Dr. Levy's CBT Blog
Insights on Well-Being, Contentment, and Cognitive Behavioral Therapy
When presented with important choices in their lives, clients often ask me "Is this the right choice?...Is this OK?..." The clear answer for that is "It depends!!!". What is right for your life obviously hinges on your personal values, dreams, and aspirations. While no one can give you answers on what to aim for, we can suggest parameters to consider when weighing your choices and making important (or even everyday...) decisions.
A "great life," however it looks like for you, should maximize your ratings and satisfaction across the dimensions below:
In short, choices that increase your purpose in life; social, financial, and physical well-being; or community belonging are likely "right" and definitely "OK." Sometimes we move along these axes in unison, other times we need to make trade-offs among them. But those are the key ingredients in a great life for everyone of us. How you mix them up to create your own unique recipe, it's up to you.
Before starting therapy, clients often wonder "How long will I be in therapy?" This funny video from The Onion provides a clever satire of the open-ended, long-term model of therapy that is often portrayed by the popular media:
Cognitive behavioral therapy (CBT) tends to operate within a much more short-term, focused model of psychological intervention that aims to reduce current symptoms, address specific problems, and build skills that the client can take with him/her after treatment ends. Hence, treatment length is usually measured in weeks or months, rather than years or decades.
Indeed, there is ample research evidence that response to psychotherapy follows a 'negatively accelerated' curve where more and more effort is required to achieve smaller and smaller changes (that is called a log-normal curve for the math geeks out there). Dr. Ken Howard was the first to analyze this correlation and posit markers for response to psychotherapy according to dosage. Here is his original article.
The original dose-effect study was run in 1986, based on psychodynamic or interpersonal treatment only, with the following findings:
* About 15% of patients improve before the first session of therapy
* 50% of patients typically improve at 8 sessions
* 75% of patients typically improve at 26 sessions
* 85% of patients typically improve at 52 sessions
It is possible that modern psychological techniques have accelerated that theoretical curve in the past 30 years. In practice, however, there are many factors influencing the right dose of psychotherapy for each client, including diagnosis, acuity, readiness to change, social circumstances, and frequency of treatment (more regular treatment is shown to be more effective). But what we can glean from the data above is that longer and longer treatment periods may indeed offer diminishing gains at increasing levels of effort.
With CBT, you and your therapist will have powerful tools for change readily available. The specific length of psychotherapy treatment will vary for each person and each presenting problem. But with commitment and focus in the context of a true partnership, CBT can lead to fast and meaningful change.
Dr. Daniele Levy is a licensed psychologist offering CBT therapy in Menlo Park, CA. Her background uniquely combines leading edge training in behavioral sciences with deep expertise coaching and mentoring working professionals in dynamic organizations.