What makes counseling work?

I often get calls from potential clients who ask what my “style” is or “method” of counseling.  They ask what “type of issues” I have experience treating in order to determine if I can help them or a family member.  While it can be reassuring to feel like a potential therapist might have experience treating a concern similar to theirs, it doesn’t necessarily mean they won’t be effective.

In 2001 the Journal of Psychotherapy determined that a “strong therapeutic alliance more closely aligned with positive outcomes than any specific intervention”.  This means that the relationship a client has with the therapist will elicit more success than any trendy tip or trick.

What makes a good therapeutic alliance?  Things to look for include:

1) agreement about goals and outcomes

2) collaboration on what steps will be necessary to see movement toward these goals

3) emotional connectedness

Clients often have a tendency to come into my office and report on all the “bad stuff” that has been happening. They feel like this is what they are supposed to be talking about and forget to address what has been going right in their lives.   I usually try to get a client to reflect on the positive things that have occurred to highlight what all their effort has accomplished.  As a therapist, I strive to avoid being seen as the advice giver.  It is difficult since most people come to see me because they feel they are all out of options.  If I can focus on just listening and accepting their feelings in a non-judgmental manner; showing them I am not afraid of joining with them, a marvelous thing starts to happen.  Client’s open up and options begin to develop.

What happens if things are not changing?                  

If therapy begins to feel like it is not helpful;  it might be time to determine if everyone is still on the same page.  Is everyone still heading for the same goal?  If so, check the pace of the counseling.  It could be that too much is happening too quickly to actually adjust.  A client should always be in control and allowed to navigate these areas.

What about when a client doesn’t want to participate?

When I meet resistance from a client, especially a child, I often try to partner with them in understanding that they don’t want to be here.  I often ask what we can work on since they have to be here anyway; which allows the client to make the first move but removes the need to resist another person telling them what to do.  If things don’t progress after several attempts, it may be time to look into other options and address that the client is not ready for counseling.  Trying to make something happen when there is overwhelming resistance only ends up making everyone frustrated.

 

Stephanie Phillips, LPC, NCC, CCTP