Great interview with dr. Bruce Wampold by dr. Scott Miller. Brief summary:
Psychotherapy is incredibly effective - often better than giving clients medication for mental disorders.
However, the field of psychotherapy has not significantly improved its outcome effectiveness in decades, even though vast efforts have been put into comparing different treatment modalities (e.g. CBT, psychodynamic, ACT, EFT, etc.)
What doesn’t seem to help the client:
Medicalizing talk therapy (i.e. protocol focused rather than person focused, focusing on which modality fits best, focusing on the diagnostic label)
Coming up with new buzzwords/topics that change every so often, which do have deep value, but often don’t massively change the actual work (e.g. evidence based, trauma, attachment, neuroscience focused, etc.).
Seeing therapists and clients as commodities (any therapist or layperson who can follow a manual will do + clients seen as a number by some institutions)
What does help:
Focus on the relationship between client & therapist AND have a treatment plan and goal.
Enhace interpersonal skills of the therapist when faced with challenging emotions of the client (social skills alone do not predict better therapy outcome).
A good therapist is flexible to meet the needs of the client, adapting your treatment approach where necessary.
Deliberate practice (see previous blog post)
Moreover, what preventative and systemic measures could be taken to avoid mental health problems getting out of hand? This is a broader societal context that therapists often rather not touch as it's too complex and uncomfortable, with no clear answers, imho.