Does Therapy Really Work?

There are times when I find myself asking if therapy works. Do my clients really benefit from working with me? Why is it that some people leave changed and others either take eons to make any progress, or sadder still, leave abruptly or feel hopeless? Is it about them? Is it about me?  And, on top of all of this, I have read that 30% of people seeking therapy feel better, 30% feel worse (yikes!) and 30% feel like nothing changed. I am not sure about the other 10% but maybe that's for another time.

When I think about the times I have gone to my own therapy, I found each time to be very helpful. Even when I disagreed with my therapist, I found myself even years later pondering what was said and why I reacted negatively to that exchange. Was therapy hard? Absolutely. I've gone for grief therapy (more than once) and marital therapy. There were times when I thought I'd rather cancel and call it a day, but I went anyway and it was good that I did. If I didn't change as a person, I changed my perspective and sometimes, my behavior.

What do I notice from my clients? I have noticed that some people run with it! They come to therapy prepared (I never did that!), notebook in hand, mind open, ready to move and move on. Some people come in tentatively; unsure what will happen, if they want to change at all, unsure about me, unsure about the process. Some people come in because they were forced to--either by a partner or a parent or some loved one who said they had to or else. I get all of that. Therapy is hard and if I am honest, highly intrusive.

What are the results? I think intuitively we all can come to the same conclusion. The ones that come in expectedly, wanting to move and ready to change, do! The ones who come in tentatively do one of two things; they either slowly open up to change, and do!-- or they slowly shut down and put up a wall--not willing or unable (for various reasons) to put in the effort and make the change. Do I think sometimes the issue is with me? Yes. In therapy world we call that "a goodness of fit." We have to have a good rapport to build a connection because, as I said, therapy is intrusive by nature and we have to feel safe. I have been fortunate to not have that happen often at all, but it can and it needs to be respected by both the therapist and client when it does.

So, what's the conclusion. Does therapy help? I think so. If it didn't then I'm a charlatan who takes people's money and snickers on their way out. But it helps only when this happens:
1. There is a good fit between client and therapist.
2. The client or clients are ready to work.
3. The client or clients are "sick of being sick" and are motivated to work hard.
4. The clients are clearly informed that 50 minutes a week (or 100 minutes if I see a couple) will not change anything unless they put in the work  between sessions. 
 5. The clients use the tools provided and know that it's not a one-time fix but a minute-to-minute, sometimes day-to- day practice.

Are you ready to make the change?