Along with taking care of physical health, awareness of mental health is slowly but surely entering people’s lives. We are interested in lifestyle, what is good and what is bad for us, we read about the connection between the body and the mind, and often we decide to visit a psychologist or therapist for our problems. However, doubts or questions arise about how this professional can actually help us. And it’s not just laypeople who ask this question, but also psychotherapists and researchers interested in the study of psychotherapy.
In this article, I will attempt to present the results of some research on what is the “effective factor” in psychotherapy. However, you may already know that there is not just one type of psychotherapy, and there are a large number of different psychotherapeutic approaches (around 250). Is it even possible to think about what “works” in psychotherapy in general, or does each approach have its own effective factors?
The truth is that professionals have been asking this question for several decades. And thanks to that, I can tell you something about effective therapeutic factors that we encounter in essentially all established therapeutic schools and approaches. In this article, I will introduce a selection of “common helping factors” as described by Kratochvíl (2012), who summarizes the results of research by other authors (Garfield, 1989, Frank, Franková 1991, Lambert 1992, Weinberg 1993).
The relationship between therapist and client is fundamental
It may sound strange, what can be healing about the relationship between people? But the reality is that this is often mentioned as a factor that, as we can expect, appears in every psychotherapy. Every therapy involves a client and a therapist. However, effective and efficient therapy will only be one where these two establish a real and intimate relationship. The client trusts that the therapist will help them, and the therapist is determined to help the client and provide acceptance and understanding.
Explanation of disorders and providing information
The explanation of a disorder provides the patient with the opportunity to understand what is happening to them. In the therapeutic process, the most important factor is how the therapist delivers this explanation, how well the client understands it, and whether they can accept it. This factor could also be extended to the provision of various information. Not only people suffering from various mental disorders attend therapy, but also those going through a difficult life period or those who find themselves in a situation they cannot handle. The therapist can provide them with various information related to their experiences or behaviors that will help them understand their problems. At the same time, the client learns to understand themselves better.
Emotional release In therapy, the client has a space for themselves and their emotions. They can experience and ventilate any current or past feelings in a safe environment. They do not have to fear that the therapist will tell them not to cry, not to be angry, or that the therapist will be afraid of their emotions.
Confrontation with one’s own problems
Through therapy, the client stops avoiding their problems, stops being afraid of them, and learns to face them. Gradually, they learn to cope with their problems and also gain a sense of competence – the feeling that they can handle their problems.
Kratochvíl writes about how the therapist strengthens desirable behavior and experiences of the client with their words and behavior and helps to eliminate unwanted behavior. Cognitive-behavioral therapy emphasizes this aspect, but even in therapy led by therapists who use a different approach, the client gradually learns to distinguish between adaptive and maladaptive ways of behaving and reacting.
Kratochvíl chose these five factors from the results of various research. Many other authors also mention the personality of the therapist as an important factor – that the therapist understands the clients, can handle even difficult or taboo topics, creates a safe environment, provides hope, and that the client trusts the therapist and is not afraid to open up about painful topics.
The quartet of factors that contribute to therapeutic change, authored by Lambert (1992), is also very well known. These factors are grouped into the following categories: common factors (these are factors that function regardless of the therapeutic approach used by the therapist, including those mentioned above), therapeutic techniques (which are specific to a particular therapeutic direction and the way the therapist works), extra-therapeutic factors (such as the personality of the client, their traits, social environment, support, etc.), and the client’s expectations of therapy.
The Placebo Effect in Therapy?
Once again, we confirm that a person’s psyche is a powerful factor in and of itself. Therefore, the course and outcome of psychotherapy can also be influenced by what you actually expected from it. Did you go to therapy because someone forced you to, and you don’t really believe that talking to someone who calls themselves a therapist can be helpful? Well, in that case, you might be right. Conversely, did you look forward to therapy and believe that it would help you deal with your difficulties? Again, you’re right.
It’s even possible that you’ll notice a certain change after you’ve decided to schedule a therapeutic consultation, even though you haven’t actually attended it yet. It’s a similar placebo effect to when your tooth stops hurting for a while after you finally make an appointment with the dentist.
We see that there are many factors that contribute to therapeutic change. There are also many studies that deal with this topic, and their results and the names used for individual factors may differ and intertwine in places. It would therefore be impossible, or at least very challenging, to create one established and all-encompassing list.
It is equally important to think about the fact that each client may perceive something slightly different as subjectively beneficial. If you have had a therapeutic experience, you can also reflect on what you perceived as useful and what helped you specifically.