With the help of a hearing aid, boy hears for the first time.
This is for those who are thinking about seeking help. Maybe you are wondering, unsure of who to go to and what to look out for. Or maybe you just need a reason to give a shot at therapy/counselling before you take a psychotropic drug for your emotional problems.
Here’s what you need to know.
Effectiveness of Psychotherapy
Based on more than 50 years of psychotherapy outcomes research, the average treated person better off than 80% of those who did not receive treatment (Miller, Hubble, Chow, & Seidel, 2013; Wampold & Imel, 2015). This is equivalent to an effect size (i.e., magnitude of change) of 0.8, which is considered as a large effect.
Conventionally used in evidence based medicine, the number need treat refers to the number of patients needed to receive treatment in order to experience a positive outcome relative to untreated patients. To put into context, here are the following NNTs for various treatments (Note: smaller numbers indicate more effective a treatment):
Surprising Fact #1: Psychotherapy is more effective than most medical treatments and has lesser side-effects.
Psychotherapy has been shown to reduce the use of medications, consultations with primary-care physicians, length of inpatient stays, and general health care expenditures by 60% to 90% (Chiles, Lambert, & Hatch, 1999; Kraft, Puschner, Lambert, & Kordy, 2006).
More recently, based on a real-world study of over 22,000 clients in a five-year period, the data suggests outpatient psychotherapy has a large reduction of work disability days (41.8%), hospitalisation days (27.4%), and inpatient costs (21.5%). In terms of long-term effects, the researchers found that the year after therapy, the number of work disability days was lower (23.8%) (Altman et al., 2016).
From an investment standpoint, for every dollar spent in terms of care, $2 to $3 are returned! And for every dollar spent in terms of care, it resulted in 3 to 5 times of benefit for health returns (Chisholm et al., 2016). It’s hard to find any other area in healthcare for such returns, with few side-effects.
Are you spinning by now?
Here’s the gist: Psychological treatment is an effective treatment, when delivered in a manner that is cogent with the person, by someone with expertise in a given domain (e.g., depression, anxiety, trauma related, relational issues, psychosomatic complaints).
Why It’s Important for Therapists to Monitor Outcomes
Given the resounding evidence in our field, one of the biggest scandals in psychotherapy is terminating treatment before the experience of benefit. Clinicians typically achieve robust outcomes with clients who are engaged in the process, but too many discontinue from treatment.
Surprising Fact #2: Therapist average about 47% in client dropout rate.
A quick way to resolve this issue is to systematically elicit formal patient feedback. This is done by using brief measures that tracks the progress and engagement level of each patient at each session. More than a dozen RCTs involving more than 10,000 diverse consumers have found that adopting a routine outcome monitoring (ROM) into their clinical practice, reduces dropout rates by half. In addition, the practice of ROM doubles the “effect size” of treatment, compared to not systematically monitoring and feedbacking progress with patients. Furthermore, evidence suggest that the more effective therapists seem to be able to weave in the feedback beyond just as a measurement tool (Chow et al., 2016; Miller, Hubble, Chow, & Seidel, 2016).
My Outcomes: For close to a decade, I have been collecting data about my effectiveness. My outcomes suggest that compared to the average clinician, I am 65% more likely to achieve reliable improvement (71% vs. 43%) with my clients, and about 72% less (13% vs. 47%) dropout rates . In addition, contrary to the conventional wisdom that meaningful change takes longer rather than shorter time, my data suggest that my average client experiences reliable improvement between the 3rd or 4th visit, and thus more like to experience gains in subsequent sessions.
Now, our team at Henry Street Centre systematically measuring our outcomes and using that data for improvement. As the research points, this increases the chance of a successful outcome with our clients.