Psychotherapy: science, craft or art?
Ever since the emergence of modern psychotherapy, there has been a dispute around its scientific status (see Cook et al., 2017; Chrząstowski, 2019; Eysenck, 1952; Lambert, 1992; Rakowska, 2005). Are the psychotherapeutic theory and practice based, or should they be based, on scientific data, just like medicine (see evidence-based medicine)? Or is psychotherapy rather a set of practical skills which can be practiced like craft?
Perhaps the psychotherapist should only use their unique intuition and clinical experience while working with people and not subject themselves to the rigid criteria of scientific assessment, and psychotherapy is a form of art and each psychotherapist is an artist to an extent?
Trying to answer the above questions, we need to attempt to combine two issues that are difficult to combine at first glance. On the one hand, you need to take into account the criterion of scientific viability from the perspective of philosophy of science (Brzeziński, 2019). On the other hand, the theory- and research-based object of psychotherapy needs to be taken into account, as well as its non-homogeneity, interdisciplinarity and peculiar entanglement into many different disciplines of science – from philosophy, through psychiatry, psychology, sociology, culture studies, down to neurobiology even (Kratochvil, 2003). Simply speaking, sciences can be divided into formal (e.g. mathematics and logic) and empirical sciences, which are classified into natural (e.g. physics and biology), humanistic and social (e.g. philosophy and psychology). In such a perspective, psychotherapy can be classified under empirical studies, but some of its modalities are closer to natural sciences (see the cognitive-behavioural modality) or humanistic and social sciences (e.g. the humanistic-existential modality). This peculiar methodological split – that is manoeuvring between the methodology of natural sciences (see behaviourism, neopositivism), the methodology of humanistic and social sciences (see mentalism and phenomenology) and the contemporary integrative and transtheoretical takes – makes it more difficult to explicitly answer the question about the scientific status of psychotherapy. In addition to the above, sciences are also divided into pure and applied sciences. In this perspective, psychotherapy should be regarded as an applied science as most theories of schools of psychotherapy came to existence on the basis of practice.
In addition, the deepening division and the formation of even newer modalities and methods of psychotherapy (just to remind you – there are currently around 500 of them!) encouraged psychotherapists to seek similarities and start a creative dialogue between representatives of different schools, which resulted in tendencies towards integration in psychotherapy (Norcross and Goldfried, 2005). The integrative movement aims to create the possible most effective form of therapy for a specific group of clients, use of the best ideas and methods from different schools in a new theory and a new practical system of work (Grzesiuk and Suszek, 2010). In other words, instead of asking whether and how psychotherapy works, psychotherapists are focusing more on seeking answers to the question of what works and on whom.
To sum up, psychotherapy can be regarded as an interdisciplinary, applied, empirical science located between natural sciences and humanistic-social sciences (Prochaska and Norcross, 2018). Its research field cannot be brought down merely to the methodology of natural sciences as it is expanded by the world of internal experiences of clients, their emotions, search for meaning and other objectively immeasurable phenomena. However, psychotherapy cannot disregard the scientific approach, particularly the practices based on scientific data (evidence-based practice, i.e. EBP, Chrząstowski, 2019). Otherwise psychotherapy will change into a collection of pseudoscientific procedures of psychological support, harming both the clients and the social image of psychotherapy as such. Instead of closing themselves off in the premises of their own school, should exhibit a wider acceptance of this peculiar duality of psychotherapy and of the fact that pursuing their profession, they are to some extent scientists, craftsmen and artists all at the same time.
Brzeziński J. (2019). Metodologia badań psychologicznych [Methodology of psychological studies]. Warsaw: Polish Scientific Publishers PWN.
Chrząstowski S. (2019). Praktyka psychoterapeutyczna oparta na danych naukowych – za i przeciw [Psychotherapeutic practice based on scientific data – arguments for and against]. Psychoterapia, 189, pp. 45–57.
Cook S., Schwartz A., Kaslow N. (2017). Evidence-based psychotherapy: advantages and challenges. Neurotherapeutics, 14, 537-545.
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Norcross J., Goldfried M. (ed.) (2005). Oxford series in clinical psychology. Handbook of psychotherapy integration (issue 2.). Oxford University Press.
Prochaska J., Norcross J. (2018). Systems of Psychotherapy: A Transtheoretical Analysis. (issue 9). Wadsworth Publishing Company.
Rakowska J. (2005). Skuteczność psychoterapii [Effectiveness of psychotherapy] Warsaw: SCHOLAR Scientific Publishing House.