To broaden the analysis I think correcting for an implementation bias is useful. Fidelity to the protocol by psychotherapists is often way lower in real life than in research studies. This could make the average numbers more pessimistic, but the added value of a psychotherapist being aware of those cognitive impediments way higher, and possibly a more interesting career option (training and supervising younger therapists, lobbying for evidence based psychotherapy). But that just might be a self-serving bias speaking, the recent meta-analysis by Cuijpers made me doubt if I want to continue my work as a psychotherapist.
Yes, I agree: probably much of the therapy given is not given according to the protocol and that means the average effectiveness is likely lower than the numbers in the studies indicate. In many cases, I think this might not be due to the psychotherapists or therapists themselves but the organization which they work in, e.g. crowded outpatient clinics where the policy is to meet each client in every 3 weeks or in order to not to make the queues to treatment appear so long.
I think think there might be potential for big impact for somebody with clinical background who is willing to advocate long-term for systemic change within mental health care and psychotherapy: optimal treatment protocols (best value per therapy-hour or so), triage, adherance to protocols etc.
Great, thanks!
To broaden the analysis I think correcting for an implementation bias is useful. Fidelity to the protocol by psychotherapists is often way lower in real life than in research studies. This could make the average numbers more pessimistic, but the added value of a psychotherapist being aware of those cognitive impediments way higher, and possibly a more interesting career option (training and supervising younger therapists, lobbying for evidence based psychotherapy). But that just might be a self-serving bias speaking, the recent meta-analysis by Cuijpers made me doubt if I want to continue my work as a psychotherapist.
Yes, I agree: probably much of the therapy given is not given according to the protocol and that means the average effectiveness is likely lower than the numbers in the studies indicate. In many cases, I think this might not be due to the psychotherapists or therapists themselves but the organization which they work in, e.g. crowded outpatient clinics where the policy is to meet each client in every 3 weeks or in order to not to make the queues to treatment appear so long.
I think think there might be potential for big impact for somebody with clinical background who is willing to advocate long-term for systemic change within mental health care and psychotherapy: optimal treatment protocols (best value per therapy-hour or so), triage, adherance to protocols etc.