There are a fair number of therapists reading this blog. Rather, I should say of the very few people who read my rants, several are therapists. But enough sniveling.
On a Positive Psychology discussion group the following question was posted:
Is anyone familiar with research which has been done to treat people with generalized or other types of anxiety disorders using pp interventions?
Thanks for your help!
So I said:
I don’t know, but there is an unexamined assumption behind your question, that the diagnosis is related to the treatment. That isn’t necessarily so. Years ago David Barlow found patients with different diagnoses, depression or anxiety, and Barlow designed two specific programs, one for depression and one for anxiety. He varied the presentation. Half got the anxiety component first, half got the depression component first. They reversed at something like six weeks. Or so.
His prediction: patients with anxiety would do best with the targeted treatment for anxiety, but wouldn’t do well with depression-focused treatment first. And vice-versa. So some anxious patients started with depression treatment, some depression patient started with anxiety treatment, and some started with the treatment to match their complaints. Barlow was sure that matching treatment program to type of complaint would give the best results.
Results: opposite. Everyone improved, at equal rates. Targeting symptoms was not helpful.
There is no data I know of that demonstrates diagnosis-treatment specificity.
Those of us trained in psychoanalytic psychotherapy OR in solution-focused therapy always believed that. Only the behavioral and cognitive schools seemed to believe that different conditions required
Now as to Positive Psychotherapy and treatment specificity. I myself have pondered this a good deal. I no longer think there is anything to it. Improving quality of life reduces symptoms. Acacia Parks was recently an author in a study on schizophrenia-diagnosed patients. They simply did a package of treatments from Positive Psychotherapy like expressing gratitude and using strengths, and not only did the depression in these patients go down, but also there was a reduction in psychotic symptoms. They didn’t target any symptoms.
Quality of Life Therapy(QOLT, created by Mike Frisch at Baylor) has been compared with Cognitive Behavioral Therapy and seems to come out a bit more effective, p
So I would suggest you check your premises! Review the Dodo Bird Hypothesis ca 1930 and shown over and over to fit the data best. “Everyone has won and all must have prizes.” See “The Great Psychotherapy Debate” by Wampold, a book reviewing all that evidence.
Psychotherapy effect is as much about what is in our hearts as what is in our heads. Probably more, much more. Alliance and hope fill two of St.Paul’s three critical factors. I suppose I must have faith in my system of therapy so as to offer hope; thus St. Paul can rest easy.
I could say a bit more about this. (Shocked?) In medical treatment, specificity of treatment is a sine qua non, which means “Even the French do it.” Or something like that. But in treating emotional issues, we are treating the soul, and we need St. Paul’s Faith, Hope, and Charity/Love. So in working with people having difficulties in living, we aren’t working with a pathogen or a diseased organ. There is no appendix to remove. There is no antibiotic targeting the specific germ. Placebos work almost as well as antidepressants, and frankly, no one really seems to know why either work. The antidepressants are not working in the way the drug companies have been telling us, that is for sure.
In the Greatest Movie Ever Made, which is of course, Joe Versus the Volcano, Patricia Graynamore says to Joe Banks, “I don’t know what your situation is but I wanted you to know what mine is not just to explain some rude behavior, but because we’re on a little boat for a while and… I’m soul sick. And you’re going to see that.”
We can become soul sick, and techniques are something that can help, but really, faith in a higher power, hope that such a higher power can restore us and redeem us, and love towards others are always the cure to soul sickness. In the 1930s there was an article about this, suggesting all different forms of psychotherapy got essentially the same outcomes, and that has been shown to be true over and over. That is why it is called the “Dodo Bird Hypothesis” or the “Dodo Bird Verdict.” In Alice in Wonderland, the dodo is asked which animal won a race in which they ran in various directions for different amounts of time, and the dodo wisely says, “Everyone has won and all must have prizes.”
Run your race with faith, hopeful of everyone having prizes. Run with love towards all those who run with you. Your race will count. You will finish well.