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DR. JAN NEWMAN
Has anyone ever suggested “maybe you should see someone?”
When a loved one or health care provider says that “therapy” might help, what do they mean?
Without more specificity, the word “therapy” doesn’t really mean anything.
When most people recommend or consider “therapy” for a problem, they seem to assume that all therapy and therapists are created equally, which is simply not true.
What most people need is effective therapy—therapy that actually helps them live their lives to the fullest and do what matters to them.
What is effective therapy?
The research on effective therapy indicates that the following factors contribute to the client’s improvement in therapy.
Of these, there are several that center around factors more outside of your control and more focused on the therapist, including:
In this article, we go through the key factors to consider when you’re finding the right therapist. You can also check out our list of 30 questions to ask a potential therapist.
WHAT IS EVIDENCE-BASED PRACTICE?
The Association of Behavioral and Cognitive Therapies (ABCT) defines evidence-based practice or EBP as the:
application of research-based treatments, that are tailored by an experienced therapist to meet the individual needs, preferences, and cultural expectations of those receiving them.
A therapist who uses EBP does these three things:
People often assume that all psychological treatments used in therapy are rooted in scientific evidence, yet that is, put simply, not the case.
We’re not saying therapy that isn’t rooted in scientific evidence is voodoo and can’t be helpful. Instead, it means that we don’t know what the therapy is exactly or if or why it works.
It is crucial to understand that not all therapies are equally effective. Some treatments just work better for some problems than others.
Mental health professionals have different training and approaches. Some therapists rely on therapeutic models grounded in scientific research, and others do not.
Compare this to antidepressant medications. The FDA must closely examine and approve the efficacy, effectiveness, and safety of psychotropic drugs before they can ever be prescribed. Yet therapists could technically use methods that do not have any scientific research to support them.
Scientific evidence does not mean anecdotal experience like, “I have found that this therapy has generally worked for my clients in the past.”
Scientific evidence means rigorous, controlled research such as support from randomized controlled trials (RCTs). To be a part of an evidence-based practice, a particular therapy doesn’t necessarily have to be supported by an RCT, yet this is the highest form of research support.
Here are some examples of evidence-based treatment models with RCT support:
The type of psychological problem could also impact what treatment is most effective. For example, although EFT is effective for couples, it is not considered a “gold standard” treatment for PTSD, such as cognitive processing therapy, prolonged exposure therapy, or trauma-informed CBT for children and teens.
If you are unsure what model a prospective therapist uses, ask them.
If you have never heard of their model, ask them to show you its scientific support.
Please take a look at our list of 30 questions you could ask a potential therapist for more ideas.
Therapy is a big commitment of internal and external resources. You are committing your time, money, and effort. You are trusting this person with your psychological health or that of your loved one.
You must have a strong voice in the type of treatment you receive.
The therapeutic alliance is one of the predictors of positive outcomes in therapy (discussed below). This alliance is a collaborative process that can’t happen unless your values are considered.
You may prefer that a therapist identifies as a particular gender or ethnicity. You may prefer a therapist who has a similar cultural background. Although current research consistently shows that therapy can still be effective when your therapist is of a different gender, ethnicity, or background, you may still want to speak to your therapist about your concerns.
Having sufficient clinical expertise would include several things related to the therapist’s training, experience, and competency in:
Even if a therapist uses an empirically supported treatment, they still need the requisite training and expertise to interpret the research or implement the method correctly.
Most professional organizations require their members to be culturally competent. For example, the APA has adopted specific guidelines for psychologists.
However, additional training and expertise may be required to be fully competent in working with certain populations.
If you are a member of a special population due to gender, ethnicity, background, or anything else, the therapist should be culturally competent in working with you. For instance, treating PTSD in a veteran might be different than a civilian. Treating a female soldier who experienced military sexual trauma may be different than working with a male with combat trauma.
Here is a nonexhaustive list of population competencies:
Another aspect of evidence-based practice is ensuring that the provider has expertise in using the therapy they plan to use.
If a therapist has told you that they are trained or qualified in a particular evidence-based treatment or specialty, it is helpful that you feel that those credentials and training are sufficient.
Several therapies offer certification. If your therapy suggests using a specific therapy, ask the therapist what specific training or certification that they have in the therapy.
BEST FIT
In addition to all of these factors, we know that another important predictor of effective treatment is the relationship between the therapist and the client or therapeutic alliance, which is highly influenced by the therapist’s interpersonal and communication skills.
Current research has shown that therapist’s with better interpersonal and relationship skills are associated with better outcomes in therapy.
Therapist attributes that are associated with better therapeutic alliance in the research include:
Hopefully, this article has helped you in understanding helpful factors in choosing the right therapist.
If you want more information, please check out our article on 30 questions to ask a potential therapist:
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As well as having extensive training in the treatment of anxiety and its related issues, our team of therapists also offers a wide variety of online therapy services in North Carolina and all PSYPACT states. We work with lawyers, entrepreneurs, students, parents, and teens who are dealing with stress and burnout, trauma and loss, ADHD, depression, and life transitions. Our goal is to help you find success both professionally and personally so you can gain Momentum to excel in a bright future.
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