How therapy works! The Therapeutic Relationship.
Whatever theoretical approach to counselling or psychotherapy a practitioner is trained in, or prefers to use, and whatever models they adopt or tools they offer the client, there is only one aspect of talking therapy which is absolutely key to its effectiveness, and that is the level of trust which is built between the client and the therapist. It is this, the ‘therapeutic relationship’, which allows the transparency of sharing to create the environment for change.
It is common for counsellors and psychotherapists to rely on their training, on their experience and on their accreditation with a recognised Membership Body as evidence of their effectiveness as practitioners, and all these aspects are very necessary aspects of being registered on the Professional Standards Authority accredited register which, if held by their Membership Body, does much to give public assurance of skill, experience and ethical practice. However, without an intuitive sense of a client’s frame of reference, and without a compassionate and respectful acceptance of the client as a fellow human being, all the skill and training available and utilised by the therapist will not make him or her necessarily effective.
It is in the initial session, sometimes called the assessment session, which usually takes place before there is an agreement to start therapy, that both the client and the therapist have a chance to size each other up and to get a ‘feel’ for the success of a working alliance between them. It is actually through intuitive judgement that this takes place! As a counsellor, I take pains to explain that I am not judgemental in my work, and this is true to the extent that I avoid criticism, both in word and more importantly, in thought. If I become aware that I have been triggered by a prejudice I become aware that I hold, subconsciously, I talk this over with a senior professional and take ownership of my reactions, but I need to maintain my ‘judgement’ when deciding whether a potential client is presenting with an issue which is outside my competence to help, or whether therapy seems an inappropriate way forward for a client at the current stage of their journey. The judgement is not towards a client as a person, or against their feelings and emotions. The judgement is actually not ‘against’ anything about them, but it might be useful as a positive appraisal to ensure safety at all times where possible.
There are no guarantees about counselling or psychotherapy, although some will swear that a certain model or theoretical approach has proven benefits. There are ways to gather evidence about the effectiveness of an approach and these are useful and can point in a direction which can be most effective, most of the time. However, as human beings, we are all unique and what model or approach works for one will not work for another. What does work, I would like to imagine for all, is a sense of being properly heard, safely held in a confidential environment, with someone who ‘gets it’ and is prepared to reflect what you say to show they have listened, to share your story back to you in their own words for you to notice what you have said, to be silent with you while you reflect and gather your thoughts, to offer you autonomy and boundaries, so that you can take back power over your own life with a sense of relief that you have given yourself permission to live..