“Why Talk Therapy Works: Unveiling its Effectiveness” In the memoir, Group, a young law student ranked at the top of her class, but in her personal life struggled with an eating disorder, suicidal ideation, and intimacy issues. An acquaintance put her in touch with a therapist who recommended she participate in group therapy sessions.
The author had to open up to the other group members during the sessions and share parts of herself that she would prefer to keep hidden. In turn, she listened as other group members told their own stories and questioned the parts of their lives that made the least sense. The author has maintained group therapy sessions for decades and credits them with saving her life.
Psychotherapy (also known as talk therapy) is an approach that, according to some historians, dates back to ancient times. In recent decades, scientists have learned how to measure the benefits of talk therapy. In some circumstances, researchers have found that talk therapy is best.
What is talk therapy?
Talk therapy is when a person meets with a licensed mental health professional to address their concerns. There are a variety of reasons why a person may seek help through talk therapy, including stress, coping with trauma, or specific symptoms such as irritability.
Psychotherapists use a variety of techniques, including problem-solving strategies, mindfulness, or behavioral tracking. A psychotherapist may use cognitive behavioral therapy (CBT) to help a person change their patterns. An example of CBT would be facing a fear through exposure therapy.
Does psychotherapy work?
Psychotherapy is effective, and two-thirds of people who have attended talk therapy say their mental health has improved. They report having less depression, anxiety, and neurotic behavior.
Researchers have also found that psychotherapy is beneficial for people with post-traumatic stress disorder (PTSD). In a 2019 study in JAMA Psychiatry, the authors conducted a meta-analysis of 12 randomized clinical trials that included 922 people who were treated for PTSD. Participants were treated with psychotherapy, pharmaceuticals, or a combination of both strategies.
The authors see no evidence for pharmaceuticals as an effective first-line treatment approach. At follow-up, psychotherapy showed greater benefit than medication. The study confirmed previous research that talk therapy provides the longest-lasting relief for people with PTSD.
2016 study in Depression and anxiety, for example, concluded that talk therapy should be the first approach for PTSD. The authors analyzed 55 studies with 6,313 participants who underwent various treatments for PTSD, including medication and talk therapy. People who were treated with talk therapy were less likely to drop out of their treatment program.
The authors found that the effects of talk therapy were stronger than pharmaceuticals, leading them to conclude “… by every measure examined in this study, [trauma-focused psychotherapies] they were superior to medicine.”
Read more: Do antidepressants change your personality?
Benefits of talk therapy
Flexibility is an advantage of psychotherapy. While one person may benefit from one-on-one talk therapy, another may benefit from support in a group setting. In the memoir group, the author describes her struggle with overeating and admits to her therapist that she ate seven apples in one sitting. He identified her habit of keeping a secret as problematic and challenged her to call a member of the group every day to report what she was eating. She found the accountability helpful.
Researchers are considering other ways that talk therapy may be effective in different settings. A 2020 study in Review of Clinical Psychology conducted a literature review of studies on the effectiveness of talk therapy in natural settings.
Between 1994 and 2019, they found 38 qualifying articles that detailed outdoor psychotherapy. One common theme was that nature-based talk therapy works in situations where both client and clinician feel at ease in natural spaces. They also found that the outdoor setting worked for people who were uncomfortable or embarrassed by the idea of traditional therapy.
Outdoor therapy can allow a client or clinician to apply metaphors from the natural world to life. One might consider, for example, how a gardener might plant a seed and grow a growing plant, but external factors mean that the outcome is beyond their control.
New types of talk therapy
Applying natural metaphors to life’s personal challenges is one of many new twists in the talk therapy approach. Psychotherapy as a term came into use in the late nineteenth century but was overshadowed in the mid-twentieth century by psychoanalysis.
In psychoanalysis, clients would stretch out on a couch, facing the therapist, and talk about their memories of once-forgotten events. Over time, the analyst would offer insight into what ailed the person’s thinking, which was supposed to reduce anxiety and bring a sense of peace.
The technique was most associated with the famous neurologist Sigmund Freud, who often attributed clients’ problems to one of his unproven theories. A woman’s anxiety, for example, can be diagnosed as a symptom of penis envy.
One historian described how Freud’s approach fell into disfavor “…because of his frequent refusal to accept at face value the painful discourses of his patients; instead, he forced them to confess to esoteric sexual fantasies.
How to find a therapist
Unlike psychoanalysis, proponents of talk therapy in Freud’s day encouraged clinicians to empathize with the client and acknowledge “their true sources of disorder.”
Today, clients are encouraged to find a therapist that best suits their needs. Many psychotherapists specialize in treating specific conditions such as PTSD or anxiety. Others use specific treatments such as CBT, and some offer a variety of settings such as virtual or outdoor.
The National Institute of Mental Health (NIMH) recommends that people have preliminary conversations with prospective therapists and they offer a list of questions on their website that clients can ask prospective therapists during a meet and greet.
If a therapist doesn’t feel like the right partner, the NIMH advises people to keep looking because “relationship and trust are essential” in the client-therapist relationship.
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