Thoughts on Therapy: What is good counselling?

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A women talking with a counsellorIt isn’t always easy to persuade someone to seek help for a mental health issue. Sometimes it’s denial, but other times it’s simply being afraid of the unknown – not knowing what good counselling would look like. A great first step to accessing therapy is to get a sense of what the therapy experience is, and moreover, what defines good therapy.

Generally speaking, therapy is a professional relationship that empowers individuals, families, and groups to accomplish the maintenance and enhancement of physical, intellectual, emotional, social and interpersonal functioning. And more specifically, good therapy is defined as a sum of essential elements that guide participants through a positive therapy process and outcome.

A number of research studies point to common factors that underpin good therapy:

  1. The therapeutic relationship

 The establishment of a safe and trusting relationship between the client and the therapist seems to be a central factor in therapy. Most people who seek counselling are in pain and are eager for help. They generally respond well to a caring and empathic counsellor.

  1. Empowerment

Therapists who empower their clients maintain the belief that people have the capacity for change and are equipped with the inner resources to do so. Good therapy is based on the belief that people can heal if they want to, and if they are able to contribute what is sufficient and necessary to their own personal growth.

  1. Professionalism

Most therapists are members of professional associations and/or colleges that regulate their activities. A regulated therapist is required by law to deliver professional services competently and ethically. The foundation for good therapy also exists when a counsellor works within their scope of practice (guided by their education and training), and is able to identify clients who must be referred elsewhere.

  1. Boundaries between the participants

Boundaries are the framework within which the therapist/client relationship occurs. Boundaries make the relationship professional and safe for the client, and set the parameters within which therapy is conducted. Professional boundaries typically include length and time of a session, personal disclosure, limits regarding the use of touch, fee setting, and the general tone of the professional relationship. In a more subtle fashion, the boundary can refer to the line between the self of the client and the self of the therapist.

  1. Assessment formulation

The assessment process is a way of saying to the client, “You are special and I want to get to know and understand you so that I can determine the best way to help you.” Good therapy requires a good assessment of the client and of their environment in order to formulate a treatment plan and therapy goals. Ideally, good therapy is collaboration between the therapist and the client in which both gain in knowledge and understanding while enhancing their working relationship. Assessment also leads to knowing how the therapy is progressing and when to end the process.

  1. Effective Therapeutic Process

Conversations with therapist should be natural and well balanced. Independent of therapeutic orientation, good therapy helps clients see their own role in their level of happiness and recognizes that blame is a destructive force and cannot be part of healthy choices. Effective therapeutic process focuses both on the symptoms and root causes of the presenting problem. It provides the client with effective coping strategies while working through and resolving the underlying causes of those symptoms.

By Barbara Lesniak, Manager, Government Counselling Services

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