Still, psychotherapy definitely works.<\/strong><\/p>\n\n\n\n A good book, probably the best in this matter, is \u2018The Great Psychotherapy Debate: The Evidence for What Makes Psychotherapy Work (Counseling and Psychotherapy)<\/em>\u2019 by Bruce E. Wampold and Zac E. Imel (Routledge, 2015).<\/p>\n\n\n\n The authors distinguish the medical model vs. the contextual model of psychotherapy. The former is about the theoretical models of psychotherapy (technique-oriented). Tthe latter is about \u2018common factors\u2019 (human-oriented). The contention of the book is that the common factors (empathy, placebo<\/a>)<\/strong> are the essential elements of effectiveness, not the theoretical model of any individual psychotherapy<\/strong>.<\/p>\n\n\n\n You can find a great introductory lecture by B.Wampold at YouTube<\/a>. <\/p>\n\n\n\n A related great lecture is by Stephen Bacon, also at YouTube<\/a>. Highly recommended!<\/p>\n\n\n\n Another take can be found in this lecture at Youtube by Scott Miller<\/a>, who somewhat weirdly concludes that people can unproblematically be referred to primitive magicians rather than Western psychotherapists. That is not my conclusion, but the premises are the same: Present-day, conceptual, Western, client-oriented methodologies don\u2019t add to the effectiveness of psychotherapy.<\/p>\n\n\n\n Definition of psychotherapy<\/strong><\/p>\n\n\n\n To Wampold&Imel, a psychotherapy is “a primarily interpersonal treatment that is based on psychological principles; involves a trained therapist and a client who is seeking help\u2026; is intended by the therapist to be remedial for the client disorder\u2026; and is adapted or individualized for the particular client and his or her disorder.”<\/p>\n\n\n\n Making it easy to myself, here are some more quotes (all from the above book that you should read!):<\/strong><\/p>\n\n\n\n If all theoretical models are equally effective, do we need to choose one?<\/strong><\/p>\n\n\n\n Or should we choose several and use them according to what fits the client most?<\/p>\n\n\n\n This treats the individual theoretical models in the same way as different kinds of placebo. It is not the model that is effective, but the application\/administration of the model. There\u2019s a huge difference. The Wampold&Imel argument includes that without any model, there is no administration-of-model; therefore, you need one or more of them.<\/p>\n\n\n\n I agree. And I don\u2019t agree.<\/p>\n\n\n\n I don\u2019t because I see the same \u2018side effects\u2019 as in any placebo case. [see RG: Placebos have many \u2018side-effects\u2019<\/a>] There is a \u2018fake\u2019 involved, which is not congruent with any of the five Aurelian values<\/a>.<\/p>\n\n\n\n Then again, I do agree, in the following way:<\/p>\n\n\n\n The chosen theoretical model should be empathy itself<\/strong><\/p>\n\n\n\n or better said: Compassion, basically<\/a>, of which empathy is a part. Doing so, we are entirely AURELIS-congruent. So the question becomes: Can we use empathy\/Compassion<\/a> as a theoretical framework? In my view, we definitely can. We can look at Wampold&Imel\u2019s arguments for taking on a model:<\/p>\n\n\n\n With empathy-as-model, neither of these comes easily. One can \u2013 and should \u2013 specifically work on them. In my view, while doing so, one can heighten the empathy factor. Even more, this work itself is in all openness an excellent instrument. Therefore, one should welcome the challenge. It encourages one to delve into what the concept of \u2018empathy\u2019 really means. That is so much more than just being a bit friendly. It is at the same time much more complex and much more effective than is generally thought even in professional circles. We might call this \u2018empathy+\u2019 or \u2018empathy-beyond\u2019 to distinguish it from the term\u2019s low-key use. There is a wealth of cognitive neuroscience at the meaningful level of neuronal patterns showing how change can come about through this.<\/p>\n\n\n\n With empathy-beyond, one can readily satisfy Wampold&Imel\u2019s arguments for taking a model.<\/p>\n\n\n\n Even so, why making it difficult?<\/strong><\/p>\n\n\n\n Again, look at the \u2018side effects of placebo.\u2019 What encourages me most towards making it difficult is that this also makes it more open, thus prone to empathy. Empathy lives in openness.<\/p>\n\n\n\n Any \u2018technique\u2019 between therapist and client may jeopardize openness.<\/p>\n\n\n\n Techniques are recipients.<\/strong><\/p>\n\n\n\n They are not the content of the recipient.<\/p>\n\n\n\n Using any technique as content leads to many mistakes. It\u2019s as if you try to drink the material glass of a glass-of-water. On the other side, if the therapist knows<\/em> that it’s about the water and still pretends it’s about the glass, he deceives the client \u2015 even when his intentions are good. This is not efficient, not durable, and not scientifically correct.<\/p>\n\n\n\n As to the science of evidence-based therapies,<\/strong><\/p>\n\n\n\n the obvious point is made by Wampold&Imel. Intriguingly, with A.I.-tools, we will soon be able to generate lots of real-world evidence.<\/p>\n\n\n\n In my view, the medical model of the future will prevail\u2026 combining rationality and depth. Taking the latter into account, it will show to be the same as the contextual model. This will not be a failure of the medical model but a triumph. It puts high validity on the correct mechanism of change. Thus, it is eventually allergic to placebo \u2015 including any theoretical psychotherapeutic model that makes the therapy \u2019work\u2019 through the power of the administration, not the power of itself. Historically, Western medical science has been based on NOT accepting a questionable mechanism of illness remediation. That is the groundwork of the building, and rightly so.<\/p>\n\n\n\n