One of the most important elements in therapy is active participation. When you seek therapy, the therapist can guide you in understanding and addressing your issues, but they cannot fix everything. You have to put in the work yourself. The quality of the client’s involvement in psychotherapy is a significant determinant for the outcome, as Orlinsky, Rønnestad, and Willutski emphasised in 2004. In other words, the more committed and actively engaged the client is, the more likely they are to experience positive changes in their life.

Jason Byrne’s personal experience with therapy further reinforces this idea. He believes that therapy is something everyone should consider at some point. His therapist imparted a valuable lesson.

My therapist said: ‘I bet you think that I’m going to fix your life’, and I said, ‘yeah do you?’ She said ‘no, but I’m going to teach you how to sit in your own shit. I can’t get rid of it. You’ve got to do all that.’ I thought that was brilliant what she does. I go to her for a service now and again’.

Research conducted by Assay and Lambert in 1999 revealed that 40% of the change that occurs during therapy can be attributed to external factors. These factors include the client’s motivation, perception of therapy, commitment to the process, and applying what they learn in their lives (Bohart & Wade, 2013).

Why Therapy Really Works

video by Forrest Hanson

Psychotherapy works

Psychotherapy is effective. Reviewing over 40 years of the efficacy of clinical work (Duncan, Miller, Wampold, & Hubble, 2010), in most studies, the average treated client is better off than 80% of the untreated comparison sample.

The Therapeutic Relationship

In therapy, what matters most is the therapist-client relationship. The strength of the therapeutic alliance is the consistent key factor in achieving positive therapeutic outcomes. This strong alliance forms when the therapist and client genuinely like and trust each other. The most effective clinical practice occurs when there is mutual agreement on the nature of their relationship, the goals of their work, and their approach to working together (Prescott et al., 2017).

Interestingly, the qualities and skills of the therapist can have a more significant impact on therapy success than the specific therapy models employed. As Barkham, Lutz, Lambert, and Saxon (2017) highlight, who the client works with often holds more significance than the type of therapy provided. This emphasises the importance of finding a therapist who is not only skilled but also someone with whom you feel comfortable and connected.

Feedback Informed Treatment

Feedback Informed Treatment (FIT) has emerged as a valuable approach to enhance therapy quality and achieve better results. FIT involves regular monitoring of progress in therapy and evaluating the collaboration between the client and therapist. By consistently monitoring client progress and obtaining feedback on various aspects of therapy, including the therapeutic alliance, goals, and approach, therapy effectiveness can be improved by up to 25%. Recent research by Bovendeerd et al. in 2022 found that FIT, particularly the routine use of Outcome and Session Rating Scales to assess outcomes and the therapeutic alliance, significantly enhances effectiveness compared to standard treatment.

Jason Byrne

Jason Byrne is an Irish stand-up comedian and has long championed mental health support in Ireland. Join Jason and his co-host Mar Cusack as they partner with the online mental health service through their insightful podcast on mental health and wellbeing, “Mind Your Loaf”.

Forrest Hanson

Forrest Hanson is an author, podcaster, and content creator focused on helping people understand themselves better, and become the person they want to be.