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Measuring the road to mental health

Takuya Minami, assistant professor of counseling and applied psychology at Northeastern, is doing something that might have made even Dr. Freud blanch. Minami is trying to quantify how well psychotherapy works.

His ultimate goal: Figuring out why it works.

“Psychotherapy doesn’t work like traditional medicine,” Minami says. “If someone breaks his arm or has a fever, there are standard treatments to address those patient needs. But psychotherapy problems are so specialized, and the way psychotherapy is practiced is so individualized. Therapists often tailor their approach to a particular patient. And all therapists have unique styles.”

Before earning his doctoral degree in counseling and applied psychology at the University of Wisconsin at Madison, Minami studied mechanical engineering at Waseda University, in Japan. It is, he admits with a laugh, much easier to evaluate cars than psychotherapists.

“If you want to compare a Porsche and a Honda, it’s a simple matter to test how fast each can travel a mile,” he says. “But we don’t manufacture therapists—they’re not robots—so testing methods defy standardization.”

Aiming to add to what was a dearth of knowledge on the outcomes of therapy, Minami has already conducted research that compared tens of thousands of “before therapy” and “after therapy” self-reports filled out by psychotherapy patients.

One group of patients was selected from a managed-care database. The other came from a university counseling center.

Judging from these questionnaires, Minami says, it seems therapy does work. “Patients report a return to ‘normal,’ or the attainment of a better, happier life,” he explains.

Now, he says, “I want to figure out how people get better.”

Minami recently documented his work in two papers. Last year, the Journal of Consulting and Clinical Psychology included his article “Benchmarking the Effectiveness of Psychotherapy Treatment for Adult Depression in a Managed Care Environment: A Preliminary Study.” This year, the Journal of Counseling Psychology published “Preliminary Evidence on the Effectiveness of Psychological Treatments Delivered at a University Counseling Center.”

According to Minami, who joined Northeastern last September, the scientific community hasn’t “done enough to assess the effectiveness of therapy in the real world. What leads to people attaining a better life is the ultimate question.”

Currently, he’s planning two studies to learn more. He intends to look at the relationship between client and therapist, to understand more fully how it works.

And he plans to assess the connection between the expectations a client brings into therapy and that therapy’s success. Client expectations, Minami suspects, may be a bigger driver of success in psychotherapy than they are in other doctor-patient interactions.

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