As a clinical psychologist and educator, I am often asked to recommend a psychotherapist for people in need. These requests come with a sense of urgency to find the best possible therapist. Many people are at a loss over what to look for.
Here I offer an answer, not just to the question of what makes for a great therapist, but what else helps make therapy work. Decades of research on what improves psychotherapy outcomes yields surprising answers.
Curiously, some things that could matter a lot don’t. These include the therapist’s experience, gender, profession or graduate degree, and even the school of therapy practised. In fact, differences among therapists account for only five per cent of the variability in treatment outcomes.
Of course, five per cent is not nothing and I’ll come back to what makes up these therapist differences. However, it is clear we need to look elsewhere to discover what else makes therapy work.
Be willing to endure discomfort
First, it’s important to know that, in general, psychotherapy is highly effective. Across a wide range of psychological problems and many different types of people, therapy simply works.
For some, the benefits of therapy can be obtained in as few as seven sessions, while others need more to improve. Considering that many untreated problems last for years, or even a lifetime, psychotherapy can be life-changing.
If the particular therapist and type of therapy received are not as important as we thought, who or what does influence outcome?
To a large extent it’s the client. The quality of a patient’s participation in therapy is a key determinant of the outcome.
Understanding how clients make therapy work requires a drastic overhaul of the assumption that they passively respond to the ministrations of guru-like therapists. On the contrary, it is clients’ active participation in therapy through their involvement, learning and application of what they learn that leads to improvement.
For this to occur, it helps if clients are open to exploring their emotions and internal experiences and are willing to endure discomfort and make efforts to achieve change. This requires motivation; enhancing motivation prior to therapy improves outcomes.
Therapist as dance partner
Clients undergoing in-person therapy don’t do this work on their own but in collaboration with their therapist. The quality of this collaborative relationship is in itself an enormously important contributor to good therapy outcomes.
In a good collaboration, both therapist and client work at maintaining a positive relationship and need to continuously respond and adjust to the other, much like dance partners working in synchrony do.
As it turns out, good therapists (I said I’d come back to this) are attentive to building just such a positive alliance and repairing it as needed. They are good at being responsive to clients’ evolving needs and wishes in treatment.
Finding a good therapist then becomes a matter of finding someone who listens well, empathizes, is responsive and can empower the client with hope and bravery to do the difficult work ahead.
Here’s why Trump contradicted his own White House on the Supreme Court rulings
Following the Supreme Court's pair of 7-2 decisions rejecting President Donald Trump's claim to have absolute immunity from subpoenas, he blasted the ruling on Twitter, claiming he being unfairly targeted and the victim of "prosecutorial misconduct." However, White House Press Secretary Kayleigh McEnany released a statement saying that "President Trump is gratified by today’s decision."
‘They deserve it’: Republican strategist tells GOP it’s their own fault for going down with Trump because ‘they know better’
Republican strategist Susan del Percio said that there is no excuse for GOP members who failed to do the right thing and fight back against President Donald Trump when they had the opportunity.
Speaking to MSNBC's Joy Reid Thursday, del Percio called Trump "the anchor" around the GOP's necks, "dragging them down."
"But, you know what, they deserve it," she continued. "There are Republicans out there that deserve this because they know better. They should have been better on impeachment. They should have been holding him accountable all along. Now they are scared and worried about themselves. Well, boohoo, you brought it on. there's no excuse."
‘The monarch has taken a body blow’: Ex-prosecutor explains why Court ruling is devastating for Trump
On MSNBC Thursday, former federal prosecutor John Flannery broke down the implications of the Supreme Court's ruling against President Donald Trump on immunity from subpoenas.
"I think what it says is that the monarch has taken a body blow as a result of what will be an historic decision, as we've indicated," said Flannery. "I think that the position of the DA in New York is very special, because he can speed this up in a way that the House can',t and has a specific strength, I think, in this case, that it is criminal."
"The most significant thing about it is this is the first Supreme Court case in which there's ever been agreed that a prosecutor could subpoena a president," added Flannery. "Prior prosecutions have been federal, that have been treated by the Supreme Court. So this is a big difference. The majority of the court, 7-2, basically said, from 1740 on, the public is entitled to the testimony, to the evidence of any person. They said that the documents — the question is the character documents, not the character of the person. In this case, what we have is a situation which I bet that the DA is going to go to the court as soon as possible, move to compel an appearance to their subpoena, and going to have the discussion as to what if anything may be limited or excluded and get production as quickly as possible."