Initiating Positive Change in Therapy

Within the helping professions It is commonly but mistakenly supposed that results in therapy are attributable to a specific treatment choice. Mental health training stresses learning how to administer specific, empirically validated interventions. However it just isn’t possible to receive instruction in all the thousands of excellent intervention modalities available, especially when exciting new ones regularly come out. Some approaches have been favoured due to the sheer quantity of data supporting their validity; in particular Cognitive Behaviour Therapy (CBT) and Interpersonal Process Therapy (IPT) are prime examples. The decades’ of therapy outcome research concludes that all therapy does actually work, but the evidence of one modality’s superiority over another is unclear. Indeed, a review of psychotherapy outcome studies announced the famous “dodo-bird outcome” adapted from Alice in Wonderland: “Everyone has won and all must have prizes” (Luborsky et al., 1985). A more convincing explanation, based on a wide-ranging review of the research since 1970, is that within all positive change there are four common factors, which if present, guarantee successful outcomes (Hubble et al.,1999). Here are the descriptions of these common factors: Client Factors (40%) By far the most important catalysts of change are client factors and these make up 40% of the variance observed in successful therapeutic outcomes. These factors are the strengths and resources that clients bring into treatment. These resources can be visceral, spiritual, instrumental, social or psychological, such as good health, friends and a sense of humour. Successful outcomes in therapy are guaranteed when a therapist is able to engage, develop and extend their clients’ copious positive features. Clients are often surprised when they become aware how resourced they actually are and benefit from having their focus redirected in the direction of their abilities and away from their failures. Therapeutic Relationship (30%) A good therapeutic relationship, where clients feel supported, understood and respected accounts for at least 30% of the variance in the change observed. The medical counterpart is having a good “bedside manner”. A first-rate therapeutic relationship has the following qualities: => The therapist’s aptitude for compassion, caring and empathy => Loving and liking the client => Mutual positive regard between therapist and client => How much the therapist can support the client to take risks and acquire mastery => Enhancing the client’s ability for self-responsibility => A focus on teamwork as opposed to giving advice. Placebo or Expectancy (15%) Change also to occura because clients expect it to and this can explain 15% of the observed change. If clients observe their therapist to be an experienced, proficient and trustworthy individual then they are more likely to expect positive change to happen in themselves. Model or Technique (15%) The exact type of intervention only depicts 15% of the observed change, yet despite this finding, they are typically emphasised above all else in university education. As a result, there are many professionals who become technicians, using manuals to treat clients-by-numbers rather than confront the complex and unique whole individual. Competence in particular intervention modalities does not guarantee that therapists are able to tap into the four common factors, thus their ability to facilitate deep change will be limited. Alternatively if the four common factors are successfully included into therapy, the outcomes are bound to be favourable. When you are looking for a therapist, make sure they demonstrate the following traits: attunement to you and the ability to tell you the truth, kindness, compassion, intelligence and experience. It is also indispensable that you like each other! ReferencesrnHubble, M. A., Duncan, B. L., & Miller, S. D. (1999). The Heart And Soul Of Change: What Works In Therapy. Washington, DC: APArnLuborsky, Singer & Luborsky. (1985). Therapist success and its determinants. Archives of General Psychiatry, 42, 602 – 611.