Originally posted January 1, 2018.
When I was in therapy, I was always curious about what techniques were behind my therapists work. I read alot about different psychotherapeutic approaches. I wondered if she knew what was best for me, or should I try some other things?
I had these questions in mind when I began to study psychotherapy. Which therapies work best as there are alot of techniques out there! Which therapy approach would work best for my clients? How could I know what I studied was the best I could offer to my clients? And my clients ask me to differentiate between the therapies as well.
CBT, EMDR, DBT, EFT, CBT-I are just some of the alphabet soup names of therapies in use. Do any really work better than others? And every year several “new”techniques are developed and copyrighted, and more continuing education classes created.
During the beginning of my studies, I had the mistaken idea that magical techniques would help cure the client, and I would be a successful therapist if only I could just learn the right techniques.
However, as I studied in graduate school, I found that forty years of empirical research proves otherwise.
The evidence shows there are common factors which are conducive to successful client change in therapy. And the evidence shows those factors have little to do with specific techniques.
Research shows that the bulk of the change factors, 40%, are attributable to individual client factors such as ego strength and social support, and then a whopping 30% to the client’s positive experience of the therapeutic relationship with the therapist, 15% to expectancy and placebo effect, and only 15% to the unique technique. This means that the client has alot to do with the process of change. And that the 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.
So, I was taught this evidence-based research. But as a new therapist, I didn’t know what this actually meant in practice. I learned as many techniques as I could, to have as many tools in my toolbox as I needed to help my clients. I learned humanistic, expressive art, guided imagery, and cognitive behavioral techniques, etc. They are all helpful. It was a good foundation.
But as I gained experience in practicing 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.
So I noticed some people come in and stick with the therapy and over time, make profound and lasting changes in their lives and in how they feel. But then, others do not, or cannot, make these changes.
I have found that people who were able to glean help from the therapeutic relationship over a period of time, either had or developed these eight key skills:
REALISM: Being realistic about how therapy works, and understand it’s not a magic wand
CONTRIBUTION: Be realistic about yourself, and be willing to explore what you may be contributing to the situation
TAKE RESPONSIBILITY: Take responsibility for yourself, instead of blaming others
DEVELOP EMOTIONAL INTELLIGENCE: Be neither afraid of nor completely cut-off from your emotions, or be at least willing to expand your understanding about your emotions and then be willing to express (or learn to express) your emotions
DEVELOP HEALTHY THOUGHT PATTERNS: Be willing to re-evaluate your thinking patterns and work to create new thinking patterns
LEARN PRODUCTIVE COPING SKILLS: Be willing to learn how to cope with, or manage, personal emotions and thoughts
PRACTICE COPING SKILLS IN LIFE: Learn to actively apply coping skills in real time, in real situations
BECOME AN ACTIVE CREATOR OF YOUR LIFE: Take steps to identify, create plan to develop 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.
There’s always hope and it’s fascinating to me to see that the research indicates the process of change is facilitated by client factors and the strength of the therapeutic relationship. And that’s what plays out in my office, year after year.
May 2018 be the year you develop and pursue new dreams!