From: Professor Adrian Furnham of University College, London

All Interventions are Equally Effective

Doctors call them placebo-effects while psychologists call them non-specific effects. In education they are called the inspirational teacher effect. But the news has not got through to the business world. And too many consultants want to keep it that way.

This is the story. When trying to determine the efficacy of a treatment or course it is important to distinguish between two different factors. The first are called direct specific effects. That means the type of treatment. For the medic it may be quite different drugs or methods of treating the same problem. For the psychologist it may be using a Freudian psychoanalytic versus a cognitive behaviour therapy approach to a phobic or depressed patient. For the teacher it may be trying to teach the same topic in seminars versus lectures, or by case studies versus principles.

And for the business person it means using quite varied techniques like quality circles or 360o feedback to managers, or introducing self-directing, empowered teams to solve similar problems in productivity.

Specific effects are observed when different medicines, treatments, courses, interventions have quite different effects. People become zealous proselytisers of their method. They become believers in their theory, therapy and application, believing only it works best.

But there are also non-specific effects in medicine, therapy, education and business. Non-specific effects arise as a result of the intervention, whatever form that happened to take. They are sometimes called the therapist effect, though they could equally be called the consultant effect. They are also sometimes called the allegiance effect.

What this means is that the relationship with the therapist, teacher, consultant is a powerful force in the ultimate efficacy of the outcome. They help by giving the client positive expectations. They help by making them focus on their problems. They help by giving considerable support (social, emotional, informational). And they help by getting involved in shared goals and activities.

What studies of psycho-therapy have revealed seems contradictory at first. It is that all therapies are equally effective (the specific effects are trivial). But the non-specific effects account for success. That is, it is not what is done, but who does it and how.

Consider the four factors shown to be powerful predictors of psychotherapy success. And ponder whether this is exactly what happens in consultant-client relationships. First, a positive but emotionally charged, confiding relationship with a helping persona. That is, the relationship is powerful, close and affective, leading to some sort of bond. Next, the setting is one of renewal, change, healing, novelty. Third, that the consultant provides a theory, an explanation (even a myth) that describes both how problems arose in the first place and how to cure or resolve them. This is, of course, the magic bullet..which is the non-effective specific effect. But it is the belief in the efficacy of the effect rather than the effect itself which is the powerful ingredient.

Lastly, the consultant needs to endorse, demand or even take part in a ritual, rite or procedure with the client that is (supposedly) believed by both to be efficacious. The more psychobabbly the gobbledegook the better. But the ritual, whatever it is, has to fit the zeitgeist.

The scientific literature on psychotherapy shows two things, both fairly indigestible to many in the business. First, that the training of people makes very little difference to their efficacy and patient outcomes. This in effect means you have it or you haven't and training does not instil it. Next that the therapist is more important than the therapy. The intervener is more important than the intervention. The consultant, more important than the change process.

What all this means is well known to insightful managers and good consultants. Success is a matter of relationships. The inspirational teacher is inspirational, irrespective of the topic or subject of that inspiration. Whatever one might believe or want to believe about the power of a particular strategy to effect change and benefits in an organisations, it is the case that most work or don't work equally well.

There are no magic bullets but there are magic marksmen. Choose your consultant with care. It is your relationship with them and their skill, charisma and charm that really does the business.

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