Seven habits of successful therapists
Therapy is a field with many contentions: what one school of therapy believes is the underlying source of mental distress is often viewed by competing schools as less relevant or unimportant. But there is one area that most schools of therapy agree upon: the importance of the therapeutic relationship in effecting change (the main disagreement here is whether the relationship is necessary and sufficient or simply necessary and must be supplemented).
Given the importance of the therapy relationship to the client’s potential for change, I have outlined seven habits/dispositions that successful therapists possess and how to recognise when they are present:
- Empathy: empathy can be defined as the therapist’s ability to enter your inner world and understand it as accurately as possible. This helps the client better understand their own thoughts and feelings, and so they have a clearer sense of what to change and how to do it. Signs that your counsellor is empathic: you sense that your counsellor understands the essence of what you are thinking and feeling; your counsellor is often able to summarise and get at the gist of what you were relating to him or her; your counsellor accurately picks up on the subtext of what you say (i.e. the unspoken implications) and relates it to you; your feelings are mirrored to a lesser degree by your therapist (I say to a lesser degree, as you do not want your therapist to be as sad as you are feeling; on the other hand, you do not want them to appear indifferent).
- Genuineness: genuineness is the ability on the part of the therapist to be ‘real’ rather than phoney; to mean what they say rather than say what ‘looks good’; to be a human being first and therapist as a close second. Genuineness is important in therapy because it fosters trust, as you know what s/he thinks and feels about matters relevant to your therapy. Signs of genuineness: you get a sense that what your therapist says and what s/he does match up; what they say is said with the corresponding feeling; they are prepared to tactfully disagree with you at points; they are willing to be their own individual selves (they do not try and copy you) and are open enough to make relevant self-disclosures when appropriate.
- Warmth (acceptance): you do not want your therapist to be ‘cold’ in the sense of hardly showing any warmth or appropriate affection, as an emotionally cold atmosphere is likely to feel a judgemental space rather than a safe, acceptant space. Signs that your therapist is warm: they are not scared to show their care and affection for you; they are willing to be moved by your plight; they remember and honour the small details of your life that are not directly related to your problem (e.g. at the beginning of a session, they ask you how you got on at the party last week); most importantly, they are broadminded rather than judgemental, and are not easily shocked by the details of people’s private lives.
- Concreteness: concreteness is the ability of the therapist to talk in a direct, non-theoretical way about the nature of your problems. This minimises the chances of being misunderstood, as well as minimising the risk that you remain unaware of the dimensions of your problem (e.g. you are less likely to deny a problem when your therapist says, ‘I’ve noticed that every time I mention your mother, you change subject’ than when they remark ‘I believe you have latent hostility towards your subjective representation of your mother’). Signs of concreteness: your therapist talks in a direct and succinct way about what s/he has observed; they use a minimum of jargon and what they do use they explain in simple terms; they use examples to elucidate rather than long winded explanations.
- Immediacy: immediacy is the ability to offer cogent explanations (interpretations) of your feelings and actions. Immediacy is important as it is making sense of the nature of your problems and ways of addressing them. Signs of immediacy: the explanations (interpretations) offered are understandable and they fit closely the texture of your life; the therapist’s interpretations make the previously unintelligible intelligible (e.g. your compulsion to check the gas taps is because you are harbouring hostile wishes towards your partner and you were frightened of your own impulses); their explanations allow you to see the bigger, thematic patterns in your life (e.g. you have a tendency in all of your relationships to resist affection).
- Gentle challenge: your therapist should be acceptant and empathic, but they should not always agree with what you say. A therapist that is always agreeable in this sense is thwarting your growth, as they may end up being complicit in your wish to avoid tackling certain issues. A key dimension of therapy is that the therapist is prepared to fight for you, and that means sometimes they align themselves with your constructive tendencies against your willingness to avoid facing your problems. Signs of gentle challenge: they sometimes tactfully disagree with what you say or do and point out how your actions might be harming you or consolidating the problem; they are willing to gently and sympathetically challenge your irrational or unhelpful thinking; they are prepared to have higher yet achievable expectations for your potential than maybe what you currently have.
- Collaborative: effective therapists always include the client in the process of treatment. Collaboration is a willingness to explain what options there are for treatment and be prepared to go forward with your preferences. Signs of a collaborative therapist: they ask you about what preferences you have for therapy (if any); they honour your preferences and what makes sense to you and try and include that in their treatment plan; when they disagree with your choices of therapy, they are willing to discuss it (e.g. you might believe CBT is the best option for you whereas your therapist might believe that a psychodynamic process is better suited to your problem); they are open to have regular check-ins to find out how things are going and are open to amend the therapy process to make it more effective.
If you are currently searching for a therapist, keep these qualities in mind and see how present they are in your initial sessions, as this can help you make an informed decision. If you are already in therapy with a therapist, you can have a discussion with them about certain qualities you might feel aren't present enough (e.g. perhaps you feel your therapist doesn't challenge you enough).
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About Alexander Fox
I am a counsellor with three private practices across the country (Harley street, London; Dundee; St. Andrews). I am trained to Masters level in pluralistic counselling, and I utilize a wide variety of different therapeutic approaches when working with clients. I also have a doctorate in English literature and my literary training informs my work.