Research shows it’s not about the specific treatment approach — it’s about the therapeutic relationship and building skills
All Major Therapy Approaches are Equally Effective When Applied Well
As a parent, you likely want to explore every option available to help your child recover from addiction and improve their mental health. It’s understandable to think that some highly touted approaches like CBT or DBT may be more effective than others. However, research paints a different picture.
Studies show that structured, research-backed approaches like CBT, DBT, MI, and others all achieve similar results when applied by a well-trained, engaged therapist. It’s not the specific theoretical approach itself that matters most. The key factors driving your child’s improvement will be the connection with their therapist, belief that change is possible, and learning pragmatic skills to support recovery.
This may come as a surprise, since we naturally assume different techniques have specific effects. CBT challenges negative thought patterns. DBT builds emotion regulation skills. EMDR processes trauma. While those ideas make logical sense, study after study has failed to show any one branded approach reliably outperforms others.
Of course, this doesn’t mean therapy is ineffective. On the contrary, research shows therapy substantially helps 75% of patients versus no treatment. It means the specific theory or tools don’t matter as much as we believe. Your child can benefit greatly from working with a therapist regardless of formal approach.
The Therapeutic Relationship is the Driver
According to prominent psychologists like Bruce Wampold, there are 3 vital components present in any effective therapy:
You can see how these apply across modalities. A strong therapeutic relationship provides the foundation. The therapist explains their approach in a way the patient believes could help them. The patient then engages in activities intended to create positive change per the agreed approach.
The key is subjective belief. When we believe change is attainable for us, this shapes our thoughts and actions in a self-fulfilling cycle. A skilled therapist helps a patient connect their goals to a change theory they believe in. This shifts their mindset as the first step.
But an empathetic bond between therapist and patient jumpstarts the process. Your child must trust their therapist deeply and feel understood. Look for a therapist your child feels comfortable opening up to. The therapeutic relationship will catalyze their self-belief more than any specific technique.
Concrete Skills Make the Greatest Therapists
So if therapy approach doesn’t drive results, what does help patients improve further? Developing concrete skills related to engaging and motivating patients.
Research shows the most effective therapists excel at:
For example, consider a scenario where your child enters treatment hoping to reconcile with an estranged friend. However, the therapist insists the real focus should be your child’s anxiety. This misalignment of goals damages the alliance and optimism needed for change. An effective therapist aligns with stated goals while guiding the patient to connect the dots on their own.
The most successful therapists keep the patient’s hopes anchored while improving motivation and trust through micro-skills like reflective listening, open-ended questions and body language. These concrete techniques make a big impact when applied artfully.
Change Requires Learning New Skills
So where does specific therapy theory come into play? While a strong bond and belief in change initiate progress, the final step is practicing new skills.
Think of it this way — believing you can drive a car doesn’t mean you can navigate traffic safely. You need behind-the-wheel practice. For your child to translate hope into real change, they need to build skills for managing emotions, relationships and behavior in real-world situations.
A therapist’s job includes teaching pragmatic coping strategies in a step-by-step way while providing support. For example, your child may understand intellectually that standing up to peers requires assertive communication. But they need practice using “I statements,” firm but polite language, and responding confidently in difficult interactions.
Recovery requires learning new habits over time. An effective therapist acts as coach and cheerleader, encouraging skill-building practice until those behaviors come naturally. Specific exercises may draw from CBT, DBT or other theories, but again, no approach inherently outperforms others. The methodology matters less than the patient practicing and improving real, applicable skills.
How You Can Support Your Child’s Growth
As a parent, you play a pivotal role in your child’s recovery journey:
Your child’s improvement depends less on theory and more on motivation, trust and practice. You can provide the steadfast backbone of support they need to believe change is possible for them as they develop skills to translate insight into action. Keep the focus on helping them feel understood, capable (use their real examples not platitudes) and hopeful. With your help, they can find their way forward.
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Smith, M.L., Glass, G. V (1977) Meta-analysis of psychotherapy outcome studies. American Psychologist, 32, 752–760.
Imel, Z., Wampold, B. (2015) The Great Psychotherapy Debate: The Evidence for What Makes Psychotherapy Work (2nd Edition). New York. Routledge.