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Nicolas Pablo De la Tierra, August 10 2023

WHAT IS THE BEST THERAPY TYPE FOR YOU?

Would you be surprised if I told you that the best therapy type for you is all of them and none of them?! I know that I would, because perhaps like you and many others, I have grown into this world thinking that technique is what makes the difference between effective and not-effective practices. 

But in the world of therapy, there is now 70 years of serious research to show that none of the 400 official talk-therapy out there have a real edge on one another. EMDR is the fashion of the day, but it too, can only claim a full 30% recovery rate. So… when we collect all of the studies done to date and run what we call a meta-analysis, we find that no modality has any significant advantage over another. Absolutely none! 

And “Yes!”, since the 1950s research has been conducted to establish which, among the 400 official talk-therapy out there, is the most effective modality. There are thousands of academic papers running these comparisons, at times properly set up as rigorous scientific experiments, and at other times the result of qualitative studies, where researchers interview clients in their natural settings after or during the therapeutic process, and the conclusion, as I just mentioned, is that technique is not what predicts outcome. I feel you! Because from my own point of view too, this means that hundreds or thousands of dollars I have spent on this or that course, are worth very very little when we meet. 

So where does that leave us? Well, in all of this research we have now learned that our biggest impact as therapists resides in what we call, the common factors. The common factors are a set of qualities that are independent of technique, that the therapist and client bring to the counseling process and have a consistent large impact on therapeutic outcome. Let me list them for you here the common qualities a therapist needs to bring to the table. On the therapist side we have: 

Through these common factors, the therapist facilitates the Therapeutic Alliance, and the Therapeutic Alliance is the most critical factor in successful therapy. The Therapeutic Alliance is the collaborative relationship between a therapist and their client. When the therapist and client work together effectively, it creates a safe space for the client to explore their thoughts and feelings, which is key to making progress. A strong Therapeutic Alliance also allows the therapist to take more calculated risks, make better guesses, challenge the client more effectively, and provide deeper unconditional acceptance. 

But as I have just mentioned, this Alliance, is a two people's affair, so there are also common factors associated with how you participate in the therapeutic process, and these are:

So these are the common factors that predict positive therapeutic outcomes, and as you can see, they have very little to do with this or that technique, approach, brand, orientation or education. In your search for a therapist, therefore, focus on whether you feel understood, held in unconditional positive regard, reflected with empathy and presence, positively challenged, and whether you perceive the therapist as genuine, present, and open to learning your inner world. 

Meanwhile, ask yourself how much you believe in the process you are engaging with, whether you are ready to do some work on yourself, and how open to change and exploration you are. With this in mind, therapy will most likely work for you!

Look after your Heart,

Your Shrink in Bansko 

Written by

Nicolas Pablo De la Tierra

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