For those thinking about therapy for the first time, it can be a very anxiety-provoking thought. After all, you're expected to share your innermost thoughts and difficulties with a stranger sitting in front of you. Here, a common question I hear is, "How do I find the right therapist for me?"
At its core, therapy is a safe space for you to explore your thoughts, feelings, and behaviours. But more than that, we want therapy to be effective, helping you move closer to your goals - whether that's becoming more confident in setting boundaries with family or at work, quieting crippling self-doubts and regrets, or becoming a more assured, grounded version of yourself.
To answer this question, research in the field highlights something known as Common Factors1.
These are elements that contribute to the effectiveness of therapy, regardless of the specific therapeutic approach used. The most widely recognised factors include the therapeutic relationship, therapist empathy, clients' expectations (otherwise known as the hope effect), clients' motivation, specific therapeutic techniques, etc. But here, I'll focus on the first Common Factor, without which therapy cannot be effective: the Therapeutic Relationship.
More than 10 years ago, I began my career as a Counsellor at a Residential Home. Young, idealistic, and faced with the challenge of hardened teenagers who did not want to be counselled, I had no idea where to begin and buried my head into the Therapy books. My mentor at the time told me, Forget the books for the first three months and go spend time with the youths. If you don't have a relationship with them, you can forget about therapy. Armed with her words, I gave myself permission to just be. In those three months, they taught me basketball, skateboarding, soccer, and many more. With each fall and bruise, I unwittingly eased myself into their fabric of their lives and they slowly began to trust me. And that's where the work began.
Before therapy can work, an initial therapeutic relationship must be established. It may not take any skateboarding this time (bless my elbows and knees!), but fundamental questions like, "Can i trust her/him?", "Can she/him help me?", "Is this more than a job for her/him (i.e., will she/he take the time and effort to understand me, and the issues I am facing?") needs to be answered. By the end of the first hour, you will likely have a sense of the answers to these questions. For this reason, I usually tell my own clients to not rush into deciding whether to continue the sessions with me. While you don't need to feel like your therapist is your best friend, but at the very least, you should feel that they are not being judged, that there is genuine care, and have hope that things will get better - even from the very first session.
As Gelso (2014) puts it, "The real relationship between therapist and client marked by the extent to which each is genuine with the other, and perceives/experiences the other in ways that befit the other"2
If, and only if, the therapeutic relationship is established, then the real work of therapy begins.
1 Wampold, B. E. (2015). How important are the common factors in psychotherapy? An update. World Psychiatry, 14(3), 270-77.
2 Gelso, C. (2014). A tripartite model of the therapeutic relationship: theory, research, and practice. Psychotherapy Research, 24, 117-31.
Comments