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Which is More Important – the Therapy or the Therapist?

This article is for informational purposes only. It is not intended to be used in place of professional advice, treatment, or care in any way. Lawyers, law students, judges, and other legal professionals in Massachusetts can find more on scheduling a Free & Confidential appointment with a licensed clinician here.

When we see lawyers/law students (or their family members) at LCL who we think would benefit from ongoing therapy (you can call it counseling if you prefer), we make an effort to match them with clinicians with whom we have some experience or have at least acquired relevant information.  That’s one of the reasons why coming to LCL for a referral is usually better than simply selecting one from a list.  My own approach, if I’ve gotten to know the therapist even a little, is to visualize him or her with the client in front of me, and get a sense of how that might go.  The fact is that, while some therapists are more helpful than others, none is a good match for everyone.


If you have not spent much time in the mental health services world, you may think that therapy is a relatively unitary phenomenon.  Of course, one can generally assume that it will involve speaking openly, and in guaranteed confidence, about matters that one might not discuss at length with friends or even family, and that the notion of recognizing feelings is usually a part of what goes on.  But if you were to see a few different therapists (not at the same time, please), you might have a few very different experiences.  Therapists vary in both (a) technique and (b) style/personality.


It’s worth learning about various techniques, which range from highly focused on measurable variables and “evidence-based” (currently a very sexy term in treatment circles) to “out there” (techniques that might involve, say, put crystals under your bed or tapping parts of your body).  We can help you distinguish among these.  Each of them tends to be extolled and found effective in studies by their own practitioners (kind of like medications in studies by pharmaceutical companies like


But there is also quite a bit of evidence that, technique aside, it is the relationship between the therapist and the client/patient that is most linked with effectiveness.  For most mental health issues, therapy is as effective as medications (and combining the two may be most helpful).  What makes a therapist effective with a particular patient/client is not adherence to a particular treatment method; it is something about the person and the relationship that eludes definition but that clearly includes empathy and a sense of collaboration.  Although technique does not seem to make a crucial difference, it seems to be important for both the helper and help-seeker to agree on their goals, to share information and expectations, and to collaboratively work toward and monitor progress.


If, after a few sessions with a new therapist, you have no sense that any of this is happening, it may be wise to consider seeing another therapist.  If, on the other hand, a formerly productive/collaborative therapy relationship seems to have lost ground, it is worth (a) raising the issue with your therapist, reviewing and updating goals and how progress is discerned, and/or (b) arranging a consultation (typically one to three sessions) with another therapist who can provide you and the clinician with feedback and recommendations.


Jeff Fortgang, PhD



CATEGORIES: Treatment & Therapy | Uncategorized

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