According to research by Dr. Michael J. Lambert and Dr. Dean E. Barley, in "Handbook of Psychotherapy Integration," the most important factor predicting successful psychotherapy is the therapist's relationship with the patient. No matter what type(s) of therapy, or what type(s) of psychological issues, the statement above remains true. Therapists behave in a variety of ways depending upon their experience, type of therapy used and their theoretical perspective. Some are active and openly direct the patient; others avoid directing the patient almost entirely because they do not want to unduly influence the patient with their own viewpoints. The traits that follow below are communication traits true of many therapists.
Listening
Probably the most important communication trait of therapists is their ability to listen empathically to things the patient may say. Most patients want and need to be heard by someone warm and empathic who is genuinely interested in them.
Voice, Body Language and Facial Expression
A therapist's posture, tone and volume of voice, her body language, and any outward signs of her facial expression can influence a patient's reaction(s) in therapy enormously. Therapists learn to be genuine, yet non-intrusive with their voices, are careful about their body language and are aware of how they use facial expression.
Allowing and Facilitating the Patient's Work on Goals
Good therapeutic communication means the therapist must genuinely respect the patient, and the patient's autonomy. As facilitators, therapists help patients become aware of ways in which patients would like to change, and they assist with goal-setting to effect change. This is done by pointing out or reflecting what the therapist is hearing from the patient, and encouraging the patient to set goals for herself, consistent with the patient's set of values and dreams, not those of the therapist.
Interpretation of the Patient's Patterns and Problems
As the therapist listens to and observes the content and psychological processes occurring during sessions, she may interpret this material in order to aid the patient. Such interpretations, if they are timed well, and if the therapist avoids over-interpretation, lead to the patient's better understanding of meanings of his thoughts and feelings, so he may view his issues in a new, expanded way.
Setting and Observing Boundaries
Beyond following ethics codes and laws applicable to therapists' boundaries with clients, therapists keep boundaries in the therapy relationship. These boundaries are set for reasons like keeping the session time consistent, payment, protection against their own exploitation of the patient, safety and confidentiality. Therapists use boundaries to avoid harming the patient and therapy by using the therapy to work out their own issues.
References
- "Helping Skills"; Clara E. Hill, Karen M. O'Brien; 1999
- "Interpersonal Process in Therapy"; Edward Teyber; 2006
- "Handbook of Psychotherapy Integration"; Psychotherapy Outcome Research: Implications for Integrative and Eclectic Therapists; Michael J. Lambert and Dean E. Barley; J.C.Norcross and M.R. Goldfried, eds.; 2002
