Psychology Place

Does therapeutic technique matter?

By Michael Green

So you’ve decided to see a psychologist. Asked around, searched the web. What’s important in your search: experience, training, age, gender, compatability? And then there are all those brands of therapy: CBT, psychodynamic, interpersonal, experiential, existential to name but a few. What are they? And does it matter?

The Dodo Bird lives

In 1936 the eminent American psychologist, Saul Rosenzweig, wrote a paper quoting the Dodo Bird in Lewis Carroll’s Alice in Wonderland. Judging a race around a lake the Dodo Bird, after much consideration, declared “Everybody has won and all must have prizes”. The so-called Dodo Bird effect suggests that all psychotherapy has proven benefits (all must have prizes), but that the benefits are not the result of the technique used. Rather outcomes rely upon other factors such as the treatment situation, client personality and disposition, and the strength of the working alliance between therapist and client.

Surely its not that simple?

Well, no, when it comes to humans it rarely is. Opponents of the Dodo Bird proposition point to an array of research that suggests that some treatments are better than others. Specifically, many argue that cognitive-behaviour therapy (CBT) has been proven superior to all other therapies for most psychological ailments. Is this true, or just a matter of one therapy being better suited to the research situation of controlled trials and selected populations? Rather than wade through the arguments for and against, here are a few tips on what how to address technique when choosing a psychologist.

How do I choose?

Regardless of technique, almost all psychologists agree on the relevance of the therapeutic alliance. Whilst some discomfort is not unusual in a treatment setting (you are after all dealing with psychological distress), you should always feel safe and that your psychologist strives to actively understand and empathise with your specific situation.

Ask about the experience and training of the psychologist. Clinical psychologists are trained to Masters or Doctoral level and are required to undertake an approved registrar program prior to endorsement to practice. Registered psychologists are trained to undergraduate level and serve a supervised period of practice post-university. Ask specifically about the therapist’s experience since training: what types of clients do they normally see? in what techniques have they trained? does their practice include referral to colleagues for specific conditions?

Ask the psychologist what experience they have in working with people with similar conditions. Whilst the treatment should be individual, a psychologist with experience in similar conditions can more efficiently design a treatment program and adapt this to suit changes as they arise.

If the psychologist seems to adopt a ‘one size fits all’ approach this is not a good sign. The exception might be certain conditions such as specific phobias and some anxiety conditions which generally see a faster reduction in symptoms through cognitive and behavioural interventions.

Finally, psychological therapy should always be tailored to suit the individual. You should expect that your psychologist will work actively to design an individual treatment program for you and will discuss and clarify the goals of therapy and the tasks which will be involved along the way. This may take a few sessions for the psychologist to get to know you properly. And getting to know you properly includes knowing your strengths and capabilities. After all, if the Dodo Bird is right, its these in combination with the alliance you create with your therapist that will effect the change you’re looking for.