Knapp, S., Sternlieb, J., & Kornblith, S.
(2025, February).
Psychotherapy Bulletin, 60(2).
Often, psychotherapy researchers find that their contributions to psychotherapy get lost in the discussions of complex methodological issues that appear far removed from the real-life work of psychotherapists. Consequently, few psychotherapists regularly read research-based studies, and researchers communicate primarily with each other and less with psychotherapists. Fortunately, the pioneering work of Castonguay et al. (2019) has identified evidence-supported principles of change that improve patient outcomes, regardless of the psychotherapist’s theoretical orientation. They help bridge the researcher/practitioner gap by identifying, in succinct terms, evidence-supported findings related to improved patient outcomes. Psychotherapy scholars identified these principles after exhaustingly reviewing thousands of studies on psychotherapy.
Of course, none of the principles of change should be implemented in isolation. Nevertheless, together, they can guide psychotherapists on how to improve and personalize their treatment plans. Examples have been given of how psychotherapists can apply these change principles to improve the treatment of patients with suicidal thoughts (Knapp, 2022) and anxiety, depression, and other disorders (Castonguay et al., 2019).
Some of the principles appeared to support the conventional wisdom on what is effective in psychotherapy. For example, Principle 3 states, “Clients with more secure attachment may benefit more from psychotherapy than clients with less secure attachment” (McAleavey et al., 2019, p. 16). However, other principles conflict with some popular beliefs about the effectiveness of psychotherapy. For example, Principle 20 states, “Clients with substance use problems may be equally likely to benefit from psychotherapy delivered by a therapist with or without his or her own history of substance use problems” (McAleavey et al., 2019, p. 17).
Here are some thoughts:
The article argues for recognizing the mental health of psychotherapists as a transtheoretical principle of change, emphasizing its impact on patient outcomes. Building on the work of Castonguay et al. (2019), which identified principles that enhance patient outcomes across theoretical orientations, the authors propose that a psychotherapist's emotional well-being should be considered a key factor in effective treatment. They suggest that clients benefit more when their therapist experiences fewer symptoms of mental distress, highlighting the need for psychotherapists to prioritize self-care and emotional health.
Psychotherapists face numerous stressors, including administrative burdens, exposure to patient traumas, and the emotional demands of their work, all of which have intensified during the COVID-19 pandemic. Research indicates that higher levels of therapist burnout and distress correlate with poorer patient outcomes, underscoring the importance of addressing these issues. To enhance patient care, the article recommends integrating self-care practices into psychotherapy training and fostering supportive environments within institutions. By promoting self-awareness, self-compassion, and social connections, psychotherapists can better manage their emotional well-being and provide more effective treatment. The authors emphasize the need for ongoing research and open discussions to destigmatize mental health issues within the profession, ensuring that psychotherapists feel supported in seeking help when needed. Ultimately, prioritizing the mental health of psychotherapists is essential for improving both patient outcomes and the well-being of mental health professionals.