What makes therapy work?

So you have decided to see a Therapist!

Where to start? Who to see? What to look for? What to expect?

What will make your visit to a Therapist helpful for you

How is seeing a Therapist any different to having a chat about your problems and concerns with a friend?

These are all valid and important questions to ask as you start your therapy journey.

Let me be clear about one pertinent point first – every profession has its ‘bad eggs’ who for whatever reason have done harm or done the wrong thing by their clients.  Therapy is no different – it has its bad eggs – although like all professions, most of its members are good people who want to skilfully and safely support others to a healthier and happier life.  If you see a therapist and find yourself feeling unhealthily uncomfortable or unsafe, trust your feelings and seek out a new therapist.

You have that right and you do not have to explain your actions at all. 

But do seek out a new therapist, because therapy can be an extremely positive and fruitful relationship for you to experience, as it encourages you learn and grow and create the life that you want.

So, back to the original questions – what to look for and how to make therapy helpful to you?  Interestingly enough, there has been a lot of research completed to help answer these questions.  The answers may surprise you! 

Feeling safe and heard in therapy will make your therapy more successful.

Margaret McCoy Lynch (2012) reports “The therapeutic alliance remains a key component of creating successful outcomes in psychotherapy. Empathy also continues to be an integral factor to not only forming the alliance, but also increasing a client’s ability to feel validated and understood. It appears that… no one type of therapeutic modality is superior to another.”

So given that it is a key component, what is therapeutic alliance? This refers to the quality of the relationship between yourself and your therapist.

Yes! Therapy is a relationship!  

Dr Lynne Knobloch-Fedders (2008) of The Family Institute of Northwestern University explains how Therapists build relationship to ensure good outcomes for their clients, explaining “The therapist’s ability to communicate empathy and understanding to the patient is very important. Another essential component is the therapist’s openness, flexibility and willingness to adapt the treatment to the patient’s needs. Skilled therapists actively solicit patients’ input about the goals and methods of treatment, in order to facilitate collaboration.”

Finding the therapist that is a ‘fit’ for you is more important than anything else.

Why should therapeutic relationship matter to you?

Think about it – imagine being able to sit with another person and share your concerns and difficulties, all the while knowing that you can trust this person to respect and care about you, to help you set goals that are focussed on what you feel is important to you, openly and flexibly communicating with you while supporting you collaboratively in making changes in your life for the positive.  

As far as interpersonal experiences go – how does this sound to you? Helpful? Positive? Beneficial? Nurturing? Safe?

It sounds quite different to .hanging out chatting with a friend’ doesn’t it? Of course it does! As supportive as our friends are for us, it is hard for them to stay focussed on what is best for us because they are also influenced by their own emotions about our situation. 

So working with a Therapist who you have a strong therapeutic relationship with can literally be a ‘life changing’ chat! The relationship that you have with your Therapist is the component of therapy that you need to have for your therapy to be successful.  

Therapists educate through a variety of training pathways, and engage in developing their skill in a range of treatment modalities, offering you a diverse and eclectic range of Therapists to engage.  

So as you begin your search – asking for recommendations from others, exploring google searches, speaking with other health professionals – stay focussed on finding the therapist who you feel is likely to be a good ‘fit’ for you.   Read and view their online bio’s to see how they feel to you, read reviews both positive and negative, and attend your first visit with a focus on asking questions and noticing how the relationship feels between yourself and the therapist.


Knobloch-Fedders, L., 2008, The importance of the relationship with the therapist: Research shows that the therapeutic relationship is one of the strongest predictors of successful treatment. https://www.family-institute.org/behavioral-health-resources/importance-relationship-therapist

McCoy Lynch, M., 2012, Factors Influencing Successful Psychotherapy Outcomes, MSW Clinical Research Paper.

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