What is Successful Therapy?

Not all therapy is the same.

What does therapy look like? When I ask people who have never been to therapy before this question, they tell me they picture themselves lying on a reclining chair, rambling about whatever comes to mind or “free associating” with the psychologist out of view behind them, jotting down notes. Although that chair seems extremely comfortable, oftentimes therapy sessions don’t look like this. In fact, therapy can be challenging and even uncomfortable.

Therapy is about changing a mindset - a pattern you’ve had for years and finally realizing that it is not adaptive anymore. Therapy is deciding that it’s time for a change.

“A comfort zone is a beautiful place but Nothing ever grows there.”

There are 3 crucial components that make therapy successful.

1. Relates to the client and psychologist -One of the most important things is having a good psychologist and client relationship. What is “good?” For many, it means having “good” rapport. Client needs to feel they can trust the therapist, and feel like they are not judged, but rather understood. Honest conversations are important, but it is done with empathy and respect. It is this relationship with your psychologist that is foundational in therapy. If clients feel that they cannot connect with the psychologist (after some effort) it might be time to find one they can.

2. Relates to the psychologist - Therapy is not just about passing time, and talking about your day. It may involve some small talk as this is necessary to build rapport, but therapy should have concrete, realistic, and specific goals. Psychologists are not viewed as friends; they are not connected to their clients’ social world and therefore can provide objective perspectives and limited bias. Importantly, psychologists should be trained and experts in an evidence-based therapeutic modality. Evidenced-based therapy includes Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy, Acceptance and Commitment Therapy, etc. “Evidenced-based” essentially means the research supports this type of treatment. CBT, a type of therapy that identifies maladaptive thought patterns for example, has been tested in several empirical studies and has been proven to help and improve the mood of those suffering from depression and anxiety among other mental health conditions. Although anecdotal information like your neighbor saying this herb can “cure” your PTSD may be helpful for some, I recommend people approach “cures” that have not been extensively studied with caution, and always have some healthy skepticism. What research tells you is out of hundreds of people who have attempted this specific treatment, a great deal of them saw improvement.

3. Relates to the client - The client needs to be motivated to change. Oftentimes, psychologists see people dragged into office by their parents, spouse, friend, etc. but these people may not necessarily be aware that there is a problem. Change cannot happen without awareness, but it goes a step further than that. Change cannot happen if there is no motivation. Clients need to put in the work to see change. This means not only actively learning the skills in therapy, but also applying and making an effort to utilize them in their day-to-day lives. Having depression can certainly make it even more challenging to be motivated, but that is what the psychologist is there for - to help gain insight and provide support to make a meaningful difference in their lives.