How Much Does Your Therapist Matter?


We all understand there are good doctors and not-so-good doctors. Some, for whatever reason, have a higher success rate. The picture is the same when it comes to treating addiction, and while many facilities publish a general percentage of recovery achieved, it’s much harder to pin down which professional, if any, made the difference.

An article in the journal Addiction (abstract here) shows that it does matter who you see, and researchers found it mattered significantly.

The study, which was done with more than 49,000 participants in England, looked at smoking cessation rates for different counselors. Importantly, this was in the National Health Services system, where treatment to stop smoking is largely standardized. Because of this, the variation in outcomes can’t be simply a matter of different treatments, but must be due to other factors – the therapist involved being one.

So how much did it matter?

According to the report, 7.6% of the patient variation in outcome (quitting smoking) could be laid at the feet of individual therapists. In other words, if you saw the worst practitioner, you had a much lower chance of stopping smoking for any significant period compared to seeing the best practitioner.

How might this translate into addiction treatment overall?

As treatment programs become more and more standardized – best practices, what insurance will pay for, costs overall – the differences between facilities will become less and less. But the variation in who is delivering the services will remain. At some point, it might be critical to have access to individual therapist’s success rates. Especially in so serious a matter as alcohol or drug addiction, where even a 5% change in success rates is huge.

This study also brings up another question

Is it true that a particular program of therapy is inherently better than another, or could it be that the person an addict interacts with matters more? If it’s the latter, duplicating a “good therapist” instead of a “good program” is much harder.


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