9 Common Elements of Good Therapy

Psychotherapy is used to treat a variety of mental health issues. In many cases, counseling is more effective than traditional medical treatments, according to the American Psychological Association. It reduces disability and mortality and improves work function for many people. Psychotherapy also teaches clients skills that last beyond the therapy session. Additionally, psychotherapy does not carry the risk of serious side effects that many medications do. However, to experience the full benefit of treatment, you must have a good therapist who uses an appropriate approach for your specific issues.

If you are thinking of going to therapy, you probably know that the idea of finding the right therapist can be daunting. Searching for a good therapist online might not be much help either. There are countless therapists, not to mention a variety of schools of thought in psychotherapy. All too often, it’s easy to get overwhelmed by the choices. Given this, how can you tell if your therapist is a good one? How do you know that therapy is working? Here is a list of the things that great therapists do.

#1 Doesn't Judge You

Therapy involves sharing your feelings, thoughts and experiences without being judged, condemned or criticized by your therapist. Good counseling involves a non-judgmental environment where you can feel safe expressing your innermost thoughts and feelings. Famed American psychologist Carl Rogers, who was also known as the “Father of Client-Centered Therapy” advocated what he called unconditional positive regard in therapy. What this means is that no matter what you share with your therapist, they should still hold a positive view of you. You should feel safe in therapy, even when talking about less desirable behaviors or aspects of yourself.

#2 Focus on You

In therapy, it should be clear that the sole purpose is to help you. A good therapist keeps their issues separate from therapy with clients. If a therapist is talking about their problems during your session, it is not benefiting you in any way. Your therapist should always make your meetings productive and helpful to you. They can do this by not:

  • Sharing personal information - Everything that your therapist shares should benefit you in some way. Unless it holds some therapeutic value to you, they should not disclose personal information.
  • Asking you for help with things outside of therapy - This may indicate that your therapist does not have a good sense of appropriate boundaries with clients.

#3 Tell You Why They Are Using a Certain Approach

Since Sigmund Freud began his experimentation with therapy approximately one hundred years ago, there have been many approaches and methods. Therapy is not a “one size fits all model.” Depending upon your specific issues, some interventions may prove more helpful than others. Some of the standard therapeutic approaches include:

  • Cognitive Behavioral Therapy or CBT - This approach involves the idea that one's thoughts influence feelings, which in turn influence behaviors. CBT therapists help clients gain awareness of thoughts that are contributing to negative emotions. By changing their ideas patterns, clients learn to change behaviors. This approach works well for a variety of psychological issues. It is particularly useful for depression and anxiety.
  • Exposure Therapy - This is used to treat anxiety disorders. During this type of therapy, clients are slowly and carefully exposed to a feared situation or object without any danger. Eventually, when the person sees that there is no risk associated with the feared object, they overcome the anxiety.
  • Motivational Interviewing - Involves getting rid of uncertainty and indecision and finding the motivation to make a change. This technique is used extensively to treat substance abuse disorders.
  • Dialectical Behavior Therapy or DBT - This therapy is used to treat borderline personality disorder and mood disorders. This approach helps the client transform destructive behaviors into more adaptive ones.

These are just a few of the methods used during therapy. No one method is more effective than the others. Regardless of what approach your therapist uses, they should be able to explain to you why they are using the chosen method. If your therapist cannot tell you what approach they are using or why they are using this method, then consider another counselor.

#4 Review Progress with You

The only way to know if therapy is working is to periodically discuss the progress that you have made. The reason that most people go to therapy is to change something in their life. If therapy isn’t helping, then what is the point of continuing to go? At the beginning of therapy, your therapist should work with you to establish therapeutic goals or milestones that you want to achieve in therapy. These goals should not be things that the therapist thinks that you want but rather—goals that you have for yourself. If your therapist does not ask you to identify goals upon beginning therapy, that is a big red flag. Not only that, but you should review the progress that you have made in therapy periodically. Your therapist should feel comfortable having a clear, honest conversation about your progress—or lack thereof. If you are not making progress, then you should discuss trying different approaches with your counselor. They should not feel offended or be afraid to change directions if you are not making progress.

#5 Keep Your Secrets

Confidentiality is one of the most important aspects of a counseling relationship. You want to be sure that your inner secrets, desires and fears are safe and that your therapist will not share these with the rest of the world. But, it is important to understand that there are times a therapist may have to break confidentiality, such as when you are a danger to yourself or others or in cases that involve child abuse.

So, how do you know when confidentiality cannot be maintained? Surprisingly, the answer is not always clear and can vary from state to state depending upon laws. Your counselor has a duty to explain to you any circumstance in which they might have to break confidentiality. Usually, they review this process this during their first session with you. They may have you sign a confidentiality agreement. Additionally, many therapists use technology, such as email to communicate with clients. The confidentiality surrounding email and other forms of technology is not always clear. If your counselor uses email or other non-private methods of communication, they should clearly explain that this method of communication is not confidential. You should have a clear understanding of what is and is not confidential in your therapy sessions. If your counselor cannot tell you what will be kept private, then it is time to find a new therapist.

#6 Respects Your Cultural Beliefs

A competent therapist does not make offensive comments about a client's gender, sexual orientation, cultural background or religion. Not only that—but they should be aware of cultural attitudes in your community. Your therapist should understand or be willing to learn about important cultural traditions and prohibitions in your life. If your therapist does not understand your cultural beliefs, it is fine to help educate them. A good counselor will listen to your beliefs and make suggestions that work with your beliefs and value systems. They should not maintain a rigid treatment approach that involves asking you to do things that go against your cultural beliefs.

#7 Listens to You

All therapists must have good listening skills. A therapist's job is to listen to what you have to say—so that they can help you sort out problems. Although your counselor might not remember every little detail about your life, they should be able to recall key facts like your name and what brought you to therapy in the first place. If you feel like you are constantly reminding them of important things about your life, then it is time to take your counseling elsewhere. After all, how can a counselor really help you if they are not absorbing what you are telling them?

#8 Pays Attention During Your Sessions

A good therapist makes you the focus of the counseling session. Their job is not to check their cell phone during the session or to look at the clock repeatedly. The only time that they should interrupt the session is if there is an actual emergency. Their attention should be completely on you. Some therapists use a computer or electronic device to take notes during the session. While that is fine, it should be unobtrusive. You should feel that they are listening to you rather than focusing on other tasks. If they seem distracted during sessions, bring it up to them. If it happens again, find a new counselor.

#9 Does Not Try to Be Your Friend

Although you tell your therapist your innermost secrets, your therapist is not your friend. There are many significant differences between a therapist and a friend, including the fact that friends are not always objective. If your therapists invites you to her wedding, asks you out for lunch or to go for coffee, it is time to find a new therapist. For therapy to work, there must be boundaries to the relationship between a counselor and client. Your therapist should be polite and friendly but the relationship should not feel like a friendship. If it does, then it is not good therapy.