A Danish Study Sheds Light on the Importance of Choice and Autonomy in Talking Therapies, Supporting the Direct Access to Counselling Campaign
As the age-old saying goes, 'one size doesn't fit all', and a new Danish study provides a substantial body of evidence in support of this adage, at least when it comes to talking therapy. The National Counselling & Psychotherapy Society's (NCPS) Direct Access to Counselling Campaign advocates precisely for this philosophy: the freedom to choose a therapist and therapy method (modality) that aligns with each person's unique needs and preferences.
The study, called "Common factors, Responsiveness and Outcome in Psychotherapy (CROP)", could hold the keys to improving therapeutic outcomes for many, supporting the tenets of our Direct Access Campaign. The study shines a light on the interplay of factors that determine the success of therapy.
The research suggests that whilst psychotherapy as a practice is generally effective, a sizeable portion of patients still do not achieve a satisfactory outcome; there is clearly much room for improvement here. Only 48% of patients with anxiety and 43% of patients with depression reach "full remission" at the end of treatment. The study urges us to re-evaluate our approach to therapy, particularly in the selection of therapeutic methods and therapists.
One of the primary acknowledgements of the CROP study is the importance of common factors - therapist's empathy and facilitative interpersonal skills - over specific therapeutic techniques. These common factors, consistent across all therapeutic approaches, are instrumental in establishing a successful relationship between the client and therapist, consequently improving therapeutic outcomes. This is not a new concept, and has been studied a number of times over the years (this is not a complete list):
- The empirical case for the common factors in therapy: Quantitative findings Asay, T. P., & Lambert, M. J. (1999)
- Let's Face Facts: Common Factors Are More Potent Than Specific Therapy Ingredients Messer, S. B., & Wampold, B.E. (2006)
- Is Who Delivers the Treatment More Important than the Treatment Itself? The Role of The Therapist in Common Factors Blow, A.J., Davis, S.D., & Sprenkle, D. H. (2007)
- The Therapeutic Pyramid: A Common Factors Synthesis of Techniques, Alliance, and Way of Being Fife, S. T., Whiting, J.B., Bradford, K., & Davis, S. (2013)
- Predicting the effect of cognitive therapy for depression: A study of unique and common factors Castonguay, L. G., Goldfried, M. R., Wiser, S., Raue, P. J., & Hayes, A. M. (1996)
- Where are the commonalities among the therapeutic common factors? Grencavage, L. M., & Norcross, J. C. (1990)
This view echoes the philosophy of our Direct Access to Counselling Campaign. The freedom to choose a therapist ensures that the client finds someone who they feel understands and values them, who they can truly connect with, which in turn creates an environment conducive to successful therapy. The diversity in human beings, our personalities, the way we present ourselves, our capacity for and way in which we demonstrate empathy, and our unique interpersonal skills are a testament to the importance of choice in therapy.
Having said this, the study does also reveal the potential significance of specific therapeutic techniques. When used responsively, adapting to the unique needs and preferences of each client, these techniques can also contribute to the effectiveness of the therapy. This aligns perfectly with the second of three principles of the Direct Access Campaign, being the that people should have the ability to choose their therapy method (modality).
The concept of therapeutic responsiveness is central to the study's findings. This refers to the therapist's ability to tailor their approach according to their client's specific needs, characteristics, and preferences. The freedom of choice promoted by the Direct Access Campaign enables people to find a therapist and therapeutic method that works best for them, increasing their chances of achieving a successful therapeutic outcome.
Though in its nascent stages, the CROP study provides a scientific lens through which to view the principles of the Direct Access Campaign. It calls for further research into the complex interactions of common and specific factors in therapy and how therapists can adapt their approach to accommodate these factors.
The study corroborates the philosophy of the Direct Access to Counselling Campaign: that therapy should be personalised according to the unique needs of each client. By empowering people with the freedom to choose their therapist and therapy method, we create an environment where therapy is as unique as the individuals it seeks to help.
