DOES PSYCHOTHERAPY REALLY WORK?

U. S. News and World Report recently (May 23) ran a lead article titled "Does Therapy Work? The growing controversy." Please note that the subtitle is "The growing controversy." The issue regarding the efficacy of psychotherapy is far from settled. However, people are quick to point to the following quote from Michael Lambert and Allen Bergin in the article:

There is now little doubt that psychological treatments are, overall and in general, beneficial, although it remains equally true that not everyone benefits to a satisfactory degree.

True, the above quote was in the article. But, so was the following statement:

Yet with only few exceptions, scientists have failed, in study after study, to demonstrate the superiority of any major therapeutic school, a phenomenon psychologist Lester Luborsky and his colleagues at the University of Pennsylvania compare with the dodo bird’s pronouncement in "Alice’s Adventures in Wonderland": "Everyone has won and all must have prizes."

We have quoted the "dodo bird’s pronouncement" for years. What the research demonstrates simply is that all psychotherapy works and it all seems to work equally well. Is this a testimony for the efficacy of psychotherapy? Or, is it a testimony for something far simpler than anything to do with years of learning techniques and theories? The literature thus far supports the latter.

 What Is Really at Work?

Numerous outcome studies have found little influence of results due to technique factors. There is an uncomfortable realization among researchers that if all psychotherapies work about the same, then the psychological hypotheses themselves are called into question.

Dr. Joseph Wortis, State University of New York, clarifies the confusion caused by the "dodo bird’s pronouncement" by saying:

The proposition of whether psychotherapy can be beneficial can be reduced to its simplest terms of whether talk is very helpful.

He goes on to say,

And that doesn’t need to be researched. It is self evident that talk can be helpful.

While what he says about talk being the commonality of therapies leading to possible benefit, we must quickly add that talk may not be helpful for Christians in therapy. It depends on what is being said. If the talk leads people into themselves and away from the Lord, into believing the wisdom of men instead of the Word of God, and into believing a lie instead of the Truth, we say talk can be dangerous for Christians even though it may relieve personal pain.

 What Kinds of Therapists and Clients?

Over the years we have quoted from numerous research studies that question the efficacy of psychotherapy. One significant factor is that studies determining the efficacy of psychotherapy are usually based upon the use of the best therapists. When one is doing a study, he ends up with a select group of therapists. The therapists are asked because they are known to be good therapists or the therapists agree to participate because they are confident in their counseling abilities.

The use of above-average therapists would tend to inflate outcome results greatly. To this day no one has proved that average or below average therapists do as well as no treatment at all.

The clientele also makes a difference. The article refers to a study by John Vessey and Kenneth Howard that indicates that "those most likely to enter therapy are female, white, educated, well paid and divorced, separated or never married." Dr. Hans Strupp from Vanderbilt University has said that "psychotherapy works best for those who need it least." More people entering therapy may be from categories of "those who need it least," and that population certainly skews the results of efficacy studies.

 Professionals versus Nonprofessionals

Does therapy work? We cover this question more exhaustively in our book PsychoHeresy. However, the general answer could be stated this way: Whatever "therapy" one creates (and there are now over 475 approaches) in the hands of an amateur or professional appears to help certain individuals.

Although millions of people have sought help from the highly paid professionals of psychotherapy, the research has not been able to demonstrate that professional psychotherapists produce sufficiently better results than nonprofessionals. Based upon the outcome studies there is no moral justification for the high fees charged for psychotherapy.

Letters to U. S. News & World Report (June 5), responding to the article "Does Therapy Work?" include the following remarks:

Sure, talk therapy works for people facing the common problem of the human condition, just as talking to the clergy or a good friend worked in earlier generations.

I am convinced psychotherapy and its practitioners will one day be rightfully viewed as soothsayers, fortunetellers, shamans and astrologers. People will wonder how "civilized" individuals were naive enough to give such therapy any credence.

 Our Primary Concern

Our concern about psychotherapy is more serious than whether or not it "works." We are concerned about how it conflicts with the Word of God and work of the Holy Spirit in a person’s life. Psychological counseling theories and therapies may help a person function better in the flesh and fulfill the desires of the flesh and of the mind. Paul described that kind of functioning as:

. . . according to the course of this world, according to the prince of the power of the air, the spirit that now worketh in the children of disobedience: among whom also we all had our conversation in times past in the lusts of our flesh, fulfilling the desires of the flesh and of the mind; and were by nature the children of wrath. . . (Ephesians 2:2,3).

Therapy may "work" to strengthen what Paul calls the "flesh" or to help one feel better about oneself, but it is working against the purposes of God. That is because psychotherapy is of the world. It attempts to accomplish that which only God can accomplish—the spiritual transformation of a child of God. The work of God cannot be accomplished through worldly theories or methods.

For they that are after the flesh do mind the things of the flesh; but they that are after the Spirit the things of the Spirit. For to be carnally minded is death; but to be spiritually minded is life and peace. Because the carnal mind is enmity against God: for it is not subject to the law of God, neither indeed can be.

Christians are attempting to accomplish the work of God through worldly means—to improve the human condition through psychological counseling theories and therapies. However, psychotherapy does not glorify God in a person's life. Psychotherapy cannot save a person from sin or produce new life in Christ. It cannot save, justify, sanctify, or glorify. It cannot conform a person to the image of Christ. Although it may work to substitute one sin for another, it cannot enable a person to overcome the power of sin or enable one to live a life pleasing to God.

Unfortunately, psychotherapy can work for a Christian to help the sinful self (which is to be counted dead) to live in a way more pleasing to itself. Perhaps that’s the drawing factor. Perhaps that’s why so many love the psychological way and see no conflict between the way of the Lord and the ways of the world.