Does Therapy Work?

Increasing numbers of people in the United Kingdom are turning to therapy to help improve their mental health, but does therapy actually work?

This topic was explored in a recent podcast with Journalist Horatio Clare and Psychiatrist Femi Oyebode.

The focus was mainly on the use of psychotherapy to combat more serious mental health issues such as schizophrenia, bipolar disorder and post traumatic stress disorders, and the overwhelming consensus was that therapy can help and the podcast explores why, as well as what makes for effective therapy.

What is psychotherapy?

Psychotherapy is the use of words as a means of treating another human being

Both psychiatrists and psychotherapists use talking therapy as part of their work, but a psychiatrist is someone who has had medical training, so is qualified to prescribe drug treatments to patients, whereas a psychotherapist doesn’t have prior medical training and so is limited to only do talking therapy with clients.

On misconception about the difference between the two is that psychotherapy focus on dealing with the causes of mental illness whereas psychoanalysis only deals with the symptoms, there is in fact more blurring between the two disciplines.

Types of psychotherapy

The British Council of Counselling and Psychotherapy lists over 30 types of therapy. Three of the main types of psychotherapy are:

  • Psychoanalysis, developed by Freud, is built on the theory that experiences in early childhood have a deep impact on the formation of adult personalities. Dynamic psychotherapy is a modern version of this.
  • Behavioural Therapy believes that patterns of behaviour such as OCD or anxiety arise because of conditioned behaviour, abnormalities of learning which developed either in childhood or adulthood.
  • Cognitive Behavioural Therapy, invented by Aaron Beck was a further development of behavioural therapy theorises that our emotions are dependent on our thinking, so the intent is to alter our thinking so our emotional state changes.

Psychotherapy to treat Schizophrenia

The podcast introduces as a case study one individual who used a combination of medication and talking therapy to ease his symptoms of schizophrenia.

His symptoms were serious, including hearing voices, delusions (having the wrong perception of reality), depression and paranoia which in turn created a number of severe negative emotions such as frustration, hopelessness, disappointment and an overwhelming lack of self-worth, or very low self-esteem.

Talking therapy helped him because his schizophrenia meant he only listened to himself, only heard from himself, having other people’s opinions helped him see from another perspective.

An example of how this can help is if you imagine walking into a room of people who are talking but stop when you enter, you might think ‘they must have been talking about me’ but a different perspective is that maybe they were just talking about something private and confidential.

Cognitive Behavioural Therapy can help calm the symptoms of schizophrenia in two ways.

  • Firstly it can help reduce hallucinations and delusions that may not have responded to drug treatment
  • Secondly it can help a patient deal with the low self-esteem and worthlessness that it causes.

It was suggested to him that family therapy may help, since in psychoanalytic theory childhood experiences may have contributed to his schizophrenia, but his parents refused to take part.

The concept of over-resilience was used to to describe his family’s reluctance to take up family therapy: his parents thought the family was fine as an emotional unit and had no need of therapeutic input.

Over-resilience is very common in ethnic minority families and it builds up over generations. Fathers especially want to be the family rock and so don’t want their partners or children to see them crying or stressed, and so children grow up thinking they also need to hide and not talk about negative emotional states, vulnerabilities and weaknesses.

However for some people this builds up and leads to a mental health crisis, or a breakdown as it did with the case study here.

Psychotherapy and bipolar

One guest, Katie Mason, argued that therapy can also help treat bipolar disorder.

In such cases it can help prevent relapse, addresses symptoms that occur in depression and reduce guilt and shame after someone has had a manic episode. It can also help people accept their condition, which can prevent relapse as they recognise when they are getting unwell again and get early intervention.

Eye Movement Desensitisation and Reprocessing

Another guest, Dr Logi, outlined how a relatively new type of therapy called eye movement desensitisation reprocessing can help patients process previous traumatic events and thus help with Post Traumatic Stress Disorder.

The process is roughly as follows:

  1. The patient thinks about a key even that is causing them to have negative feeling and events, for example a road traffic accident.
  2. They identify what emotions these memories trigger and where in the body they are located.
  3. Then they do something which encourages rapid eye movement while the patient thinks about those memories and feelings.

The theory is that rapid eye movements distract the clients, keeping them in the here and now while they are revisiting the past, thus enabling them to process negative emotional states caused by past events more easily.

EMDR also works with people with depression, phobias and OCD.

Effective Psychotherapy

The most effective thing about therapy is the relationship with the therapist, they work as well as each other!

A good psychotherapist needs to have cultural competence: they need to recognise that their own cultural context and narrative is not superior to that of the patient.

There are some people who believe that a psychotherapist needs to come from the same cultural background to be effective, arguing that positive results are more likely if a therapist is from the same ethnic group as the patient, but Oyebode doesn’t subscribe to this theory.

The most important qualities of a good series of psychotherapy sessions are that they are well structured and allow time for the patient to focus on themselves.

The system also needs broader structures in place to ensure that patients who need medication can find that kind of support which psychiatry doesn’t offer.

Psychiatrists need more time to spend with their patients so they can can tailor therapy more effectively. They are pushed to medicated while therapy is more of a longer game – there are times when it’s more appropriate than others.

There is very little availability of therapy in in-patient services. The average in patient stay in the U.K. is 21 to 28 days and it is not possible to do effective psychotherapy with the patient in an extremely disturbed state and in such a short period of time.

Signposting and Sources

While this material isn’t directly relevant to any of the standard A-level sociology modules I thought it was of sufficient interest given the amount of young people with poor mental health and the fact that therapy is becoming increasingly normal!

Radio 4 (February 2023) Is Psychiatry Working?: Episode 5: Therapy.

To return to the homepage –

Laboratory Experiments in sociology

A summary of the practical, ethical and theoretical advantages and disadvantages of lab experiments

This post focuses on the practical, theoretical and ethical and strengths and limitations of laboratory experiment, applied mainly to sociology…

What are laboratory Experiments?

Laboratory experiments take place in controlled environments and are the main method used in the natural sciences such as Physics, Chemistry and Biology. There are numerous experiments which have been designed to test numerous scientific theories about the temperatures at which various substances freeze or melt, or how different chemicals react when they are combined under certain conditions.

The logic of the experimental method is that it is a controlled environment which enables the scientist to measure precisely the effects of independent variables on dependent variables, thus establishing cause and effect relationships. This in turn enables them to make predictions about how the dependent variable will act in the future.

For a general introduction to the key features of experiments and the experimental method (including key terms such as hypothesis and dependent and independent variables) and some of their advantages please see this post: experiments in sociology: an introduction.

The laboratory experiment and is commonly used in psychology, where experiments are  used to measure the effects of sleep loss and alcohol on concentration and reaction time, as well as some more ethically dubious experiments designed to measure the effects of media violence on children and the responses of people to authority figures.

However, they are less common in sociology. Having said that, they are still a requirement within the research methods component of A-level sociology and the AQA exam board does seem to like setting exam questions on experiments!

Laboratory Experiments: Theoretical Factors

Theoretical Advantages of Laboratory Experiments

Accuracy and Precision– Laboratory experiments allow the precise effects of independent variables on dependent variables to be measured. This in turn makes it possible to establish cause and effect relationships between variables.

Isolation of Variables – The controlled conditions of laboratory experiments allows researchers to isolate variables more effectively than with any other research method. This further allows researchers to precisely measure the exact effect which one or more independent variables have on the dependent variable. With the ‘tomato experiment’ for example, laboratory conditions would allow the researcher to control precisely variations in temperature, moisture and light, this would not be possible in a field (no pun intended).

Controlled conditions also allow the researchers to eliminate the effects of ‘extraneous variables’. Extraneous variables are undesirable variables which are not of interest to the researcher but might interfere with the results of the experiment. If you were trying to measure the effects of alcohol on reaction time for example, keeping respondents in a lab means you could make sure they all at and drank similar things, and did similar things, in between drinking the alcohol (or placebo) and doing the reaction time test.

Laboratory experiments have excellent reliability for two major reasons:

Firstly, the controlled environment means it easy to replicate the exact environmental conditions of the original experiment and this also means it is relatively easy for the researcher to clearly outline the exact stages of the experiment, again making exact replication easier. This is not necessarily the case in a field experiment, where extraneous variables may interfere with the research process in different ways with repeat-experiments.

Secondly, there is a high level of detachment between the researcher and the respondent. In an experiment, the researcher typically takes on the role of ‘expert’ and simply manipulates variables, trying to have as little interaction with the respondents as the experiment will allow for. This means there is little room for the researcher’s own values to influence the way the respondent reacts to an experiment.

Theoretical Limitations of Laboratory Experiments

Laboratory experiments lack external validity – sociologists hardly ever use lab experiments because the artificial environment of the laboratory is so far removed from real-life that most Sociologists agree that the results gained from such experiments tell us very little about how respondents would actually act in real life. Take the Milgram experiment for example – how likely is it that you will ever be asked by scientist to give electric shocks to someone you’ve never met and who you can’t see when they give the wrong answer to a question you’ve just read out? Moreover, when was they last time you were asked to do anything to anyone by a scientist? In the real world context, many of the Milgram respondents may have responded to real-world authority figure’s demands differently.

Laboratory Experiments: Practical Factors

The practical advantages of lab experiments

In terms of practical advantages experiments (assuming they are ethical) are attractive to funding bodies because of their scientific, quantitative nature, and because science carries with it a certain prestige.

Once the experiment is set up, if it takes place in a lab, researchers can conduct research like any other day-job – there is no travelling to visit respondents for example, everyone comes to the researcher.

The practical problems of lab experiments

Practical problems include the fact that you cannot get many sociological subjects into the small scale setting of a laboratory setting. You can’t get a large group of people, or a subculture, or a community into a lab in order to observe how the interact with ‘independent variables’.

Also, the controlled nature of the experiment means you are likely to be researching one person at a time, rather than several people completing a questionnaire at once, so it may take a long time to get a large-sample.

Laboratory Experiments: Ethical Factors

The ethical limitations of laboratory experiments

Deception and lack of informed consent are an ethical problem- The Hawthorne effect gives rise to the firs ethical disadvantages often found in experiments – it is often necessary to deceive subjects as to the true nature of the experiment so that they do not act differently, meaning that they are not in a position to give full, informed consent. This was the case in the Milgram experiment, where the research subjects thought the (invisible) person receiving the shocks was the actual subject rather than themselves.

A second ethical problem concerns harm to respondents. In the case of the original Milgram experiment, ‘many research participants were observed to sweat, stutter, tremble, bit their lips and dig their nails into their flesh, full-blown, uncontrollable seizures were observed for three subjects’.

The ethical strengths of laboratory experiments

While some laboratory experiments are notorious for their ethical problems, it is at least usually obvious that research is taking place (even if the exact purpose of the research may be hidden from respondents). Also, the benefits to society might well outweigh the costs to respondents.

Related Posts

The above material is mainly relevant to the research methods aspect of A-level sociology.

Intro to Experiments in Sociology

Field Experiments in Sociology

Sources/ References

Milgram’s Experiment on Obedience to Authority, which cites Milgram, S. (1974). Obedience to Authority: An Experimental View. New York: Harper and Row. An excellent presentation of Milgram�s work is also found in Brown, R. (1986). Social Forces in Obedience and Rebellion. Social Psychology: The Second Edition. New York: The Free Press.

What is a Likert Scale?

A Likert* scale is a multiple-indicator or multiple-item measure of a set of attitudes relating to a particular area. The goal of a Likert scale is to measure intensity of feelings about the area in question.

A Likert scale about Likert scales!

In its most common format, the Likert scale consists of a statement (e.g. ‘I love Likert scales’) and then a range of ‘strength of feeling’ options which respondents choose from – in the above example, there are five such options ranging from strongly agree to strongly disagree.

Each respondents reply on each item is scored, typically with a high score (5 in the above example) being given for positive feelings and a low score (1 in the above example) for negative feelings.

Once all respondents have completed the questionnaire, the scores from all responses are aggregated to give an overall score, or ‘strength of feeling’ about the issue being measured.

Some examples of sociological research using Likert scales:

The World Values Survey is my favourite example – they use a simple four point scale to measure happiness. The poll below gives you the exact wording used in the survey…

The results on the web site (and below) show you the percentages who answer in each category, but I believe that the researchers also give scores to each response (4 to 1) and then do the same for similar questions, combine the scores and eventually come up with a happiness rating for a country out of 10. I think the USA scores around 7.2 or something like that, it might be more! Look it up if you’re interested….

America’s happiness results

Important points to remember about Likert scales

  • The items must be statements, not questions.
  • The items must all relate to the same object being measured (e.g. happiness, strength of religious belief)
  • The items that make up the scale should be interrelated so as to ensure internal reliability is strong.

*The Likert Scale is named after Rensis Likert, who developed the method.


Adapted from Bryman’s Social Research Methods