How Does Psychotherapy Work? By: Meredith Gunlicks-Stoessel, PhD, LP and Michael Bloomquist, PhD, LP

“How exactly is coming to therapy going to help me (or my child) feel better?” That’s a question that we are often asked as therapists. It’s a good question and an important one. Usually we answer by describing the theory behind the particular therapy approach that we are planning to use. If we are planning to provide cognitive behavioral therapy to a client who is depressed, we might explain that the client will be learning about how her thoughts and behaviors influence how she feels, and she will be learning to test out different ways of thinking and new ways of behaving that can lead to feeling better. We might also talk about the research evidence showing the effectiveness of cognitive behavioral therapy for treating depressive symptoms.

What’s interesting is that while decades of clinical trials have shown that certain therapy approaches work, and we have theoretical models that explain why and how we think these therapies work, the truth is that we don’t really know how even our most well studied therapies actually work. This question of how psychotherapy brings about change is important one, not only for our clients participating in therapy, but for the entire field of mental health. If we can develop a better understanding of how psychotherapy works, and the particular aspects of therapy that are responsible for bringing about change, it can help us to develop more effective and efficient therapies, and it can help us to do a better job of selecting the particular therapy approach that will be the best match for a particular client’s needs, characteristics, and circumstances.

We are very excited to announce that PrairieCare and the University of Minnesota are partnering to conduct a research study, funded by the National Institute of Mental Health, that aims to address this exact question of how psychotherapy works. The study is focusing specifically on adolescent depression and two particular psychotherapy programs that aim to treat depression in this age group.

Interpersonal Psychotherapy for Depressed Adolescents (IPT-A). IPT-A is a psychotherapy that aims to decrease depressive symptoms by helping adolescents improve their relationships and interpersonal interactions. The initial phase of treatment focuses on exploring the adolescent’s significant relationships and identifying the problem area that will be the focus of treatment. The therapist then identifies and teaches specific communication and interpersonal problem-solving skills that can improve the interpersonal difficulties that are most closely tied to the depression. The adolescent practices these skills in session with the goal of implementing them in their current relationships.

The American Psychological Association has developed criteria for classifying the extent to which a particular psychotherapy approach has enough empirical support to warrant its dissemination. They classify interventions as well established, probably efficacious, possibly efficacious, experimental, and not effective. IPT-A is one of two well-established interventions for adolescent depression (the other is cognitive behavioral therapy).

PrairieCare’s Usual Psychotherapy Practices. The therapists at PrairieCare implement a wide variety of psychotherapy approaches when working with adolescents who are experiencing depression. While therapies like IPT-A were developed in research settings, when therapists deliver therapy in real life real-world settings, they often develop ways of adapting these research-based therapies or they develop new ways of intervening with youth that they observe to be helpful. Researchers are very interested in learning more about these therapy approaches that have developed within the mental health care system, as it may help us to learn new ways and more effective ways of making treatments work in real-world settings.

We are excited about this opportunity to embark on this research partnership. It is a unique opportunity for PrairieCare providers and clients and University of Minnesota researchers to collaborate to contribute to knowledge that can help improve clinical practice and treatment outcomes for adolescents with a diagnosis that can have a profound impact on health and well-being.