The informed counselor will consider that if the common factors theory is correct, and all
therapeutically efficacious approaches share commonalities which lead to their
effectiveness, then placebo effect is recognized as one of these shared common factors.
Without going so far as to the Dodo bird verdict, which states that all effective
psychotherapeutic approaches are equivalent because of the “common factors’, the
importance of the therapist’s attitude toward the expected efficacy of the treatment is
well-established. A study by Wampold et al. in 2002 found that nearly 70% of the
variability in treatment outcomes was directly related to the therapist’s attitude. If the
therapist believed in the efficacy of the treatment, then this would be reflected in the
outcomes. Likewise, the mindset of the client is an extra-therapeutic factor. Data shows
that clients with positive mindsets are more likely to experience clinical improvement,
regardless of the counselor’s techniques. Lambert (1992) found that almost 40% of
psychotherapeutic improvement came from these client-therapist variables, and another
15% from the expectancy of improvement (placebo effect).
Current understanding of the placebo effect has been led by the psychologically oriented
community. The power of the placebo is now clearly understood to not lie in the sham
treatment of a candy pill. The power comes from the interplay of psychosocial and
neurobiological processes. Modern medicine is challenged to overcome its bias for
reductionistic and technological approaches and follow the psychotherapeutically
oriented healers who see that the placebo effect is a social phenomenon that likely
activates neurotransmitters, with the expectation of positive outcomes.
Armed with understanding of the how the mind leads the brain, the therapist can leverage
the placebo effect to increase improvement with their individual clients and families.
Simple measures can be taken to convey the therapist’s belief in the client’s ability to get
better. Increasing frequency of seeing the client, determining what treatment approach the
client prefers and doing more of it, informing the client of what they can expect,
interacting in a genuinely warm and caring manner, and listening and providing
understanding and empathy are all ways to increase the placebo effect in therapy.
Believing in and fostering the client’s belief in their brain’s healing is one of the powerful
tools we have in psychotherapy. It is likely more powerful than perfected treatment
modality techniques.
Thank you for reading!