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What Makes Counseling Work?

What makes counseling work?

I often get calls from potential clients who ask what my “style” is or “method” of counseling.  They ask what “type of issues” I have experience treating in order to determine if I can help them or a family member.  While it can be reassuring to feel like a potential therapist might have experience treating a concern similar to theirs, it doesn’t necessarily mean they won’t be effective.  So what does make counseling work?

In 2001 the Journal of Psychotherapy determined that a “strong therapeutic alliance more closely aligned with positive outcomes than any specific intervention”.  This means that the relationship a client has with the therapist will elicit more success than any trendy tip or trick.


What makes a good therapeutic alliance? 

  • Agreement about goals and outcomes

  • Collaboration on what steps will be necessary to see movement toward these goals

  • They are emotionally connected to your needs

Often clients have a tendency to come into my office and report on all the “bad stuff” that has been happening.  They feel like this is what they are supposed to be talking about and forget to address what has been going right in their lives.  I try to get clients to reflect on the positive things that have occurred to highlight what all their effort has accomplished.  As a therapist, it is important to avoid being seen as the advice giver.  It is difficult, since most people come to therapy because they feel they are all out of options.  If I can focus on listening and accepting their feelings in a non-judgmental manner, a marvelous thing starts to happen.  Client’s open up and options begin to develop.

If therapy begins to feel like it is not helpful,  it might be time to determine if everyone is still on the same page.  Is everyone still heading for the same goal?  If so, check the pace of the counseling.  It could be that too much is happening too quickly to adjust.  The client should always be in control and allowed to navigate the course.

Resistance, especially in a  child, can be frustrating.  It is important to partner with them in understanding that they don’t want to be here.   I often ask what we could work on since they “have to be here anyway”.  This allows the client to make the first move but removes the need to resist another person telling them what to do.  If things don’t progress after several attempts, it may be time to look into other options and address that the client is not ready for counseling.  Trying to make something happen when there is overwhelming resistance only ends up making everyone frustrated.

Stephanie Phillips, LCMHC

Stephanie Phillips, LCMHCS, NCC, CCTP
Psychotherapist & Owner
The Mindly Group, PLLC

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