“Know all the theories, master all the techniques, but as you touch another human soul, be just another human soul.” Carl Jung
In today’s therapeutic landscape, one can quickly become overwhelmed by the sheer volume of modalities and acronyms used to describe different types of treatment. It can seem that every day, a new “latest and greatest” treatment modality emerges, and just as quickly, others fall out of favor. For an individual or a family seeking treatment for a loved one, the difficulty of sifting through the fads can cause frustration and a lack of momentum or success in treatment. So, how does one prioritize modality when looking into residential treatment? Bridge House turns to the research to answer this question.
Michael J. Lambert, an American psychologist, spent his career researching psychotherapy measurement outcomes – in other words, which factors contribute to therapy being successful or unsuccessful for an individual. While many may find it surprising, Lambert’s decades of research have shown that the actual modality of treatment (i.e. CBT, DBT, EMDR, etc.) accounts for only 15% of the cause of improvement for any given individual in therapy. Of course, this research does not mean modality is not important, but it does indicate that the emphasis placed on the importance of specific modalities may be out of proportion with the other factors that play into a person’s successful therapeutic treatment.
According to Lambert’s research, people finding themselves needing to go to residential treatment programs often do not have a foundational feeling of meaning, purpose, and/or social and vocational connection – factors that help human beings feel fulfilled, seen, and valued. When we are missing these baseline elements in our lives, humans cannot thrive or step into a higher version of themselves, so these needs must be addressed first in order for any further therapy to be successful.
Another major factor driving whether or not therapy will succeed is the relationship between a client and a therapist. If the person receiving care holds a belief that their therapist believes in them and has confidence they can improve, that belief is just as effective as the type of treatment they receive, according to Lambert’s research. Treatment modalities such as EMDR, ACT, DBT, and CBT all share a basic underpinning in relationship and connection, which Lambert’s research indicates is the second-largest factor contributing to a successful therapeutic outcome. In other words, the modality only affects the outcome once a positive relationship between therapist and client has been established.
At Bridge House, our clinical team understands that being a good mental health professional revolves around three primary tasks: genuinely caring about our residents, getting curious about them, and asking good questions about their lives and experiences. When a clinical professional can prioritize simply sitting with a person and listening to them, sharing space with them, they begin to form a judgment-free understanding of what it means to be that person. This understanding becomes the foundation for a trusting relationship between therapist and client, therefore paving the way for effective treatment and a higher likelihood of a successful therapeutic outcome.
So what does this mean about modalities? Our experience at Bridge House is that skills-based approaches and other modalities are helpful, but only when we have built a solid foundation for our residents first – a sense of meaning, purpose, and connection, as well as feeling seen and believed in by their therapist. Our primary focus is understanding what it means to be our resident, learning what meanings and attachments they have placed on past life experiences, and getting to the “why” behind maladaptive behaviors. Only then are we able to help someone learn to meet their needs differently, so unhealthy behaviors can change, and our residents can move towards hope, health, and healing.
At Bridge House, both our experience and decades of research show the same result: without the foundational underpinnings of connection and relationship, a treatment modality has little chance of being a primary contributing factor towards long-term therapeutic success.
