The Evidence for Therapy


Millions of Americans go to talk therapy. But does it work? It’s a surprisingly difficult question to answer.

Talk therapy does produce great benefits for some people, but not for everyone, so it might not work for you, my colleague Susan Dominus wrote for The New York Times Magazine’s therapy issue, published this week.

Researchers were able to reach that conclusion only relatively recently. Since the days of Sigmund Freud, the field of psychotherapy has been resistant, even hostile, to evaluating its methods through empirical studies. “At my graduation from psychoanalytic training, a supervising analyst said to me, ‘Your analysis will cure you of the need to do research,’” Andrew Gerber, the president of a psychiatric treatment center in Connecticut, told The Times.

That resistance has waned in the past few decades, leading to hundreds of clinical trials. The results have been mixed. Some studies have found that therapy has a higher chance of helping than not. Other research has shown more limited results, suggesting that therapy helps some patients but not many or even most.

Why? It likely comes down to individual preferences. A therapist or type of therapy that works for one person might not align with someone else’s personality or problems. So a study looking at whether one kind of therapy works will likely produce limited results, no matter how effective that therapy is for certain individuals.

And for some, talk therapy might never be the right match over other kinds of help, like medication.

Some experts have drawn a disappointing conclusion. “Maybe we have reached the limit of what you can do by talking to somebody,” David Tolin, the director of another treatment center in Connecticut, said. “Maybe it’s only going to get so good.” Others are now trying to harness the evidence to improve talk therapy and to find ways to connect patients to the type of therapy that would work best for them.

Speaking to the researcher Timothy Anderson, Susan voiced her own frustrations about the murky evidence:

I had perhaps — as a longtime consumer of therapy in search of reassurance — hit my limit with the disputes among the various clinicians and researchers, the caveats and the debates over methodology. “The research seems very … baggy,” I said, not bothering to hide my frustration. “It’s not very satisfying.” I could practically hear a smile on the other end of the phone. “Well, thank you,” Anderson said. “That’s what makes this research so interesting. That there are no simple answers, right?”

Read Susan’s cover story here for more details on the evidence for different kinds of therapy and how therapists are trying to improve.

By the Book: The Pulitzer Prize winner Hernan Diaz begins his writing by reading.

Our editors’ picks: “The Covenant of Water,” which follows generations of a family in southwestern India, and eight other books.

Times best sellers: “A Day With No Words,” written by Tiffany Hammond and illustrated by Kate Cosgrove, is at the top of the children’s picture book list.

  • Greece holds elections today.

  • Two Republicans are expected to enter the presidential race this week: DeSantis and Senator Tim Scott of South Carolina.

  • A man who was photographed putting his boots on a desk in Nancy Pelosi’s office during the Jan. 6 attacks will be sentenced on Wednesday.

  • A House subcommittee will hold a hearing on bank and regulatory failures on Wednesday.

  • Biden will deliver the commencement address at his alma mater, the University of Delaware, on Saturday.



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