Is Psychotherapy All About the Relationship?
PsycCRITIQUES Associate Editor Fred Heide is enthusiastic about Irvin Yalom's new book, Creatures of a Day: And Other Tales of Psychotherapy, and he compares the work with another of Yalom's books, Love’s Executioner: And Other Tales of Psychotherapy. Love's Executioner is a remarkable little book that I have had a generation of clinical psychology and social work students read.
In his review, Dr. Heide notes:
That psychotherapy reduces suffering seems increasingly clear. Meta-analyses indicate that typical clients emerge from therapy in better shape than almost 80% of those untreated (Wampold, 2007). What accounts for these effects, however, remains shrouded in mystery. Many have proposed that the alliance between therapist and client contributes substantially (Horvath, Del Re, Fluckiger, & Symonds, 2011), as do a host of other common factors that transcend theoretical camps (Laska, Gurman, & Wampold, 2014). However, robust disagreement continues about whether the role of specific techniques is major (Hofmann, Asnaani, Vonk, Sawyer, & Fang, 2012) or relatively trivial (American Psychological Association, 2013; Wampold & Imel, 2015). (para. 2)
After a lifetime reading about, thinking about, practicing and teaching psychotherapy, I still don't know how much of the variance in outcome is associated with technique and how much is simply due to the relationship the therapist establishes with his or her client. I edit a book series for the Society of Clinical Psychology that is predicated on the idea that evidence based practice (technique) is an essential part of good practice, yet with individual clients, I often find myself agreeing with Yalom: "The one thing I’ve come to know with certainty is that if I can create a genuine and caring environment, my patients will find the help they need" (p. 81).
Will this dilemma be resolved in my lifetime?
By Frederick J. Heide
PsycCRITIQUES, 2015 Vol 60(29)