For prescribing psychiatrists who want to offer treatment alternatives to patients who prefer to avoid medication, the evidence is clear that psychotherapy is an effective choice. Even in cases in which medication is accepted, the evidence suggests that psychotherapy may significantly improve patient outcomes. Unfortunately, at this point there is little available guidance on which psychotherapy is most effective and which psychotherapists will best serve your patients.
As unscientific as it may seem, in the absence of other information, the best evidence of therapist effectiveness may be the response of patients. If patients report that they really like their therapist and that he or she is definitely helping them, that therapist would likely be a good bet for other patients. Most valuable, however, will be referring to psychotherapists who systematically measure their patientsâ€™ progress and how the patients respond to therapy.
While the evidence on the benefits of tracking the alliance and outcome is clear and robust, it is still in its infancy. Therefore, there is still no easy way to find out about therapists who routinely use these types of measures beyond inquiring. It appears to be, however, the most important question to ask.