As I mentioned at the end of my last article, research has shown that the most important factor in predicting success in psychotherapy is the quality of the relationship between the therapist and the client. In therapist lingo, this is called the therapeutic alliance. The research found that this relationship is more important than how long the therapist had been practicing or what kind of training the therapist had.
Let’s talk about what this means. It does not mean that your therapist should be your best buddy or even that you must always like your therapist. It means that your overall relationship should be a good one.
This can be a tricky thing to know, especially since many people come to therapy because they find it difficult to have good relationships. For example, if you have a hard time relaxing around other people, it is unlikely that you will immediately feel relaxed with the therapist.
Here are some general guidelines for what to expect in your relationship with your therapist: *
- You are safe with the therapist.
- The therapist is genuinely concerned about your welfare.
- The therapist consistently tries to understand you, and generally succeeds.
- The therapist focuses on you, not on himself.
Let’s talk about each of these.
- Safety is very important. If you can’t convince yourself that the therapist is safe to be with and work with, no matter how hard you try, then it is unlikely that you will get much work done and you should probably look for another therapist. There are a (very) few exceptions. For example, if you were abused by your father and as a result don’t trust men, your female therapist could at some point suggest that you work with a male therapist that she knows is trustworthy to help with the healing process. But don’t force yourself to work with someone who scares you. **
- A caring therapist is very important. Keep in mind that different people show and/or feel caring in different ways. What matters is that you sense that the therapist cares.
- A therapist is constantly listening and trying to understand his or her clients. If you feel that your therapist never gets you, you might do better with someone else.
- Run, don’t walk, from a therapist who spends the whole session talking about himself. Some therapists have a more self-revealing style, telling stories from their own life to illustrate points, to educate, or to help the client feel more at ease. This is fine, but there should never be any question that the focus is on the client, not the therapist. If it seems to you that the therapist is more interested in himself than in you it is probably better to find another therapist.
(Exceptions: in the first session there are certain things the therapist tells you about his office policies, approach, etc. Also, you are entitled to know things about the therapist such as his education and training.)
* Caution: for each of these guidelines, there are some people who will not find any therapist who fits with them because of the issue(s) they are struggling with. For example, someone who feels misunderstood by everyone will probably also tend to feel misunderstood by their therapist.
** Additional safety note: sex between a psychotherapist and client is ALWAYS illegal and unethical.