Is Therapy Helpful? Why? How?

Understanding Theories

Psychotherapy is about helping people grow and change.  When clients come for help, therapists gather information and make decisions about how to intervene or proceed to best helping clients to make the changes they seek by using theories to organize and simplify the information clients share. A therapists’ theory is a kind of map and includes knowledge of human development.  The theory leads to the type of techniques and tools a therapist may use, though some draw from other theories when it fits.  A theory should fit with the way a therapist views mental health, but also fit the client issue and personality, as well as their resources.  Overall, the theory is not as important as a good fit with the therapist. 

Is Therapy Effective?

Research consistently suggests the effectiveness of therapy with between 75% and 80% of clients benefitting after 10 to 20 sessions, with lasting benefits.
What makes therapy effective?  Outcomes depend largely on how effective the therapist is using what is called “Common Factors”.  That is, factors common to all therapeutic approaches.  It is about their ability to develop a good therapeutic alliance, with real and genuine empathy, as well as both the clients’ and the therapist’s positive expectations for change, and the hope that clients experience at the beginning of therapy.  Clients need to feel heard, understood, accepted and hopeful for therapy to be effective.

Clients themselves actually attribute 40% of the change they experience in therapy to external factors such as their own resources or supports and opportunities.  About 30% of outcomes are tied to the therapist–client relationship, and only 15% to techniques.
Though differences in positive outcomes of therapy from different theoretical approaches are not strong, the approach still should fit a clients’ needs.  The therapeutic alliance is of great importance but the tools they use may be in part responsible for the development of the therapeutic alliance.  The therapist’s confidence and competence in their method influences their ability to create hope and positive expectations. These factors are inter-related.  Overall, the methods should be a good fit for the therapist and the client.

Common Factors

A common set of variables are important, regardless of the differences in approach.
Some of the factors that are important towards effective therapy outcomes are:

• A therapy relationship of trust, genuine compassion, emotional safety, positive regard for the client, support for autonomy, empowerment, spirit of collaboration.
• A shared understanding of the nature of the problem or concerns.
• Clear goals and therapy plans.   
• An understanding of what interventions are being used and how they will help a person make progress on their goals.
• A belief in clients’ ability to create change/positive expectations.
• Understanding of client motivation and resources or challenges.
• Client willingness and readiness to do the work needed.
• Openness to feedback.

Effective Therapists

The quality of the therapy relationship is the most important aspect of the therapy process. A therapist should be friendly, patient, warm and genuine.  They should be able to make appropriate and helpful self disclosures not sharing distracting stories because of over-relating. They should be encouraging, honest, and flexible with respect for differences without losing sight of what they believe to be healthy, based on in-depth knowledge of human development and wellbeing.  They should be ethical, objective and fair with good communication skills that demonstrate enthusiasm and hope. Good therapists are self aware, up to date on relevant issues and research, dedicated to life-long learning, aware of their own limitations and open to feedback from clients.

How to Get Started

Sometimes clients are unclear about their goals.  That is ok.  It can take time to feel safe, heard and understood about what feels “wrong” and what the problems really are, before deciding what change would look like.  Still, it is important to collaborate and come up with somewhat measurable goals in order to be able to track if therapy is helping.  It is important to feel safe to ask questions and to give feedback to the therapist about client experience.  Therapists are usually very well intentioned but not always effective at judging if the rapport is intact, or when there has been a rupture.  Clients can feel just a little bit less understood one day and not return to therapy.  At our clinic we value feedback and understand the importance of effective alliance building skills.  Our therapists possess the personal qualities that make for effective therapy.  We make it our ethical obligation to try to fit the client to the therapist and prefer to refer to another practice if we cannot meet the needs of a client rather than keeping them with us.  Feel free to reach out by email, clicking here for a consultation about which therapist could best fit your needs.