therapist Options

Researchers call it the "therapist effect," and do their best to control for it in experiments so that their knowledge about the effectiveness of various psychotherapy procedures won't be contaminated. So they set up randomized clinical trials where the treatment providers must rigidly adhere to a step-by-step, manualized treatment approach. And even under these conditions, the most effective therapists achieve positive results twice as often as the least effective therapists using the exact same techniques.

Beyond this simple fact-- that some therapists just seem to be better than others-- little is known. We don't yet have a scientific understanding of what makes a therapist better or worse. We need to design studies that tease apart the effects of various types of behaviors, language, and attitudes that lead to one particular therapist being more effective than another. Being a psychotherapist myself, my line of thinking has always been that I should figure out how to be the most effective at it that I can possibly be.

I'm definitely not the first one to think of it that way. Back in the 70s a mathematician named Bandler and a linguist named Grinder analyzed videos of some of the most universally recognized masters of psychotherapy in the United States-- Fritz Perls, Virginia Satir, and Milton Erickson. The result of their work was a new type of streamlined therapy that they called "neuro-linguistic programming," or NLP. Forty years later, NLP is considered to have poor research support (although the research has generally been very flawed,) but remains in use by many practitioners because it does actually tend to work very well in practice.

Regardless, to me the most important part is not the outcome of that work but the principle behind it: we should be intensely examining therapeutic successes and failures to find out what elements really distinguish the two. As get more info I explained in a recent article, the therapeutic relationship is one of the most reliable common factors in determining whether a course of psychotherapy will be successful. Therefore, we can reasonably surmise that therapists who are more skillful at building those types of relationships-- by establishing trust, rapport, authority, comfort, alliance, etc-- will likly be more effective in general.

I suspect that personal flexibility and creativity are also underestimated factors in therapeutic effectiveness. Because in order to develop a trusting relationship with a good working alliance, the therapist must be able to understand the client's condition somewhat better than the client does-- since most people feel confused about their psychological condition when they seek therapy.

As a therapist, this requires an ability to step outside of your own preconceptions about the way the world works, and the way people work. In addition to establishing this type of empathy, the therapist must also be able to generate alternative belief systems which are logical and acceptable "next steps" for the client. In other words, the successful psychotherapist must build an empathic bridge toward a new worldview.

These include LMFT (licensed marriage and family therapist), LCMFT (licensed clinical marriage and family therapist), LSCSW (licensed specialist clinical social worker), LMLP (licensed master level psychologist), or LPC (licensed professional counselor).

All of this research may seem like a hassle, but choosing the best therapist for you is imperative, because once you get started with a therapist, you will find it more of a hassle to start all over and repeat your story to someone new if the first one doesn't work out.

After finding the therapist who is right for you, psychotherapy can be an opportunity to face the crises of life and convert them to opportunities for personal growth and family renewal. And even under these conditions, the most effective therapists achieve positive results twice as often as the least effective therapists using the exact same techniques.

We need to design studies that tease apart the effects of various types of behaviors, language, and attitudes that lead to one particular therapist being more effective than another.