What parents & families need to know about psychotherapy

Before you hire a therapist for you or your family, there are a few basic facts about psychological therapy that readers should know about:

You don’t always need it

Therapy isn’t always necessary. In fact, most of the time it isn’t. Most children recover from adverse events without any professional help, in their own manner and along their own time frame. If you go off what the research on resiliency shows, in most instances, less than a third of kids will develop any type of serious symptomatology to begin with, indicating that at least two-thirds will be fine on their own. Whether you’re talking about children or adults, people are generally resilient, and seeking professional help may be of little to no benefit for much of the population. For example, one study found that 4 in 10 people who lost a loved one would have been better off WITHOUT grief counseling. (Begley, 6-23-2007) Other studies have found that therapies can help, but show no significant benefit over simply talking things out with friends or family. A competent therapist who uses evidence-based techniques will always be an asset during times of turmoil. But professional help certainly isn’t necessary for recovery in every case, or even the majority of cases.

Therapy does not need to be drawn out

“Studies of brief and solution-focused therapies show significant results after as few as two sessions,” writes Margarita Turragona in Psychology Today (2010). “Even therapies that are designed to be long-term show their greatest effectiveness within the first few months of treatment.” There is a widespread myth that psychological therapy needs to be long and drawn out. In fact, most evidence-based therapies can produce results in a dozen sessions or less. Competent and honest therapists may terminate the process after a single session if a child seems to be processing an event in healthy ways. There should be no set time frame to follow, since each case is unique, but you should understand that healing does not require a long or drawn out process. Therapists who keep their patients on the hook for years dealing with a single trauma or long past events should be fired, since they are obviously not doing their job. If they were competent, their patients would have healed years ago.

The type of therapy psychologists offer is not necessarily the most effective, and many do not use evidence-based techniques

One of the great frustrations in the field of psychology is that as research has opened up wonderful new insights about how the brain works and how people can improve their mental health, this knowledge has been extremely slow to be adapted into actual practice. As science journalist Sharon Begley writes, “For years, psychologists who conduct research have lamented what they see as an antiscience bias among clinicians, who treat patients.” (Begley, 10-12-2009) An analysis published in Perspectives on Psychological Science found that many clinicians fail to “use the interventions for which there is the strongest evidence of efficacy” and instead “give more weight to their personal experiences than to science.” Psychologist Walter Mischel, who wrote an editorial for the aforementioned study, comments that “the disconnect between what clinicians do and what science has discovered is an unconscionable embarrassment,” and laments what he sees as a “widening gulf between clinical practice and science.” (ibid)

This does not mean psychotherapy is bogus. In fact, proven therapies routinely outperform medications in improving mental health or even managing pain. It just means that the best psychologists who practice evidence-based methods are mixed in with those who do not. Methods such as cognitive behavioral therapy have been repeatedly proven to be effective in clinical trials, and are also ‘scientifically plausible,’ meaning it’s a therapy that fits well within our established knowledge of the brain and human behavior. Yet many of the country’s 93,000 psychologists don’t use these methods, and may not even understand the science behind them. (Baker, McFall & Shoham, 2008) Summarizing their research, the aforementioned authors write that “considerable evidence indicates that many, if not most, clinicians view science or research as having relatively little relevance to their practice activities…they privilege their intuition and informal problem solving over what the research literature has to offer.” Like Oprah or Dr. Phil, they dish out pop psychology nonsense based on personal feelings or hunches, and often give advice that directly contradicts research or is simply factually untrue.

Psychotherapy is a business

While few therapists would intentionally jeopardize the health of their patient, therapy is a business. Unfortunately, there is a rather perverse incentive behind the economy of psychotherapy: If you get better, therapists lose business. Their livelihood may depend NOT on healing your child quickly (in which case they lose a customer), but on you coming back in week after week for years to come. Again, while we don’t believe therapists as a whole intentionally bait and hook their patients, decades of psychological research has shown that people readily rationalize their actions according to their financial interests, whether it is working for a cigarette company or the effects of lobbyists in Washington. So keep this in mind, and realize that therapists may have a tendency to extend therapy when it isn’t needed or push it on circumstances when it isn’t helpful.

There are many reasons for a family to look into psychological therapy. Maybe you or your kids have endured a difficult event recently, and you need a little help working through it. Maybe your child has been gradually loosing touch or struggling with mental illness, and you’re looking to correct whatever is going wrong. Or perhaps your family is embroiled in conflict, and you’re looking to find a solution.

Whatever the case may be, psychological therapy can be a wonderful tool. It has saved many families that were headed for disaster and brought troubled teens back from the brink of death. It can work on a wide range of problems: everything from typical mental health problems to sleep disorders and chronic pain management. It routinely outperforms psychiatric medications in terms of benefiting patients.

Unfortunately, therapy done wrong can harm as well as heal, and may children and their families have had negative experiences with therapists. This information will help you avoid such mistakes and find a therapist who can successfully help your family through whatever you are dealing with.

The Different Types of Psychotherapy

Psychological therapy is like Baskin Robbins on steroids: it comes in a variety of flavors. “Someone once stopped counting at 1,000 forms of psychotherapy in use,” says psychologist Timothy B. Baker of the University of Wisconsin, who studies the effectiveness of psychotherapies. (Begley, 10-12-2009) Although it wouldn’t be practical to write about every method being used in this publication, the information herein will cover the major forms of mental health therapy, so that you can make the best and most educated decision for you and your family.

If you’re wondering about a type of psychotherapy that isn’t listed below, then chances are it’s a less-established practice with little or no solid evidence backing its efficacy, and families should proceed at their own risk. However, we should point out that most of these backwoods psychotherapies are actually offshoots of more well-known forms, so this doesn’t necessarily mean that all lesser-known therapies are no good. So long as the philosophical approach is sound and grounded in science, it may be helpful. Whenever considering a type of therapy that isn’t listed here, you should inquire about the therapist’s background and ask her to describe what discipline her techniques are influenced by. You can then compare it to the information here in order to get a better idea about whether it would be helpful.

Additional information on therapy for children & families:

The following information will further help you in selecting a therapist for your family:  [child-pages]