The effectiveness of counselling (also known as “success determinants”) depends largely upon the therapeutic relationship you are able to obtain with the counsellor / psychologist. In layman’s terms that often boils down to trust, personality and similar life experiences that may dictate how well you relate to each other. It is the reason some therapists like me choose to specialise (see About and why I became a counsellor) to give you the best chance of success.
The Therapeutic Relationship This was made clear by the work of Lambert that has been repeated and validated since first proposed.
There is an excellent video on how to interpret these factor by Talk-Works Psychotherapy (where the diagram has been taken and it is only 2 minutes long) but briefly:
- Techniques and model factors relate to CBT (Cognitive Behavioural Therapy), ACT (Acceptance and Commitment Therapy) and many other tools counsellors have in their “tool kit” that can be applied ideally to suit the clients situation rather than therapists preference.
- Expectancy and Placebo Effects – the fact that a client wants a solution and believes in a solution may be enough to make the solution work.
- Client variable and extratheraputic events – basically means the clients life has changed (maybe they got a job so no longer depressed) or we sipply do not know.
- The Therapeutic relationship which is how well you relate to and trust in the therapist. This is the area you have the most control over when selecting a therapist!
The therapeutic relationship may be driven by many factors. Many women coming out of a abusive relationship may not relate to men and similarly men to women. Younger people may not be able to relate to older people (but many will as consider them like a wise grandparent)! The reasons someone may not related to their therapist may also relate to the counselling skills (being challenged too early in the relationship) etc.
Lived Experience / ability to relate: While a strong ability to have professional empathy is essential, ability of the therapist to build rapport and the therapists personal experience can be critical as demonstrated though the experience of the psychologist Tony Gee. His experience was documented when he launched the Charter for Peer Support and Centre for Excellence in Peer Support (see embedded PDF immediately below) and talks about the best support he got when his youngest daughter suicided was not from the “professionals” but those with “lived experience”.