Why Good Therapy Is More About Teaching Than Treating
Instead of treating "diagnoses," therapy should focus on teaching skills.
Posted February 27, 2019
Most people seek therapy because they've been feeling poorly or having difficulty in one or more zones of their lives. And while some people do have diagnosable disorders or conditions (e.g., OCD, panic, major depression, etc.) many therapy clients’ problems are simply difficulties arising from the challenges of everyday life and don’t need to be diagnosed or labeled as “pathologies.” In fact, most people who are in therapy suffer from nothing more than specific gaps in their personal psychological repertoire and do not need to have a diagnostic label attached to them. Thus, what motivates most people to enter therapy is not the presence of a “condition,” a “disorder” or a “pathology,” but rather the absence of specific knowledge and skills.
In this way, therapy can be seen as a psychoeducational endeavor instead of a quasi-medical or curative therapeutic process. Indeed, traditional therapy delves into a person’s past or “unconscious” mind and attempts to provide “insight” and corrective emotional experiences. Yet there is little evidence supporting the efficacy of these interventions. There is plenty of evidence, however, that the more a person learns in therapy the better he/she/they will fare (e.g., C. Lazarus, 2017; Lazarus & Lazarus, in press).
Fundamentally, there are three important aspects of psychoeducational therapy: skills deficits, misinformation, and missing information.
It is important to keep in mind, however, that like all good therapy approaches, psychoeducational methods are firmly rooted in the soil of the therapeutic relationship. It is not a mechanical or pedantic process but rather an organic, evolving, alliance based collaboration between therapist and client.
People are not born with an innate repertoire of practical life skills. And few people are lucky enough to be taught or learn a full array of them during their upbringing. Thus, common skills deficits include a wide range of absent abilities such as communicating effectively, being responsibly assertive, regulating emotions, and managing stress (to name only a few). Therapy that helps people learn and apply these specific skills usually produces good and lasting results. Alternatively, no matter how much people learn about their “unconscious,” or gain insight, they will not likely benefit much because specific behavioral and emotional change will not automatically occur.
Correcting misinformation is another vital aspect of psychoeducational therapy. Just as we are born with very few innate practical skills, we are not born with much instinctual knowledge, either. What’s more, most of us are exposed to host of erroneous notions and irrational ideas during our upbringing. Despite their best intentions, most of our parents—and other psychologically influential people—fill our heads with a host of erroneous notions and irrational ideas that contribute to much of our conflict and distress. Therefore, helping clients to identify and replace their happiness subverting thoughts and beliefs is essential for success. Typical examples of unhappiness promoting misinformation include believing things like, “don’t express your feelings;” “total honesty is always the best policy;” “you should strive for perfection;” “it’s important to please most other people;” and “try to be liked by everyone.”
Missing information simply refers to specific gaps in a person’s fund of knowledge. It is usually very helpful when therapy provides people with ideas and facts they are unaware of. Part of this is, of course, integrally related to teaching skills. Nevertheless, beyond facilitating skills acquisition, providing clients with practical information they lack is often desirable. Common examples of missing information include matters like knowing the importance of sleep hygiene; both cardiopulmonary and strength training exercise; appropriate alcohol use; balanced nutrition; and facts about sexuality.
Hence, instead of treating “disorders” or diagnoses, therapy can be seen as an alliance based, collaborative process of helping clients acquire a range of practical life skills; aiding them in replacing irrational and self-defeating beliefs with more realistic and adaptive ones; and providing them with some helpful factual information they’re unaware of. In this way, positive results can be achieved relatively quickly, and benefits are usually powerful and durable.
Remember: Think well, Act well, Feel well, Be well!
Dear Reader: The advertisements contained in this post do not necessarily reflect my opinions nor are they endorsed by me. —Clifford
Copyright 2019 Clifford N. Lazarus, Ph.D. This post is for informational purposes only. It is not intended to be a substitute for professional assistance or personal mental health treatment by a qualified clinician.
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Lazarus, C. N. (2017). Multimodal Therapy. In A. Wenzel (ED.), The SAGE Encyclopedia of Abnormal and Clinical Psychology (Volume 4, pp. 2163-2166). Los Angeles: CA.
Lazarus, C. N. & Lazarus, A. A. (In Press). Multimodal Therapy. In J. Norcross (Ed.) Handbook of Psychotherapy Integration, Third Edition. Oxford: NY.