What makes a good therapist

If successful therapy is built on the strength of the therapeutic relationship, between client and therapist, how does a good therapist contribute to this? What are you paying your money for?

It goes without saying, that a good therapist is one who can embody and offer qualities of compassion, trust, warmth, empathy, non-judgement, presence and patience. As well as being an extremely good listener.

That’s a no-brainer.

But there are some other particular skills, that enable a therapist to connect with their client, which lead to more successful outcomes in therapy.

It’s about a ‘real’ relationship

When we talk about the therapeutic relationship we’re describing a collaborative relationship between client and therapist, which is warm, authentic and affirming.

A genuine and unabashedly real relationship which creates an emotional bond.

It’s very different to the classical view of a therapist as a ‘blank slate’. A mute figure who refuses to answer questions, has their patient lay prostrate on a couch, while they sit safely behind a mahogany desk looming large in a grandiose chair. Mentioning no names, *Sigmund.

*went to the Freud Museum recently, in North West London, it’s great!

Nowadays, a good therapist is not afraid to immerse themselves in the therapy. To get down into the metaphorical dirt with you.

 
An appreciation of difference

Successful therapy doesn’t depend on finding a therapist who looks and sounds just like you (though this may be your preference and feel more immediately comfortable).

What’s important is a recognition and exploration of differences.

This is particularly crucial if there’s an implicit power differential.

If it feels helpful to the work, a good therapist will acknowledge your differences to deepen the connection. Noting any gender, age, race, or socioeconomic power dynamics.

Congruence, immediacy, and self-disclosure

Authenticity, key to building this ‘real relationship’, is often referred to as congruence; when the therapist’s inner experience aligns with their outward expression or behaviour.

Two skills a therapist might use to facilitate this are Immediacy and Self-disclosure.

Immediacy

At times a therapist may bring attention to the here-and-now; what is being experienced in this very moment in the session. Such as: “right now I’m sitting with a feeling of sadness, I’m wondering if that’s present for you too”. Or: “I’m noticing I’ve stepped into the role of an authority figure right now, how might that be for you?”.

Self-disclosure

If it feels like it might be beneficial to the client, a therapist may reveal an aspect of their experience from outside of the work, sharing a glimpse of life beyond the therapy room. It might sound like: “I once worked in a similar role to you and can perhaps recognise some of the challenges you are facing”.

There is a skill to using Immediacy and self-disclosure, a misstep can land as making it about the therapist not the client. I’m sure we’ve all been there with friends, who in response to you sharing your struggles, divert the focus onto them by talking about how they’ve experienced something similar.

Annoying.

Conceptualisation of the problems and a framework for change

The goal of a therapist is, in some way, to normalise the issues you are encountering. They should be able to (at least partially) alleviate any feeling of aloneness and give hope your difficulties have a workable solution.

A good therapist will tailor their approach to your needs and characteristics, or refer you elsewhere.

Interestingly, it’s not so much the therapist adapting to a client’s diagnosis eg “you have depression / borderline personality disorder / OCD, therefore we must work a certain way”.

The human connection comes before any generalised idea of what theoretical approach is best.

Through a collaborative approach, using the therapist’s skills and experience, it’s about finding ways of working you feel are helpful.

Giving and receiving of feedback

Therapy is an ongoing two-way conversation in which the conditions are created to allow for feedback to be given.  

A therapist will look to show enthusiastic support and bring attention to when things have gone well, celebrating those wins with you, while keeping a focus on what work is still required to reach your goals.

It might include regular check-ins about how the therapy is going, what has been helpful or unhelpful, and encouraging an active participation in shaping the therapy.

Repairing ruptures

Sometimes things go ‘wrong’ in therapy; a misunderstanding of what the client is communicating, an ill-timed response and missed cue for empathy, or a mistake with the organisation of a session.

Often these moments provide an opportunity to practice safe communication about what happened and how each person felt (one of the more common needs of those entering therapy).

Through the rupture and repair we discover that disappointments, when they are acknowledged, can deepen a relationship rather than end it.

You might note a theme throughout this blog

A lot of the skills therapists use are also ones that can help you and your relationships. And that’s part of the experience of therapy ~ what takes it beyond just talking.

It becomes experiential, with the therapist mirroring ‘relational skills’, at times inviting their client into the practice of them. Through this process, connection is deepened, insight is gained, and new skills are learned. 

This is what makes a good therapist.