What Is The Key To Successful Psychotherapy?

For years they have tried to identify the variables that most determine the effectiveness of a therapy process: what are the factors involved and what weight each one of them has. Does successful psychotherapy come from the skill of the therapist or does it depend on the approach and the psychological stream that is followed?

Knowing the answer to these questions is of great relevance, especially if we are considering the possibility of starting a treatment.

It is possible that we have doubts about which professional is best for us, in what aspects we have to look at when deciding. In the same way, for any psychologist it is important to know what the key to success is, so that the elements involved can be maximized. In the following article we review the information available in this regard.

Successful psychotherapy or skilled therapists?

At first, the debate focused on discovering which therapeutic techniques or procedures were those that enhanced the effectiveness of the treatment.

The conclusion reached was that success was determined to a greater extent by common factors than by differential elements. That is, there are a series of components shared by the various psychological currents that are the ones that would truly lead to successful change.

The idea then emerged that “it is not about the therapy, but about the therapist”. Under this premise, the weight of efficacy was placed on the figure of the psychologist, a fact that led many of them to consider themselves magicians of the human mind. However, this statement has been amply denied, making it clear that the highest percentage of variance in success is determined by the patient himself.

Keys to a successful psychotherapy

Michael Lambert identifies the four main factors that predict patient improvement and the relative weight of each of them. These are divided into: customer factors, common factors, expectation, and techniques.

Customer factors

Also called extra-therapeutic factors, they refer to all aspects related to the client or patient that help in recovery. They can be character strengths or personality traits, such as perseverance or optimism.

Supportive elements in your environment (such as having a loving family or loyal friends) and even random occurrences (such as finding a job) are also included. All these resources favorably influence the therapeutic process and explain 40% of the variance of the success obtained.

Common factors

They are mainly concerned with the relationship that is established between the patient and the therapist . The essential conditions necessary for it to be positive and fruitful. Aspects contributed by the therapist, such as empathy, affirmation, motivation to take risks. .. , help to forge a healthy and functional therapeutic bond.

They are called common factors since they are present in most interventions that are framed in the different psychological currents. They are responsible for 30% of the variance of the effectiveness of psychotherapy.

Expectation

Also called placebo or hope, expectation refers to the degree of credibility that the patient gives to the therapist and the procedures.

It is, in short, the fact of being aware of being in a treatment process together with the faith, both of the patient and the therapist, in the restorative power of the techniques used.

This simple subjective assessment has a 15% weight in the explanation of therapeutic success.

Techniques or models

This last factor represents the influence of the specific procedures and the psychological current that is followed. It includes both the theoretical framework that explains the symptoms and the strategies and techniques that are put in place for their resolution.

Their weight is relatively low – 15% – and is related to the fact that all of them lead the patient to take action and make a significant change in their behavior.

In light of these results, we can conclude that a successful psychotherapy is supported by different variables, but of all of them those related to the patient himself have a special weight.

It is your qualities, environment and disposition towards therapy that have the greatest influence on the final result. The need to use empirically endorsed procedures is evident and the impact of the therapeutic alliance is unquestionable. However, its weight is not decisive.