Evidence-Based Counseling is a current trend in psychology that aims to track the efficacy of treatment plans, with the goal of providing clients with treatments that have solid evidence backing their effectiveness. (“What is Evidenced-Based Therapy: 3 EBT Interventions'', positivepsychology.com)
Longitudinal research is often used to examine the effectiveness of specific counseling interventions. Longitudinal research involves repeated observations of the same variables over time. This type of research was used in the development of the CPREP curriculum we use in marriage counseling and marriage preparation counseling. From 1980 until approximately 1995 a group of approximately 135 couples who were planning marriage or who were formally engaged in the Denver area were part of a significant longitudinal study done through Denver University. The massive research project was led by Drs. Howard Markman and Scott Stanley. The 135 couples came in for yearly research sessions which included assessment data and videotaped communication between them.
Through painstaking analysis, certain factors that were observed premaritally were identified as the best predictors of future relationship and marital breakdown. It was determined that the overall predictor of the success of a relationship was how well a couple handles conflict and disagreements. (The Christian PREP Leader’s Manual, Version. 1.7, October 1997, pp. 7-8)
This is a good example of evidence used in Evidence-Based Counseling. Additional evidence is gathered every time the evidence-based interventions are used during counseling sessions. The premise of CPREP is to protect the good things of marriage from destructive and disrespectful communication patterns that will destroy the relationship over time.
Every treatment provider needs to be aware of the evidence for and efficacy of the treatment they provide. To do otherwise is both irresponsible and dangerous. The Hippocratic Oath requires practitioners to “do no harm.” I was often reminded in my marriage and family classes that the need of the client must be the priority of the counselor. A counselor, therapist, medical person, public servant, etc. is supposed to serve their clients with unbiased and pure motives.
I have identified some other things that I believe influence the outcome of counseling. These are based on my own experience in the counseling field for over 20 years. I would say they are character-based. Specifically: Trust, openness, acceptance of the client role, willingness to do their part, and faith in God.
- Trust: Without a trust-based relationship between client and counselor, counseling will not work. If the client does not trust that the therapist is qualified, genuinely cares, and knows what they are talking about, he/she will probably stop coming.
- Openness: Without openness it is impossible to deal with deeper issues. Sometimes even the client himself/herself may not know the deeper issues. That is why questions are especially important. We need to get everything out in the open. We have to get all the issues on the table.”
- Acceptance of the client role: It is always interesting to me that sometimes people want to tell us how they think we should counsel them. This usually means they are not ready to be a client.
- Willingness to do their part: Sometimes people decide to come to marriage counseling so we can fix their spouse. They do not see themselves as needing to make any changes.
- Faith in God: Irv and I always open and close counseling sessions in prayer. We invite God into the session. He is the Great Physician. Those who accomplish much in counseling and in life in general depend upon the Lord.
I think both evidence-based and character-based counseling is essential. If a type of treatment has not been tested over time, why would anyone trust it? If the person who tells us we should follow a specific treatment plan has not proven themselves to be trustable, why would we comply? Things to consider.
Trusting in The Great Physician,