Short answer: In theory, psychotherapy works, specifically cognitive therapy. In practice, therapy is hit-or-miss.
Slightly longer answer: The right psychotherapy matched to the right condition, practiced correctly, is likely to provide noticeable relief.
Let’s unpack this:
Why does theory and practice differ so much?
First, there are many kinds of therapy, from cognitive therapy to Freudian psychoanalysis. And within those categories, there are many subtypes. For example, psychoanalysis has at least 20 orientations. All these options create a “therapy zoo,” making it hard to study. Studies that focus on the whole zoo while showing benefits do so inconsistently. According to one review of meta-analyses, only 7% provide convincing evidence that psychotherapy, as a whole, is effective.
Meta-analysis, which aggregates studies, works well when the underlying studies are consistent, which is rarely the case in psychotherapy. For example, should PTSD treated with eye movement desensitization be studied alongside bulimia treated with unconsciousness exploration? Studying a single treatment-condition pair is hard enough considering assigning placebos in therapy is not as simple as giving someone a sugar pill. However, accumulating multiple studies on multiple treatment-condition pairs is…
