Client factors in successful therapy

Yesterday I had one of those experiences at work where I say something to the client and then realise that I didn’t even know, that I knew, what I said. I had seen this woman twice so it is certainly in the getting to know you stage (both ways for that matter).

At some point I said, “You are suited for counselling because you are introspective, intelligent and willing to express emotion”.

When I heard myself say this I got a sort of befuddled feeling because I said the words even before I had thought about it and I didn’t realise I knew that. I surprised myself.

When I thought about it later I thought it was quite a good summation so then I stopped feeling befuddled and felt even a bit impressed by myself at making a concise and precise statement about factors that can contribute to the success of therapy even before you get to the therapist’s ability. What helps from the client’s side of the equation


1. Introspection. The more the person is willing and able to look at how they are contributing to their difficulties the better the prognosis. The client who says, “My problems are because others treat me badly”, then things are not looking too good for the long term outcome. This tends to be the blamer type of person. My problems occur because of how others act and if they acted differently then it would be better for me. This person has little introspection. The problem is the others are not in the counselling room and therefore they are not going to change.

Then the therapist says, “How do you think you contribute to your difficulties?” and sees what sort of a response they get. If the person maintains that it is others impact on him that is the problem then as I said the prognosis is not looking good.

2. Intelligence. Transactional Analysis like most ‘talking’ therapies requires a level of intelligence to be effective. As a rough guideline one could say an IQ between 80 and 140 is needed. Below 90 and certainly below 80 the person does not have the ability to understand the necessary basic concepts like ego states or will find it very difficult to do 2 chair work as they cannot project the person into the empty chair. The therapist’s options become greatly reduced and they end up doing basic behavioural change contracts. The person with the good intellect has a better prognosis because they can understand the necessary theory and concepts.

Focus therapy ego states. Jpeg

The person with an IQ of 140+ may also struggle a bit more to obtain gains out of therapy. They can easily get lost in their intellectualisations and thus the Child ego state gets lost and this is crucial for any successful therapy. Also as they don’t think like normal people this can effect their ability to relate effectively with others and can impact on the therapeutic relationship.


3. Emotional expression. To be able and willing to show and release emotions in therapy is going to significantly improve the prognosis. Those who have trouble doing so will tend not to respond so successfully to treatment.

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