Wow. What matters most in therapy? There are so many schools of thought on that question it boggles the brain. Between the problem approach and the list of disorders published in the DSM-V (Diagnostic and Statistical Manual of Mental Disorders: Fifth Edition), identifying what makes therapy successful has about as many answers as there are economists predicting the stock market. When I scroll through other therapists’ listings on Psychology Today to see how many different disorders they treat, I start feeling a little queasy. Should I be treating all those? Listing all those specialties? Does that matter? Or should I maybe sound more warm and fuzzy like many sites do? Should I declare that my undying passion is to help others?

therapeutic relationship

Well that’s not my style. But frankly it’s not about me. It’s about you. It’s about your ability to move ahead with insight and understanding regarding your challenges in a way that makes a difference in your life.

Recently my daughter was sharing her experiences about a couple of counselors she talked with, and the upshot was that some fit and some didn’t, which she understood as a sense of not quite connecting with the helper or therapist. Like they really didn’t get her. And that is what makes therapy unique–the therapeutic relationship itself.

What matters most in therapy is finding the match with someone who makes you feel safe and accepted, and helps to create the space for you to dive deeply into the challenges you face.

Personally I think it is important that you can be candid with your therapist about how they are helping you–or not. How can you stay on track with your progress if you don’t measure it? The way I do that is to have my clients evaluate their sessions with me. I use a very brief written grading process that is quite efficient at the end of the hour. How does this matter? It allows me to see right away if you feel an issue was not addressed, or if I perhaps did not ask the right questions. It also allows me to zero in on what was most important to you, and teaches “course correction.”

By this I mean that it is helpful to learn, within a safe relationship, that you can repair, change course, and deepen your connections with partners, friends and family members. AKA practice. Often people give up too soon in their personal relationships, or they hardly get started for fear of rejection or lack of certainty (constantly needing certainty is a hallmark of anxiety). Practicing safely with different examples in session, and experimenting a bit out of session while  is useful. And asking for feedback is a scientifically proven way to improve almost anything–from guitar playing to therapy!


In the therapeutic relationship, the key is to work on the hard stuff. Think about practicing the piano as an example. If all you do is continue to practice your favorite parts of a piece because it’s easy and sounds good to you, you will never get good at the whole piece. It is focusing on the tough bits, the areas that give you heartburn, that help you get better at it. Looking at your responsibility within interactions that may cause pain and disconnection is not always easy to see, much less to accept and change. I mean it’s much easier to blame, right? Equally important is evaluating whether or not the relationship is a healthy one that deserves your efforts. But I digress.

We were talking about what is important in the therapeutic relationship. Oh. Right. That relationship is a terrific place to practice safely for the real deal where the hard stuff actually takes place.

I would love to help you figure out your hard stuff. Call me or shoot me an email from the contact form on my site if you’re ready to get going in 2017. Let’s make this relationship work for you!