Why are some therapists better than others: Implications for mentors

By Amy Novotney, APA

Why are some psychologists better at providing therapy than others?

“It’s quite surprising how little research has been devoted to [answering this question], particularly given its importance in psychotherapy training,” says Bruce Wampold, PhD, of the University of Wisconsin–Madison.

But that dearth of knowledge is about to change, thanks to a six-year effort involving Wampold and other internationally recognized psychotherapy researchers. In April, the 32-person group — led by Pennsylvania State University psychology professor Louis Castonguay, PhD, and University of Maryland psychology professor Clara Hill, PhD — held the first of three conferences at Penn State to delineate the characteristics of “good therapists.”…..

APA published the resulting book on the conference, “Transformation in Psychotherapy,” in June.

Characteristics of effective therapists

1. Effective therapists have a sophisticated set of interpersonal skills, including verbal fluency, warmth, acceptance, empathy and an ability to identify how a patient is feeling. Successful therapists can also form strong therapeutic alliances with a range of patients and are able to induce them to accept the treatment and work with them, he says.

2. Effective therapists are also highly tuned in to patient progress, either informally or through the use of outcome measures, according to research by Michael Lambert, PhD, a psychology professor at Brigham Young University and another participant in this latest series of Penn State conferences. He summarizes his research on the importance of client feedback in psychotherapy in his 2010 APA book “Prevention of Treatment Failure.” He says that therapists must take the time to track patient progress — ideally through client self-reporting — and take action to address issues that impede it.

“We know that psychotherapy works — research shows that a substantial number of people who come to see therapists will not only benefit from therapy but will also demonstrate clinically meaningful change,” Castonguay says. Other experts point out, however, that while therapist factors are clearly important, they are not exclusive of the models that therapists practice. It’s imperative that providers make sure the treatments they are using are based on solid science, says Thomas Sexton, PhD, a psychology professor at Indiana University and a member of APA’s Div. 43 (Society for Family Psychology) Task Force for Evidence-Based Practices.

“There’s evidence to suggest that certain intervention programs also make a difference with specific client problems,” Sexton says. “The work of the task force centered around the position that effective therapists need good interpersonal skills, a systematic model with good likelihood of success, and the ability to implement those models with fidelity and clinical complexity — or with high competence — in ways that match to the clients.”

And more clients may soon be able to experience meaningful therapeutic gains if this group can identify the therapist characteristics and actions that most help — as well as those that undermine — psychotherapy.

Amy Novotney is a writer in Chicago. This article originally appeared in the APA monitor