How Does Psychotherapy Work?

Written By: David N. Elkins Ph.D.

Psychotherapy works.  Hundreds of scientific studies have confirmed this.  However, howit works has been a matter of debate for years.

As Bruce Wampold pointed out in his book The Great Psychotherapy Debate, on one side are proponents of the medical model who believe theories and techniques are the agents of healing.  On the other side are those who believe other factors, especially the human and relational factors of therapy, are responsible for healing. 

So which side is right?  Does psychotherapy heal through (a) theories and techniques or (b) other factors, especially human and relational factors?

Extensive research suggests that the answer is "b."  In other words, psychotherapy's power to heal lies mainly in its human and relational aspects. Evidence from numerous disciplines shows that humans are evolved with the ability to heal one another emotionally through human connection and social interaction and that psychotherapy is an expression of this evolutionarily derived ability.                                                   

This has revolutionary implications for the field of psychotherapy.  Since the time of Freud, most clinical psychologists have assumed that theories and techniques are the agents of healing in psychotherapy. This assumption has shaped clinical research, training, and practice for more than a century.  Now we know that "common factors" (i.e., factors found in all bona fide therapies), and particularly human factors, are the most potent agents of healing, dwarfing the effects of theories and techniques. The human and relational elements are the "power center" of emotional healing and without them psychotherapy cannot work.