Not too long ago a client asked me if I believed that therapy works. And my pat answer is ‘yes, of course I do.’ However the question stuck in my mind and I found myself thinking about that question long after the appointment was over.
I have to acknowledge that it is far more nuanced than a yes or no answer. The success of therapy with an individual is contingent on any number of factors. From the ability of the therapist to form a therapeutic report with a client, their training, access to appropriate supervision, and their boundaries to the client’s goals, expectations and support system. However, there are other factors that can impact the success of treatment: are the client’s basic needs being met, do they live in a safe environment, is their family of origin supportive, is there access to effective health care and educational programs? Is the client a member of a group targeted by politicians like members of the LGBTQ+, black, indigenous or immigrant communities?
Yet I believe that therapy can help in most situations as long as the therapist is well informed and is getting supervision. If a therapist isn’t trained in cultural competency, for example, they risk inflicting further harm on a client from a minority group. And honestly, even if you are trained it’s still possible to misstep with a client and negatively impact trust in the relationship. Fortunately a lot of healing can be achieved when such a misstep is addressed and amens are made. A therapist needs to be able to handle having such issues brought up or even learning how to circle back to an error without the client bringing it up. That takes a lot of self awareness and skill.
I think there is even more complexity when dealing with adolescent mental health success. But that is for another day.
Furthermore, there is no therapeutic skill out there that will eliminate the impacts of a hostile work/school/home environment on a client. One cannot perform yoga to cure injustice and abuse. But a client can learn how to navigate such a situation and a therapist can support the client in advocating for a better outcome.
There are also times when the expectation of a client needs shifting. If you are dealing with a diagnosis like Bi-polar disorder, Autism or ADHD you are looking at a neurological condition that is life long. There is nothing to fix. Treatment is ongoing and may require several rounds of therapy, ongoing medication, or work/school modification. Chronic depression and anxiety may also take a shift in the concept of success. If a person has experienced multiple episodes of depression it’s possible for them to experience cycles of depression throughout their life. However, an individual can learn how to manage the inevitable storm and with those plans and skills live their lives to the fullest.
People often feel like they are broken and need fixing when they seek therapy. Again, I try to encourage people to shift that thinking to seeing the issue more along the lines of being impacted by a condition. In therapy we work together to develop mindsets, skills and support to minimize or eliminate the impact.
At the end of the day, I’m at my core a humanist. I believe that once a person’s needs are met, once they are in a place of safety, they are able to reach their full potential. We cannot expect someone to find a sense of well-being when they are being harmed by an individual or a system. In those situations I believe it is the therapist’s responsibility to validate the client’s experience and work to find support to help the clients find a safer environment.
So, yes, therapy works. As long as we continue to strive for a more inclusive, equitable, and safe community.
