Becoming a good therapist

How do I become a good therapist?  I remember asking myself this while I was in school (truth be told I still ask myself this). Of course this is part of who I am….all about being good or even the best I can be at something.  Sometimes in my life this drive can get in my way, but in my profession it’s really helpful.  It helps me keep being better at what I do, moving forward, changing what I do and looking for different ways to do good therapy.

The longer I work in this field, the more I know “not all therapists are created equally”.   You may be saying….well duh Alice…but really, the community doesn’t always know this.  When you are hurting and you are desperate for help, you reach out trusting you will get that help.  The truth is, there are some in our profession that are not helpful at all.  And then there are some that are very helpful.  Luckily, there are researchers out there who have looked at the difference between the two.   Wampold and Imel give us a body of information in their article The great psychotherapy debate: The research evidence for what works in psychotherapy.

What Doesn’t Matter:

Theoretical Orientation – They all work

Experience – Therapists earlier in their career are actually better than those with more experience

Therapist characteristics of age and gender

Therapists rating

How many of us spend time trying to get more experience, or working hard to find the best theoretical model?  We spend a lot of time and money here.  Research tells us, at the end of the day, these things don’t matter when it comes to being a good therapist. 

What Does Matter:

Alliance - Learn to form a collaborative working alliance with a range of clients (even challenging clients)

Make it Simple – Can explain aspects of therapy effectively and succinctly

Attuned – Can recognize metacommunication happening as it happens (example picking up on body language, seeing facial expressions that are in discord with words)

Grounded- warm, accepting, empathetic, modulate own emotional response while staying focused on client and his/her problems

Humble- questioning our own effectiveness and work to improve

Understanding- offering an explanation for client distress and a means to overcome it. (why do they do what they do and how do they minimize what is limiting them?)

So if you are like me, and you want to be the best therapist you can be, spend less time doing what doesn’t matter and more time doing what does.  If you are not sure about your ability to build an alliance with all clients, get training in that.  If you struggle taking hard concepts and making them simple, get coaching on this.  If you are not very good at being attuned to clients, consider extra learning in that area. 

To summarize, to be a good therapist, evaluate how you do on what matters. Spend less time and money on what doesn’t matter, and more time and money on the things that do. 

Wampold, B.E. & Imel, Z.E. (2015). The great psychotherapy debate:  The research evidence for what works in psychotherapy (2nd ed.). New York: Routledge.

Wampold, B.E. (2016 September/October)  Can we become better therapists? Yes, we can!. Family Therapy Magazine, 15(5), 16-19.