Author: Alex Kohn, M.A.
Mental health care is multifaceted and may include different modalities of therapy, medication management, support groups, or educational groups. Individual therapy is one form of mental health care that many people have questions about. Is all therapy the same? Will therapy help me? How do I find a therapist? If you yourself have not engaged with therapy, you likely have friends, family members, or acquaintances who have attended therapy. You have likely heard stories about therapy successes, therapy not going so well, or something in between. What exactly are the components involved that make therapy work? Psychologists have conducted decades of research examining treatment components and the mechanisms of change in therapy. The points below detail some of the most important ingredients of therapy:
• Therapeutic Alliance – The therapeutic alliance refers to the relationship between the therapist and client. A strong rapport between therapist and client provides the basis for therapeutic work to be carried out and for positive treatment outcomes. Effective communication, conflict resolution, collaboration, and general interpersonal skills can be modeled within the therapeutic alliance. If you find you do not have a great connection with your therapist or do not feel supported in the therapeutic space, don’t hesitate to bring this up with your therapist or have consultations with different therapists. It may take a couple of tries with different therapists to find the one with whom you’d like to continue working!
• Client Expectations and Motivation – In any given therapy experience, clients will come in with different expectations and motivation for treatment. Some clients may not believe therapy will be helpful, others may have limited beliefs in their own ability to make desired changes. Motivation in therapy can refer to a client’s effort for engaging in therapy sessions or home practice between sessions (i.e., therapy homework). Motivation may also include a client’s belief in their ability to make changes, or their belief that therapy will facilitate change. Researchers have highlighted how intrinsic motivation for change as well as client engagement in the therapeutic process are integral components of successful therapy; these elements have been shown to be associated with greater improvement from therapy.
• Generalization of Skills – In outpatient individual therapy it is common for clients to have sessions with their therapist once a week for about 50 minutes. Clients put in a significant amount of work during therapy sessions. However, engaging in therapeutic work once a week for 50 minutes and not doing anything differently outside of session will likely not yield the most benefits. Generalization of skills used in session to situations outside of sessions is an important part of why therapy works, and studies have shown that some therapies that include intentional practice of skills outside of sessions produce superior treatment effects to those that do not.
• Specific Factors – For some clinical presentations, therapeutic interventions involve specific treatment components. For example, there are evidence-based practices that look different for depressive symptoms versus symptoms of obsessive-compulsive disorder.
For more information, check out the American Psychological Association’s webpage on therapy. Here you can find further information related to why therapy works, different therapy approaches, and how to find a therapist: https://www.apa.org/topics/psychotherapy
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