How Psychotherapy Works?

Updated: Mar 23, 2020

When you have a moment, I would encourage you to watch the video below. The video describes the psycho-social mechanisms that are the focus of psychotherapy. In the video, the narrator differentiates Cognitive-Behavioural Therapy (CBT) from Psychotherapy. This is theoretically incorrect as CBT is a system of psychotherapy. The broad definition of psychotherapy is

the use of psycho-social (the interaction of social factors and psychological mechanisms i.e. thoughts, behaviours, emotions, perception, and personality) techniques and interventions in the context of a therapeutic relationship that aim to ameliorate  an individual, couple, or family's serious disorder of thought, cognition, mood, emotional regulation, perception or memory that may seriously impair the individual’s judgement, insight, behavior, communication or social functioning (taken from the Ontario College of Social Workers & Social Service Workers on May 2, 2019).

What this video is referring to is interpersonally based models of psychotherapy, which are considered long-term forms of treatment. Models such as Person-Centred Therapy, Gestalt Therapy, Interpersonal Therapy, Emotion-Focused Therapy, Compassion-Focused Therapy, and Psychodynamic Therapy all fall under relationally-based psychotherapies. This video is a great overview of how relationally-based psychotherapies work. Whilst the video suggests that the evidence for the effectiveness of relationally-oriented psychotherapy is minimal in contrast to CBT, there is mounting research that suggests otherwise. A great resource for checking the current evidence related to psychological therapies is the database on the website for the Society of Clinical Psychology.

Social Workers are among the regulated health professionals who have access to the controlled of psychotherapy. A social worker must verify his/her/their competence and training in mental health assessment and psychotherapeutic techniques. Social workers usually have to demonstrate that they hold a Master of Social Work with post-degree training.  I often hear clients with whom I consult say that they want to see a registered psychologist or psychotherapist, because of the perception of greater qualifications. I usually share with clients that social workers in North America are the primary mental health care providers in the public and private sector. 

Moreover, many jurisdictions in the U.S. and Canada have conferred licensed clinical social workers (LCSW or RCSW) with access to the controlled act of communicating a diagnosis.  In Ontario, the Ontario College of Social Workers and Social Service Workers does not have practice-specific registration, which I argue is a fundamental problem in understanding the varied scopes of practice among social work professionals in Ontario.

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