SUCCESSFUL THERAPY

We want you to be super successful in resolving your trouble spots! Therefore, we think it is important to discuss the specific factors that research says are key to successful therapy. Underneath each specific factor you’ll find the theme of how to be in a healthy relationship with others. In essence, healthy relationships between clients and psychologists are at the heart of great therapy experiences. It’s our deepest desire and professional ethical obligation to provide you with a great experience. As such, we want you to know important information about the different roles and expectations of both clients and psychologists.

Your success, as a client, is dependent upon 10 factors that you control and 6 factors that the psychologist controls1. These factors, when addressed adequately (not perfectly), give therapy the fuel it needs to drive you to your desired destination. Likely, you’re looking to go to the place of a happier, healthier, and more in control you. Regardless of whether you see an Unstuck Psychologist or some other psychologist, these factors remain the same. First, we’ll chat about you and then we’ll chat about what to look for in a psychologist.

CLIENT-FACTORS THAT INCREASE SUCCESS IN THERAPY

You have a tremendous amount of power over how well individual therapy works for you. The quality of your participation is the most important factor in therapy. It’s even more important than the psychologist’s attitude, behaviour, or chosen technique1. Researchers say that these 10 client variables positively influence outcomes in big ways1. How big? A whopping 40% big1!

And because your time is valuable, and because there’s a lot of information to cover, we’ll combine some of these factors. We’ll also highlight how an Unstuck Psychologist helps to bolster client factors.

1. CLIENT PARTICIPATION

This may seem rather obvious, but client participation is a foundational factor for success in therapy. Participation means showing up to session, in session, and out of session.

SHOW UP TO SESSION

First and foremost, consistent attendance gives you a better chance of goal achievement. After all, you can’t get to a goal if you never start to work on it. If you add momentum , you can really expedite results. When momentum is interrupted by unplanned frequent breaks or long periods of time between sessions, therapy results are delayed. Don’t let therapy end up like the gym membership that’s purchased, but inconsistently used. Instead, commit to complete a therapy goal. Complete goals, means a better feeling you. After all, isn’t that the point of therapy?

Likewise, be on time! Most therapy sessions are 50-minutes and come with a $200 price tag. Get the biggest bang for your buck and arrive 10-minutes early. An early arrival allows for some transition time from a chaotic commute, a hurried telephone conversation, or a rushed meal. Everyone needs time to transition. Give yourself the gift of 10-minutes. Get in the right frame of mind. Use the 10-minutes to sip on a beverage, think about your last session, check in with yourself, and get rid of a full bladder.

YOUR UNSTUCK EXPERIENCE

At the risk-free consultation, you and your psychologist will consider your resources (i.e. time, finances, work schedule, insurance benefits) and find the right pace for your treatment. There’s only so much of you to go around. We want your experience with therapy to be successful, not resource stressful. One way to reduce the stress on resources is to take a break. When you consider a therapy break, think about the kind of break to take. There are two types of therapy breaks – unplanned and planned.

UNPLANNED BREAKS

Unplanned breaks tend be disruptive to therapeutic success. Feelings like guilt and shame about an unplanned break often come up. When clients take an unplanned break they can feel bombarded about feeling like a failure and stop all together. A sudden stop in therapy leaves unfinished business, another incomplete relationship, and a halt in progress.

We have a better idea. Instead of the experience of built up shame and guilt about a decision made on the fly to take a break from therapy, send your Psychologist a quick email. Let them know about the need for a break, when you anticipate a return, and if you’re okay! Unstuck Psychologists are always delighted to receive short and sweet updates. Your Psychologist will invite you to return to therapy when the time is right for you.

PLANNED BREAKS

When you connect about the need for a break, we can then say it’s a planned break. Planned breaks occur when you and your Psychologist strategize about ways to continue your progress while on a break. Sometimes breaks are suggested by the Psychologist. It might be that you need some time to try out a few of your new skills. A planned break may also be necessary if your goals are achieved and now you want time to evaluate the need for further treatment. Regardless of why you take a break, please know that you’re always welcome back into relationship with your Unstuck Psychologist at anytime—even if it’s several years later!

SHOW UP IN SESSION

Another aspect of client participation has to do with how you show up in the session. Good therapy is experiential. Expect to try new skills, think in new ways, or interact with emotions differently. A little courage to explore something new is powerful. However, a psychologist should never force you to do anything you do not want to do. You are in control. It’s your right to say things like, “I’m not ready for this, or I need help, or I don’t like this, or I don’t want to do this”.

If you ever feel like a psychologist treats you in disrespectful ways or is abusive in any way (sexually, emotionally, financially, or physically) you can make a complaint to the College of Alberta Psychologists (CAP).  Psychologists are regulated healthcare providers. As such, public complaints of misconduct are investigated by CAP. CAP is an independent regulatory body from practicing psychologists. If a psychologist is found guilty of misconduct, they will be disciplined. Disciplinary actions include suspensions, fines, or even revocation of licensure.

CAP

YOUR UNSTUCK EXPERIENCE

In therapy, your Unstuck Psychologist will ask you to

  • Discuss your life and relationships
  • Tune into your body sensations.
  • Try out different skills.
  • Interact with thought patterns
  • Learn to invite and welcome emotional expression

New experiences like these can feel awkward and uncomfortable at first. However, your Psychologist has the skills to help you overcome old fear and embrace new experience. Smoothing out fear or apprehension associated with the tasks of therapy is the first place therapy usually starts. Your Unstuck Psychologist will be with you every step of the way!

SHOW UP OUTSIDE OF SESSION

Brains, minds, and relationships change when they’re exposed to new experiences. Good therapy will supply you with many new experiences. It is your responsibility to take these new ways of being and apply them to your world. Some common individual therapy assignments include:

  • Worksheets
  • Thought experiments
  • Experimentation with new communication skills
  • Observation of your reactions
  • Use of a journal
  • Emotion regulation skill practices
  • Tracking progress or stuck points

YOUR UNSTUCK EXPERIENCE

Since Unstuck Psychologists believe in good therapy, they encourage work outside of session. Your Psychologist knows that the brain needs opportunities to practice a new skill. Focused practice builds and strengthens new neuronal networks. New neuronal networks mean changes in behaviour, emotional regulation, relationship interactions, or thought processes. You see, the brain is much like a muscle. In order to grow, muscles require repetitive exercises that challenge strength and flexibility. Likewise, individual therapy is a process of incremental changes that lead to strength, flexibility, and stability.

In other words, if your Psychologist asks you to do a therapy assignment, it’s because a certain skill needs to be built or strengthened. It’s worth your while to put in the work. Your Unstuck Psychologist can’t do this for you. The only way to gain more confidence with new behaviours is to exercise your brain!

2 & 3 CLIENT COOPERATION & COLLABORATION

You can check on the level of your cooperation and collaboration by asking yourself a few quick questions:

  • Are you willing to partner with the psychologist to move in the direction of achieving your goal?
  • Will you step into the safety of the client-psychologist relationship to try something new and surprise yourself?
  • Can you be on the same team as the psychologist?

Use these questions as a guide for you to test out how strong these client factors are. Hint: The more of a team player you are, the more successful you’ll be in therapy 🙂

YOUR UNSTUCK EXPERIENCE

There are folks that either prefer to play alone or those who play with too many on the field. If you’re the kind that plays alone, that’s okay. It might even be the reason you’re seeking help. Alternatively, you may be the kind of person that surrounds yourself with lots of different people who may not always contribute to you having a solid sense of self. Regardless of your style, a powerful way to learn relational skills is to learn is from a role model.

During session, your Unstuck Psychologist will role-model the spirit and intent of a collaborative and cooperative relationship. Your psychologist will also create opportunities for you to try out the new skills of cooperation and collaboration. At Unstuck, the development of therapy goals and treatment plans are examples of such opportunities.

4 & 5 CLIENT EXPERIENCE OF AND CONTRIBUTION TO THE THERAPEUTIC BOND

The easiest way to assess how connected you feel to the psychologist and how you contribute to the relationship bond is to ask yourself some simple questions:

  • Do you experience the psychologist as kind, caring and helpful?
  • Is there a deep sense that the psychologist likes you?
  • Do you like the psychologist?
  • Can this relationship can handle a courageous conversation about things that are not working well?
  • Are you reasonably comfortable talking about uncomfortable topics?

Great relationships happen when both folks are invested in the health of the relationship. How you contribute to this relationship determines whether you achieve your goals. Here are a few tips on how to contribute to the relationship.

  • Practice fostering kind and gentle feelings towards the psychologist.
  • Make allowance for the psychologist to make missteps.
  • Practice compassion, kindness, and generous assumptions of the psychologist.

As you can see, the attitude you bring to the therapeutic relationship directly enhances your well-being. A strong bond means a deep healing.

YOUR UNSTUCK EXPERIENCE

If you’re new to therapy these factors may surprise you. While fostering a relationship with your Psychologist might be a new experience for you, it’s not new to them! Your Unstuck Psychologist is a pro and wants to you have the experience of a good, strong, dependable, and safe relationship.

The development of a great therapeutic bond is as much your responsibility as it is your Psychologist’s. As such, your Unstuck Psychologist does their part by asking for your feedback about the session. Communication about what went well in therapy; what didn’t go so well; and what you’d like to see more of or less of are valuable sources of information for your Psychologist.

PROGRESS, NOT PERFECTION

Don’t expect this relationship to be perfect. It can’t be, and that’s the beautiful thing about it! Mistakes and missteps allow for opportunities to grow and gain confidence about being in relationships. How one handles mistakes in a relationship determines how deeply healthy or deeply unhealthy that relationship becomes. Peter Bromberg said, “When we avoid difficult conversations, we trade short-term discomfort for long-term dysfunction”.

The next time your Psychologist asks for feedback, think of it as an opportunity to build your relationship skills. Skill practice that’s offered in this safe and supportive relationship, leads to increased confidence. Confident folks build respectful, care-full, and responsive relationships. Be brave. Give feedback so that you get what you need. Your Unstuck Psychologist is always on your team!

6 & 7 CLIENT EXPRESSIVENESS & OPENNESS

Expressiveness includes discussions about what’s on your mind, and the ability to express emotions and feel body sensations. Given that good therapy is an experiential process, it’s essential that you express thoughts and emotions as they come up. Therapy is meant to be a safe and judgement free place.

Openness refers to being open to explore the topics of new ideas, body sensations, emotions, and behaviours. The opposite of openness is defensiveness. Defensiveness can best be described as the sense of hiding or pushing something out of awareness because it’s unwelcome. The degree to which folks experience openness and defensiveness occurs on a continuum of extremes. Extremes in openness or defensiveness usually equate to more rigid behaviours, thoughts, or emotional expressions.

YOUR UNSTUCK EXPERIENCE

The Unstuck Psychologist is trained to be on the look out for these patterns. It’s highly likely that these extremes will show up in one way or another. When the time is right, your Psychologist will gently bring these tendencies to your attention (the patterns can be so engrained that you don’t see them) and suggest ways to soften these patterns. The benefit of focused work on either being too open or too defensive naturally leads to a better you. In fact, the hallmark of healthy psychological functioning is the ability to choose a flexible response when under moderate levels of stress.

8. THERAPY REALISATIONS

This refers to the idea of taking the experience you had in a session and incorporating it into other aspects of your life outside of session. For example, in session you worked on modulating the experience of anxiety and you experienced moments of calm. By reminding yourself of the experience of those calm moments, you can apply the experience of calm to other situations that you feel anxious about. Or perhaps, something was mentioned in session that resonated deeply with you. The more you reflect on that experience, the more your brain in strengthens the new neuronal pathways that were created in the session. In effect, you actively restructure your brain when you focus your attention on your therapeutic experiences.

YOUR UNSTUCK EXPERIENCE

Realisations in therapy are like gold! Which is why they need to be mined, extracted, and polished. There are two types of realisations – those that appear like magic, and those that we work at.

MAGICAL REALISATIONS

Magical realisations are the “ah ha” experiences that happen in session. When you have one of these, your Unstuck Psychologist will help you deepen that moment. Focused attention on realisations means you stay with the intensity longer than you normally would. Brains don’t change at random. They change under certain conditions like a realisation.

Exposure to a novel experience causes the brain to light up with electrochemical responses. In effect, realisations give a little shock to the system—like a tiny jolt of electricity. Realisations create room for new thoughts, emotions, or behaviours. Do not expect an “ah ha” realisation every session. These are certainly fun when they happen, but if you only chase that experience, you will end up disappointed and discouraged.

EARNED REALISATIONS

The type of realisations that you and your Psychologist work toward are the ones that happen through the process of trying new skillful behaviours and celebrating your successes. For example, it’s incredibly exhilarating to realize that you said no, when normally you would have said yes! Quite often there’s a tendency to speedbump right over victories. At Unstuck, your Psychologist will help you savour these.

In fact, every Unstuck session begins with identifying and celebrating your victories and successes. Your Unstuck Psychologist will help you deepen the yummy feelings of success. The reason for this is that when folks do something well, they’re more likely to do it again. Get ready to celebrate your successes each session!

9. CLIENT SUITABILITY

An important aspect of suitability to individual therapy is personal safety. If you’re in an unsafe environment, in an abusive relationship, or are actively suicidal, then safety must be the first focus of therapy. For example, anxiety is often the outcome of living in an unsafe or unstable environment. Therapy isn’t used fix fear or anxiety when they are valid.  Lastly, if there’s an imminent threat of suicide, the threat needs to be immediately addressed. Therapy can work wonders, but it doesn’t work on dead people.

Another aspect to client suitability is self-agency. If you’re in therapy because someone else says you need to, then you might resent the experience of therapy. Feelings of resentment about “doing your time” on the couch act as a barrier to change. Maybe you don’t see the need to change anything! That’s totally great too. But if you choose to attend, be completely honest about why you are going. Own a desire of change, so that you can claim a victory of possibilities you may not even be aware of.

YOUR UNSTUCK EXPERIENCE

It’s because your Unstuck Psychologist wants you to experience a long and satisfying life, that they focus on safety issues as they arise.

If your safety is at risk due to an unsafe environment or relationship, your Psychologist will partner with you to build a safety plan. They will help you locate community resources that specialize in the creation of safety.

Sometimes the risk to safety comes from one’s self. At the risk-free consultation, your Psychologist screens for suicide risk. If it’s determined that your risk is high, your Psychologist and you will work on lowering risk factors. Similarly, if suicidal thoughts, urges, or action plans come up at any time over the course of therapy, your Unstuck Psychologist will partner with you to reduce risk-factors.

10. TREATMENT DURATION

Well this is complicated. Treatment duration is connected to things like

  • goals for therapy
  • the presenting concern
  • history
  • client participation in therapy
  • the Psychologist’s treatment approach

In other words, don’t expect to solve a lifetime of anxiety in 10 sessions! For the most part, clients see small successes early in treatment with more demonstrable change occurring at around the 20-25 session mark3.

YOUR UNSTUCK EXPERIENCE

Together with your Unstuck Psychologist, you’ll build your treatment plan around resources such as time, money, and insurance. As a reminder, our Psychologists prefer to work on underlying issues. We aren’t in the “workaround” or “quick fix” business (sometimes referred to as Solution Focused Brief Therapy). If you know this upfront, then you won’t be disappointed! The Unstuck Psychologist works with your end goal in mind, and they will not keep you in individual therapy longer than necessary. From the very first session, they work towards your graduation. After achieving success, many clients use this momentum to tackle other goals.

Some folks require longer treatment. Longer treatment is usually recommended for folks who have personality structures that cause them trouble. In these cases, people require more relationship experiences with a psychologist to correct for past relationship injuries. Likewise, people who struggle with personality disorders, stress-disorders, complex PTSD, and dissociative disorders tend to require several years of treatment before they no longer meet the DSM-5 diagnostic criteria for the disorder3.

DON’T WORRY, YOU DON’T NEED ALL 10 FACTORS BEFORE YOU START!

These 10 client factors contribute to your therapeutic success. Some of these factors are learned through the process of individual therapy (i.e. how to be in a relationship). Other factors are enhanced by focused practice (i.e. experiencing openness to emotions). While other factors are about timing (i.e. financial resources, time constraints, commitment, and personal safety). Through the process of a detailed assessment, which is at the heart of the Unstuck Method, you and your Psychologist will discover your unique strengths and plan accordingly. When you bring your “Client Participation” attitude, your Unstuck Psychologist is better positioned to help you succeed!

PSYCHOLOGIST FACTORS THAT INCREASE SUCCESS IN INDIVIDUAL THERAPY

We want every person, whether they decide to see one of our psychologists or not, to experience a deep sense of well-being. Therefore, we want you to know what to look for when choosing your practitioner. Psychologists that demonstrate these specific behaviours are the ones whose clients boast of flexible emotional responding, sophisticated relational skills, and a stable sense of self-worth. Here’s what to keep an eye out for when it comes to selecting your psychologist.

1. YOU FEEL EXCITED, HOPEFUL, AND INSPIRED BY THE PSYCHOLOGIST

Here’s a little-known factoid: psychologists who believe their clients will improve, have clients that do improve1! What is this about? Well a few things. First off, brains change when they are in the presence of another brain4. We’re not talking about Mr. Spock’s mind-melding in Star Trek, yet it is kind of like mind-melding! Humans are relational creatures and our brains grow and change according to the relationships we have, what we believe about ourselves and others, and our life experiences4.

Therefore, if the psychologist has a mindset that you have potential to create a better way of being in the world, they’ll behave this way. A “yes you can” mindset from a psychologist sends this message to your brain. The message is sent by way of language, emotional resonance, body language, prosody, and tone of voice4. When your brain receives these signals, it responds by creating this same mindset in you4. Brains are meant to change and since you have a brain, well… you can change too!

2. EMOTIONAL SAFETY IN THERAPY

What is emotional safety in therapy? Well, it’s the sense you get when you know that you can talk about your deep dark secrets, and you won’t be judged. It may take you some time to get to this point. A good psychologist knows this and does not expect you to spill your guts in the first session. Instead, the psychologist will attend to the emotional safety in the relationship so that when you’re ready to share, you feel supported and cared about.

The sense of safety is crucial for another reason. Psychologists work hard to help their clients have a corrective-experience. It may be that the only thing you know is how to keep other people at a distance to feel safe. Or perhaps you absorb the emotional stuff of other people and it wears you down. Regardless of which it is, your Psychologist will provide you opportunities to stretch your current way of being and experience something different. Stretch opportunities allow folks to broaden their range of skills in the moment and apply the lessons to other life situations and relationships.

3. A TEAM EFFORT

The best psychologists are the ones that can form an alliance with their clients against the problem. A team approach allows both folks to be on the same level. No one is above or below the other. The ability of a psychologist to forge a collaborative relationship creates great outcomes for clients. Here’s mind-blowing factoid: the amount of client change that can be attributed to the psychologist’s ability to collaborate is 5-7 times greater than any specific type of individual therapy or intervention1. Shut-the-door! So, do yourself a favour and scrap the idea that a psychologist will fix you by doing therapy. Psychologists worth their salt don’t do therapy on clients, they do therapy with clients.

4. PSYCHOLOGISTS WHO CREATE STRUCTURE AND FOCUS GET BETTER RESULTS

Imagine this: You’re in individual therapy and your Psychologist has never talked with you about your goals for change. The therapy sessions seem to be about whatever comes to your mind. Sessions end with the depletion of your bank account. You haven’t experienced an improved sense of well-being and you’re confused about the point of therapy.  No! Therapy sessions need to be focused and structured. It’s the job of the psychologist to make sure this happens.

Clients often compliment their Unstuck Psychologists for attending to these tasks. At Unstuck, you’ll know what to expect at the beginning of every session. At the end of session, you’ll know what you’ll focus on in the next session. Of course, if something comes up, the plan might need to change. You will discuss the need to change together and go in the direction that makes most sense. Ah, yes, collaboration at its finest!

5. EXPECT YOUR PSYCHOLOGIST TO EXPLAIN A RATIONALE FOR YOUR PROBLEM

A psychologist should give you an explanation about what the heck is going on! Granted they may need some time to formulate this explanation. If there’s not enough information about you, it’s hard to generate an adequate explanation. The Unstuck Psychologists will usually explain the reason for the problem right after the completion of your assessment—around session 3. After which time, the both of you will agree on the goals for change and develop a treatment plan to get you moving in the right direction.

Another thing to keep in mind, is that a psychologist should always be testing their hypothesis of the problem. If the hypothesis is inadequate, the psychologist needs to reformulate and discuss that with you; this may include a course correction. Often treatment plans need to adapt because new information comes forward, life events happen, or you decide you’ve reached your goal and want to focus on something else.

6. EXUDES HUMILITY

A good psychologist will track and correct their mistakes. The self-aware psychologist expects to make mistakes occasionally. They expect this because they know that personalities are complex. As a result of this complexity, the psychologist will encounter their own new relationship experiences and consequently might make some mistakes in how they respond.

Most of the time, the mistakes are so small that only the psychologist knows when a mistake has happened. Other times, the mistakes cause a rift in the client-psychologist relationship. At this point, the team needs to break into a huddle. Discuss the mistakes of the last play. Accept responsibility for the mistakes and then devise a new strategy to progress the play forward again.

Another aspect of humility is asking for feedback. Psychologists who regularly encourage clients to give feedback about sessions and incorporate the information are in a better position to meet that client’s needs1.

You see, the best therapy occurs through a creative process. Therapy needs to be personalized to each client. Client feedback provides the psychologist with valuable information. This information is used to create a highly personalized interaction that leads to even more brain-mind-relationship changes. At Unstuck, you’ll be asked for feedback about the session. Do not worry it sounds scarier than it really is. Really, we ask 4 quick and easy questions and that’s that!

OTHER TIDBITS AND CONSIDERATIONS ABOUT PSYCHOLOGISTS

Along the same lines as giving feedback, psychologists who review and reflect on their sessions, consult with other psychologists, and go to individual therapy themselves are the ones that tend to invest deeply in their work with clients.

Notice that we didn’t say that a good psychologist has a Ph.D., is older, younger, female, male, has specific training, practices this or that type of therapy, or has oodles of experience. We didn’t say these things because not one of these things matter in terms of actually helping clients achieve their goals1! What matters the most are the psychologist factors and client factors that we’ve just covered. The rest is pretty much fancy fluff, or the personal preferences of the client or psychologist.

At Unstuck, we can only say that we are deeply committed to helping you find the right psychologist and progressing you to be the best-you ever. So, book a risk-free consultation and see how our Unstuck Psychologists measure up!

Unstuck Psychologists

References

  1. Duncan, B. L. (2009). The Heart and Soul of Change: Delivery of What Works in Therapy. American Psychological Association.
  2. Schore, A. (2012). The Science of the Art of Psychotherapy. Norton.
  3. American Psychological Association. (2020). How long will it take for treatment to work? https://www.apa.org/ptsd-guideline/patients-and-families/length-treatment
  4. Siegel, D. (2012). The Developing Mind (2nd Ed.). Guilford.