The Psychological Society of the Pikes Peak Region sponsored a conference today titled "The Science of Change: Translating What Works in Therapy." Barry Duncan, Psy.D., co-director of the Institute for the Study of Therapeutic Change, challenged recent trends in the field of mental health that emphasize treatment methods over other factors responsible for psychotherapy outcome. From his years of experience as a practitioner and review of the literature, he has come to a few conclusions:
- the therapeutic alliance is more important for psychotherapy outcome than the theoretical orientation of the service provider (e.g., clients generally don't remember what brilliant techniques we use in therapy, but how well we build a relationship with them)
- evidence based treatments aren't "bad," but overemphasized in the field of mental health and should be used on a client-by-client basis (taking into consideration client characteristics, culture, and preferences)
- most of the outcome variance in psychotherapy is due to client/extratherapeutic factors (i.e., something that happens outside of the therapy hour that helps a client to change)
- therapeutic power does not come out of identifying what clients need, but in identifying their strengths and resources that can be put to use in reaching their goals (Dr. Duncan calls this "finding the heroic client," my clinical supervisor calls it "being curious")
- asking clients what they'd like to do to deal with their problems and asking for feedback on how they think they are progressing throughout therapy improves the quality and outcome of services