possible causes of problems, flexibly utilizes therapeutic techniques and protocols, provides feedback, and facilitates new experiences.
There are dozens of approaches to psychotherapy. But the most therapeutic effect comes from the therapist’s attentiveness and non-judgmental acceptance, no matter what method they use.
Our behavior and reactions are the result of past relationships. They change in the same way they were created: only within the relationship.
A therapeutic relationship is unlike any other. In it, a person can freely express feelings without the threat of shame or rejection, process and “close” traumatic experiences, receive thoughtful attention from another, and begin to treat themselves with the same attentiveness.
