What makes therapy successful?

A very hard question which I doubt has a “one size fits all” answer. In my case there were a number of factors:

(1) Finding a clinical psychologist with whom I had rapport.

(2) Discovering, through trial-and-error, the therapeutic modalities which worked best for me. In my case they were Cognitive Behavioural Therapy (CBT) as well as Acceptance and Commitment Therapy (ACT). Other people may find other approaches more helpful.

(3) My hard work.

Good luck!

Client Factors (40%)

Client factors are the most influential force for change in psychotherapy, which make up approximately 40% of improvement. The personal strengths and resources that clients bring into treatment have a large impact on treatment outcome. These resources include a range of internal and external factors. For example a keen sense of humour and intelligence can be just as helpful as a supportive network of friends. Successful outcomes in therapy are increased when a therapist is able to engage, expand and extend their clients’ plentiful positive features. Clients are often surprised when they realise how resourced they actually are and benefit from having their focus redirected towards utilising their own abilities and rather than focusing on their failures.

Therapeutic Relationship (30%)
At least 30% of all change is accounted for by therapists’ capacity to develop a strong, positive connection with their clients. Research indicates that the below characteristics influence the success of the therapeutic relationship:- Therapist competence for empathy, compassion and caring
- Positive regard towards the client
- How much Mutual affirmation there is between therapist and client
- How much the therapist can promote the client to take risks and increase mastery
- Whether the therapist can facilitatie self-responsibility
- Active collaboration between client and therapist (working as a team)

Placebo or Expectancy (15%)

Interestingly, approximately 15% of the change happens because a client expects it to. Clients who believe their therapist to be trustworthy, competent and experienced are more likely to show positive change.

Model or Technique (15%)

The exact type of intervention or therapeutic approach only explains 15% of the observed change. Therapy is determined to succeed if all four common factors are integrated to their fullest potential during sessions.

Qualities to look for in a therapist are: the ability to attune to you and tell you the truth, kindness, compassion, wisdom, intelligence and experience. It is also vitally important that you like each other and that you see benefit in the therapeutic approach they use. See the first few sessions as a time to explore whether your therapist and their approach are the right fit for you. 

I think when you can take support and insight from the therapist you need to find a good match. The therapist also needs to meet the client where they are at and not push them into a direction that the therapist might want them to go. If you meet them with warmth, curiosity and openness the client can relax into the relationship, and explain more about where they are at with themselves.

When a relationship with the therapist and the client develops it can become such a safe haven for the client. They can move around and explore all aspects of themselves. If the therapist is truly open and compassionate then the client will become more curious and open, and compassionate with themselves.
They become not so critical with themselves, and not so judgmental with themselves. They do not have such high expectations of themselves. The more you discover and become who you are, the more changes will actually happen. It is about accepting new parts about yourself and blossoming can then occur.

What makes therapy really successful is cooperation between the therapist and the client. That means that if the client is quite motivated and you as the therapist are fairly knowledgeable and experienced on the subject, you are likely to work together well.

Quite often the client is actually sent by a third party like a GP or a family member. In which case they do come and visit, but unless you engage them, they are not likely to stay. They might drop out at the first opportunity. So in the case of a client like this, you try to encourage them, to show them or to help them identify the benefits they could gain from therapy. So it would be goal-focused, what they would like to change in their lives, what does not work, and what they wish to gain.

It is cooperation between the helping professional and the sufferer. I have noticed that what works is dealing with the ongoing problems of living that is then being stuck on gaining insight about the past events. The past is very important in terms of taking a detailed history and dealing with some unfinished business and incomplete. It is necessary to bring it to the issues of life as it happens, the current life