Can therapy help me? / 治療可以幫助我嗎？

Concierge Mental Health & Associates predominately serves Asian and Asian American women under the age of 40, many of whom come from families who do not believe in the legitimacy or efficacy of talk therapy. As the founder and primary consultant at this practice, I am often in a position of needing to converse with families about the potential benefits, limitations, and predicted outcomes for people who undergo therapy, and often respond to questions like, “What is therapy? Is it a joke?” Since there already exists an incredible body of science research on this subject (just some of which is provided at the bottom of this blog), the following article will primarily focus on a more philosophical exploration of the question of whether or not therapy is a joke, beginning with the question: “What is a joke?”

For many, jokes involve unpredictability: the unexpected. In some cases they provoke laughter, and in others they provoke thought. In that regard, therapy can certainly be considered a joke, in part because of the insane variability with regard to what works for any given individual, and in part because mental health providers’ income is often associated with people’s continued suffering. How can anyone trust mental health providers who are financially incentivized to focus on pain? Of course, the majority of providers care deeply for their clients’ wellbeing and life satisfaction. However, what remains ‘funny’ about the setup of therapy is the amount of hope that some clients put into this individual paid relationship, despite the problems inherent to humanity (mental health providers included). Below are a list of articles on the limitations and potential side effects of working with any independent providers, reviewed and provided by the Summer 2024 Research & Development Team at CMHA. One study showed that 16.8% of clients reported to “feeling violated by statements from their therapist” (Strauss, 2021), another showed that up to 5% felt they had bad lasting effects after treatment (Dandachi-FitzGerald, 2024), and another reported that “some patients felt term ‘negative’ “did not properly capture how difficult their experience had been” (Crawford, 2016).

Despite this research, this blog was written by a group of academics and practitioners who love good therapy and wish it could be freely available to all (just like good jokes).

The more important question to whether or not therapy is a joke is whether or not it can be of help or benefit. Since, in our experience, the answer has always been a “maybe”, we developed a [Talk] Therapy Appropriateness Questionnaire (TAQ), which we welcome anyone to take and discuss with us at this link.

The results should be interpreted as subjective and compared with the recommendations of trusted providers and personal intuition.

Thank you for your time.

References

Crawford, M. J., Thana, L., Farquharson, L., Palmer, L., Hancock, E., Bassett, P., Clarke, J., & Parry, G. D. (2016). Patient experience of negative effects of psychological treatment: results of a national survey†. The British journal of psychiatry : the journal of mental science, 208(3), 260–265. https://doi.org/10.1192/bjp.bp.114.162628

Cuijpers, P. (2021). Research on negative effects of psychotherapies: The next steps. Clinical Psychology: Science and Practice, 28(2), 142–144. https://doi.org/10.1037/cps0000011

A Scale for Measuring Positive and Negative Experiences of Psychotherapy (PNEP): First Psychometric Findings of a New Instrument for Monitoring Clients’ Experiences—Dandachi‐FitzGerald—2024—Clinical Psychology & Psychotherapy—Wiley Online Library. (n.d.). Retrieved August 10, 2024, from https://onlinelibrary.wiley.com/doi/10.1002/cpp.3014?af=R 

Gerke, L., Meyrose, A.-K., Ladwig, I., Rief, W., & Nestoriuc, Y. (2020). Frequencies and Predictors of Negative Effects in Routine Inpatient and Outpatient Psychotherapy: Two Observational Studies. Frontiers in Psychology, 11. https://doi.org/10.3389/fpsyg.2020.02144

Cuijpers, P., Reijnders, M., Karyotaki, E., de Wit, L., & Ebert, D. D. (2018). Negative effects of psychotherapies for adult depression: A meta-analysis of deterioration rates. Journal of Affective Disorders, 239, 138–145. https://doi.org/10.1016/j.jad.2018.05.050

Moritz, S., Nestoriuc, Y., Rief, W., Klein, J. P., Jelinek, L., & Peth, J. (2019). It can't hurt, right? Adverse effects of psychotherapy in patients with depression. European archives of psychiatry and clinical neuroscience, 269(5), 577–586. https://doi.org/10.1007/s00406-018-0931-1

Strauss, B., Gawlytta, R., Schleu, A., & Frenzl, D. (2021). Negative effects of psychotherapy: estimating the prevalence in a random national sample. BJPsych Open, 7(6), e186. https://doi.org/10.1192/bjo.2021.1025

心理治療是個笑話嗎？

Concierge Mental Health & Associates 主要為 40 歲以下的亞裔和亞裔美國女性提供服務，其中許多人來自不相信談話療法的合法性或功效的家庭。作為診所的創始人和主要顧問，我經常需要與家人討論接受治療的人的潛在益處、限制和預測結果。由於關於這個主題已經存在大量令人難以置信的科學研究（本博客底部僅提供了其中一些），因此以下文章將主要集中於對治療是否是一個笑話的問題進行更哲學的探索，以這樣的問題開始：「什麼是笑話？這一定很有趣嗎？

對許多人來說，笑話涉及不可預測性：意料之外的事。在某些情況下，它們會引起笑聲，而在其他情況下，它們會引起思考。在這方面，治療當然可以被認為是一個笑話，部分原因是對於任何特定個人來說，治療方法存在巨大的可變性，部分原因是心理健康提供者的收入往往與人們的持續痛苦相關。怎麼會有人相信那些在經濟上受到激勵而專注於疼痛的心理健康服務提供者呢？當然，大多數提供者都非常關心客戶的福祉和生活滿意度。然而，治療的設定仍然「有趣」的是，儘管存在人類固有的問題（包括心理健康提供者），但一些客戶對這種個人付費關係抱有很大的希望。以下是與任何獨立提供者合作的限制和潛在副作用的文章列表，由 CMHA 的 2024 年夏季研究與開發團隊審查和提供。一項研究顯示，16.8% 的客戶報告「感覺治療師的陳述受到了侵犯」（Strauss，2021 年），另一項研究顯示，高達5% 的客戶認為治療後產生了不良的持久影響（Dandachi- FitzGerald，2024 年），另一項研究表明報告稱，「一些患者認為『消極』一詞「沒有正確反映他們的經歷有多麼困難」（Crawford，2016）。

儘管有這項研究，這個部落格是由一群熱愛良好治療並希望它可以免費提供給所有人的學者和從業者撰寫的（就像好笑話一樣）。

關於治療是否是一個笑話，更重要的問題是它是否有幫助或益處。根據我們的經驗，答案始終是“也許”，因此我們制定了一份[談話]治療適當性調查問卷（TAQ），歡迎任何人通過訪問以下鏈接來填寫並與我們討論。

https://forms.gle/eTCBGxyYhbJyR7RE9

結果應被解釋為主觀的，並與值得信賴的提供者的建議和個人直覺進行比較。

感謝您抽出時間。