What makes therapy successful?

People who engage in any type of therapy do better than people who don’t. This is because the personal relationship between you and your therapist is the most important part of successful therapy. Therapists are successful in helping people despite having different training and using different psychological theories. Thirty percent of the difference in how well you do in therapy depends on having a warm, caring relationship with your therapist. A helpful therapist accepts you as you are. Your therapist needs to have empathy for your situation and be encouraging. Only about 15 percent of the difference between successful or unsuccessful therapy is due to the specific therapy techniques used. There is research showing that 79 percent of psychotherapy patients do better after four months than people who don’t get treatment.

There have been studies done in the past which have shown that different therapies have a

lot in common with each other. All kinds of therapy depend on listening carefully to what you

say. Hearing and listening are two different things. You are hearing many things now, but you

don’t start to listen until something jumps out at you, like the cat knocking things off the kitchen counter. Therapy depends on the kind of attention you use when you want to know what is happening around you. Therapy requires this kind of specific listening. The difference between hearing and listening is attention.

Hearing is easy. It’s worked for anything with working ears for millions of years. It is your alarm system and can help you escape danger. “What was that sound?” Really listening is hard because we all live with many distractions. Your cell phone demands your attention all the time. The people around you want your attention, especially your kids. The internet is always suggesting things you could try or do, while you are trying to do something else.

Much of what helps you do better is in your environment—forty percent of it! This includes the support you have from friends and family. A supportive home environment is especially helpful. Community support also helps. Connecting with groups of people like you who are in your community will help you get better. Support contributes to your motivation to change. Your motivation is an important part of therapy. If your environment is not supportive of you, your therapist can help you improve your support network.

We can’t ignore the placebo effect. You know that sometimes a sugar pill is just as helpful as a medication if you think it is helping you. A kiss can heal a bump on your kids head.

You are in therapy because you want to get better, and having decided to do that, you are very likely to succeed. It works because you expect it to work. Your therapist is there to join you on that journey.

Psychodynamic therapy and psychoanalysis can help you change problem behaviors by

learning about what those behaviors mean to you unconsciously. Successful psychodynamic

therapy still requires that you work in partnership with your therapist, and accurate listening is a large part of it. Behavior therapy looks at how you learned to react in certain ways. You may remember Pavlov’s dogs who began to salivate when they heard the dinner bell. These days we see the same response to the can opener when you open up the cat food can. We all learn responses. It takes careful listening to figure out how you learned your behaviors. Cognitive therapy is all about what you think instead of what you do. Getting a handle on how you think about things takes a caring and patient listener. Existential therapy is about knowing what is meaningful to you. The only way to tease out what is meaningful and what is not is by talking to someone who is listening carefully and can feed that information back to you. Client centered therapies maintain that you are the authority on yourself. The therapist is not an expert who knows better than you. There is only one way for your therapist to know what you know about yourself and that is to listen. Any successful therapy requires a warm caring relationship with your therapist who has been trained to carefully listen to what you say.

The point of this is that what helps you the best is someone who can listen to what you say and really know what it means to you, by paying close attention to you. This way listening is a very important part of therapy. Therapists work hard to learn how to listen carefully with attention.

Listening is a skill that really helps more than any technique specific to any therapy.

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Marilynne Ramsey, Ph.D

Person 2 Person Psychotherapy

Golden, Colorado