JSM Addiction Medicine and Therapy
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EditorialWidening the Lens of Psychotherapy: is it time to consider the Power of Alternative Healing Approaches?Keith Klostermann1* and Theresa Mignone21Medaille College, USA
2Enlightened Therapies of Western New York, USA*Corresponding author: Keith Klostermann, Medaille College, 18 Agassiz Circle, Buffalo, NY 14214, USA, Email: kck35@Medaille.eduSubmitted: 10 February 2019; Accepted: 17 April 2019; Published: 19 April 2019 -
In most studies of psychotherapy outcomes conducted over the past 40 years, the average treated person is better off than 80% of untreated samples. Moreover, the outcome of behavioral health services equals, and in most cases, exceeds those treatments provided for specifically medical conditions (e.g., coronary heart disease). Yet, the field is not improving and studies of overall efficacy conducted over the past 40 years do not demonstrate any appreciable difference – which begs the question, Why?Perhaps it is the near myopic focus of the field on specific models and techniques, driven in part, by the need to develop and emphasis on evidence-based treatments. Studies reveal that the average therapist plateaus in early in her or his career. Simply stated, therapists do not seem to get better with time and experience in the field – two criteria often consider when choosing a clinical supervisor or when hiring for leadership positions.In addition, In fact, the failure to address dropouts in psychotherapy is one of the biggest challenges facing our field. Research to date suggests that premature termination or dropout averages about 47% [1], for children and adolescents, the range varies from 28% to 85% [2-4]. Furthermore, results of outcome research also reveals the following alarming statistics: 1) a significant percentage (30% to 50%) of clients do not benefit from therapy, 2) deterioration rates among adult clients range between 5% and 10%, and 3) it is estimated that the clients who do not benefit or deteriorate while in psychotherapy are responsible for 60-70% of the total expenditures in the health care system.Given these alarming statistics, perhaps it is time for researchers and clinicians alike to shift their conceptualizations from the more specific view of curing/improving to a more universal construct such has healing and to better understand the allure and curative mechanisms of these alternative approaches.Interestingly in some countries (e.g., India, China), governments are beginning to provide support for religious healing practices. Results are beginning to emerge with preliminary data suggesting similar outcomes to mental health providers. Given the results of a recent Consumer Reports study revealed that participants reported being more likely to see a healer than a therapist. This finding begs the question, What is psychotherapy missing that spiritual/healing practices seem to provide? We contend that it may not be what is missing, back a lack of emphasis on factors such as the ritual of therapy, belief that ritual will help or can work (i.e., hope), the individual feeling care about, and the relationship. These concepts are very abstract and their application in treatment can difficult to ascertain from therapist perception alone as the therapists tend to be poor predictors of process and outcome – it is the client’s perceptions which matter most. Perhaps it is time to expand our thinking about how people change as well as the change process itself and how we as therapists can honor client perceptions across many different domains (e.g., emotional, spiritual, social) and access areas for healing.
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- Wierzbicki M, Pekarik G. A meta-analysis of psychotherapy dropout. Professional Psychology: Research and Practice. 1993; 24: 190-195.
- Garcia JA, Weisz JR. When youth mental health care stops: Therapeutic relationships problems and other reasons for ending youth outpatient treatment. J Consult Clin Psychol. 2002; 70: 439-443.
- Imel Z, Wampold BE, Miller S, Fleming R. Distinctions without a difference: direct comparisons of psychotherapies for alcohol use disorders. Psychol Addict Behav. 2008; 22: 533-543.
- Miller SD, Wampold BE, Varhely K. Direct comparisons of treatment modalities for youth disorders: A meta-analysis. Psychother Res. 2008; 18: 5-14.
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