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Eight Keys to Recovery Success in Therapy Plus the (not so) Secret Ingredient

Originally posted April 23, 2013.

As a practicing professional counselor, I want to positively share what I’ve noticed over the years what the conditions are for positive change in therapy.

When I began studying psychotherapy, I was confused by the abundance of techniques out there (I think the public is confused by all the techniques out there, too.). Every year a “new” technique is developed, copyrighted, books are written, continuing education classes created and supervisors in the specialty charge other therapists to learn from them.

With all this marketing, when I was a student, I had the mistaken idea that magical techniques would help cure the client, and I would be a successful therapist if only I could learn the right techniques.

But may I first share with you the research evidence about what works in therapy?

As I studied in graduate school, I was taught the results of forty years of empirical research proves otherwise.

The evidence is: there are common factors in therapy which are conducive to successful client change. And that evidence shows those factors have little to do with specific techniques.

Research shows that 40%, the bulk of the change factors, are attributable to individual client factors such as ego strength and social support, 30% to the client’s positive experience of the therapeutic relationship with the therapist, 15% to expectancy and placebo effect, and lastly, 15% to the unique technique.

This means that a therapist, as long as s/he is trained properly, can safely use an integrative variety of techniques in practice, and one is not necessarily better than another, to facilitate change.

Well, you know, I was taught this evidence. As a new therapist, I wasn’t sure what this meant in practice. So, I gathered as many techniques as I could, went to a lot of classes, to have as many tools in my toolbox as I needed to help my clients. I learned Gottman, interpersonal, expressive art, EMDR, guided imagery, cognitive behavioral techniques, object relations, etc. They are all helpful. It was a good foundation. .

But as I practiced therapy, I noticed something. I met all sorts of different people, people with all sorts of stories, all wanting to feel better.

Each person with his or her own unique story. Each person feeling angry, anxious, depressed, grieving, narcissistic, controlling, dependent.

Or coming in for therapy because the person s/he married turned out to be physically, financially or emotionally (or all three) abusive. Or maybe s/he was raped when young, raped as an adult, beaten when young, or grew up in an alcoholic home. So many different reasons to seek therapy.

Over the years, in clinical practice, I noticed some processes that might help people help themselves feel better and get better:

  1. REALISM: Be realistic about how therapy works, and realize it takes commitment and time to enact change

  2. CONTRIBUTION: Be realistic about yourself, be willing to look at yourself and be willing to explore what you may be contributing to the situation

  3. TAKE RESPONSIBILITY: Be willing to take responsibility for yourself, instead of blaming others

  4. DEVELOP EMOTIONAL INTELLIGENCE: Be neither afraid of nor completely cut-off from your emotions, or at least be willing to expand your understanding about your emotions and then be willing to express (or learn to express) your emotions

  5. DEVELOP HEALTHY THOUGHT PATTERNS: Be willing to re-evaluate your thinking patterns and work to create new thinking patterns

  6. LEARN PRODUCTIVE COPING SKILLS: Be willing to learn how to cope with, or manage, personal emotions and thoughts

  7. PRACTICE COPING SKILLS IN LIFE: Learn to actively apply coping skills in real situations

  8. BECOME AN ACTIVE CREATOR OF YOUR LIFE: Take steps to identify, create and live out realistic dreams

And the bonus key here is this.

Make sure you feel comfortable and safe with your therapist, and that you can trust him or her to consistently behave in a professional manner. The strength of the therapeutic relationship, that is, the client’s ability to feel accepted by and comfortable with, the therapist, creates a safe container for your process of growth.

And your process is not a straight line. Usually your trust and the bond builds over time. Makes sure your therapist earns your trust by being consistent, caring, professional and knowledgeable.

So , it is interesting. The research indicates the process of change is facilitated by client factors and the strength of the therapeutic relationship. And that is what plays out in my office, year after year.

Good luck to you in pursuing your dreams!


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