Given 1 and 2 and the fact that therapy works for some reason and the fact that different types of therapeautic theories contradict each other, therapy must work not only because because it improves the patient’s map of the territory, but also by another mechanism. So, what’s going on here? Maybe it improves the patient’s map of the territory despite the incorrect information in therapeautic theories?
For one thing, the Dodo bird verdict is (maybe not surprisingly, given point 3) not as well supported as people widely think. It originated decades ago, and may have set in motion the very effects that led to its own eventual lack of relevance. The study I linked to in the OP, if correct, points to just such an invalidation by presenting findings that a particular modality works better for a certain type of treatment than alternatives.
But if we take it at face value, the answer could just come down to “the human element.” Maybe good therapists are what matter and the modality, as long as it’s not utterly bankrupt, is just a vehicle. Personally I don’t believe that’s the full story, but a good relationship with the therapist does seem more important than anything else, and that factor being mostly independent from what modality the therapist uses may account for a large part of it.
Ultimately though, I think part of what my post is tries to do is point out that these different philosophies don’t necessarily contradict each other, but rather are different lenses through which to view the problems the client has. When I get a client that responds super well to CBT, and then another client who doesn’t but grabs IFS and runs with it, I don’t think “well I guess these modalities are equally effective” or think that some kind of paradox is occurring, I just think that different maps are better for different people at navigating the territory, even if they’re dealing with the same “problem.”
I know it feels a bit like a cop-out, but honestly given how complex people are, and how different each problem can be even if it shares the same diagnosis, I would be pretty shocked if a single modality just blew all the others out of the water for every kind of problem that someone might face. Which isn’t to say that they’re all the same, either, just that guidelines for good therapy have to include more than just singling out specific modalities, but also identifying which ones might work best with each client.
3. Give 1 and 2 and the fact that therapy works for some reason and the fact that different types of therapeautic theories contradict each other, therapy must work not only because because it improves the patient’s map of the territory, but also by another mechanism.
It felt to me like the overview of the therapeutic philosophies suggested a partial answer to this one: part of why different therapies contradict each other is that they describe different parts of the territory / have different mechanisms of action. E.g. if behaviorist therapy changes a person’s conditioning and systematic therapy looks at the social system they are in, then there doesn’t need to be a conflict: a person has their own individual conditioning, and that conditioning is also affected by the signals that they get from their social system. (Both are describing the same territory but emphasizing different aspects / levels of it, kind of analogous to physics and chemistry.)
When I saw the title “Philosophy of therapy”, I hoped to find some answers to the following questions:
How to think about therapy given Dodo bird verdict?
How to think about therapy given that approximately 50% of all published studies in it fail to replicate?
Given 1 and 2 and the fact that therapy works for some reason and the fact that different types of therapeautic theories contradict each other, therapy must work not only because because it improves the patient’s map of the territory, but also by another mechanism. So, what’s going on here? Maybe it improves the patient’s map of the territory despite the incorrect information in therapeautic theories?
For one thing, the Dodo bird verdict is (maybe not surprisingly, given point 3) not as well supported as people widely think. It originated decades ago, and may have set in motion the very effects that led to its own eventual lack of relevance. The study I linked to in the OP, if correct, points to just such an invalidation by presenting findings that a particular modality works better for a certain type of treatment than alternatives.
But if we take it at face value, the answer could just come down to “the human element.” Maybe good therapists are what matter and the modality, as long as it’s not utterly bankrupt, is just a vehicle. Personally I don’t believe that’s the full story, but a good relationship with the therapist does seem more important than anything else, and that factor being mostly independent from what modality the therapist uses may account for a large part of it.
Ultimately though, I think part of what my post is tries to do is point out that these different philosophies don’t necessarily contradict each other, but rather are different lenses through which to view the problems the client has. When I get a client that responds super well to CBT, and then another client who doesn’t but grabs IFS and runs with it, I don’t think “well I guess these modalities are equally effective” or think that some kind of paradox is occurring, I just think that different maps are better for different people at navigating the territory, even if they’re dealing with the same “problem.”
I know it feels a bit like a cop-out, but honestly given how complex people are, and how different each problem can be even if it shares the same diagnosis, I would be pretty shocked if a single modality just blew all the others out of the water for every kind of problem that someone might face. Which isn’t to say that they’re all the same, either, just that guidelines for good therapy have to include more than just singling out specific modalities, but also identifying which ones might work best with each client.
It felt to me like the overview of the therapeutic philosophies suggested a partial answer to this one: part of why different therapies contradict each other is that they describe different parts of the territory / have different mechanisms of action. E.g. if behaviorist therapy changes a person’s conditioning and systematic therapy looks at the social system they are in, then there doesn’t need to be a conflict: a person has their own individual conditioning, and that conditioning is also affected by the signals that they get from their social system. (Both are describing the same territory but emphasizing different aspects / levels of it, kind of analogous to physics and chemistry.)