The question is not “Does Therapy Work?”, but for whom, when, why and how does it work? The “how” we’ll address in the next section.
We have an encyclopedic wealth of research findings about the efficacy of psychotherapy. First, for whom is therapy most likely to work? Some key characteristics of these clients are:
- Proactively seeking therapy and being personally invested in it, rather than being “forced” into it, e.g. court-ordered therapy, or “my girlfriend is making me”
- Client “readiness to change”, signaling a form of commitment to oneself and/or another
- Client’s active participation and effort/engagement and involvement
- Client’s perseverance and patience with the therapy process
- Client’s depth of emotional experiencing in sessions/capacity to feel emotions, rather than objectively narrating
- Willingness to take risks and face fears, e.g. talking about unpleasant things rather than avoiding them
- The nature of the client’s social network/support system
- The severity, chronicity, and type of symptom – the pervasiveness or activity of it
If this list seems daunting, it might reassure you to learn that most clients coming in for outpatient psychotherapy already possess these qualities! By definition, “outpatient therapy” is usually voluntary; as such, motivation level is high, and the preceding client variables are built into that existing motivation. If a client does not have one or more of the above characteristics, it is the therapist’s responsibility to help you cultivate it – this becomes part of therapy and an experienced therapist will help you “grow into your own” as a client, so that you achieve your goals.