What Actually Works in Therapy (And What Doesn't)

"But in all that packaging, something important is getting lost. Because when it comes down to what really drives change in therapy, it's not the label on the box that matters. It's not whether you used "the right" protocol. It's whether you helped a person engage in a process that actually moves their life forward. To facilitate real transformations, we need to stop chasing protocols and start following processes."

"There's a common assumption in clinical psychology: If someone has a diagnosis-say, major depressive disorder-then we can match them to the "evidence-based" protocol for that diagnosis, follow the steps, and expect good outcomes. And, to be fair, protocols have helped bring science into psychotherapy. They've given us a way to test treatments and show that therapy, in general, works. But here's one problem: The vast majority of people in therapy don't show up with just one clean, textbook diagnosis."

Therapy has become dominated by labeled, manualized protocols like CBT, DBT, and CFT. That packaging conceals the more important drivers of change, which are processes that help people engage in life-moving behaviors. Matching treatments to single diagnoses fails when clients present with comorbidity, messy problems, or overlapping conditions. Diagnostic categories provide some "what" information but little "why" insight, and psychiatric syndromes have not become discrete diseases. Decades of protocol-driven practice have not increased therapy's overall impact. Emphasizing process-based approaches can better tailor care and facilitate genuine transformation.

Read at Psychology Today