SPR Ukraine: Tailoring psychotherapy to the patient

Much of the psychotherapy research literature focuses on comparing one brand of treatment against another. Despite many hundreds of studies, meta-analyses have consistently shown that there is no consistent evidence for the superiority of one set of treatment techniques over another. In a 2012 review of the psychotherapy research literature, the American Psychological Association concluded “most valid and structured psychotherapies are roughly equivalent in effectiveness”. In a subsequent review, Wampold reported that therapy techniques and adherence to treatment protocols account for a very small percentage of the variance in treatment outcomes where as “contextual factors” (empathy, the therapy relationship, patient-therapist collaboration) show consistently large effect sizes. In spite of this extensive research evidence, most psychotherapy training and practice tailors the patient to the treatment instead of tailoring the therapy to the patient.
I will present a framework based on control-mastery theory for developing a personalized, patient-centered approach to psychotherapy. Central to this approach is the patient plan formulation consisting of the patient’s adaptive goals, the obstructions or pathogenic schemas impeding them, the adverse or traumatic experiences that contributed to the pathogenic schemas, and the new experiences or insights that help the patient to disconfirm their pathogenic beliefs. I will show how such plan formulations can help therapists optimize therapeutic interventions, increase their responsiveness to patients’ needs, and achieve more effective treatment outcomes. A very brief summary of research supporting these ideas will be presented.