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1. What works in counseling?
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Gay Men's Counseling uses an outcome-directed process based on research by Chicago's Institute for Therapeutic Change.
Researchers asked: "What works in therapy?" and identified four elements:
- Extra-therapeutic: social and environmental influences in a client's life, unrelated to therapy, that contribute to symptom relief and problem resolution. Extra-therapeutic factors account for about 40% of client change.
- Client-counselor relationship: the rapport or connection a client experiences with his therapist. Relationship—sometimes called therapeutic alliance—contributes about 30% to change.
- Hope: a client's expectation that therapy will help. Hope influences change by about 15%.
- Clinical methodology: the specific theory or technique a counselor uses. Methodology accounts for about 15% of change.
Researchers also noted that, while counseled individuals showed better outcomes than non-counseled peers, no therapeutic method seemed any better than any other. In other words, although therapy works, all methods—even those in sharp contradiction—are about equally effective. Meanwhile, methodology itself contributed only a modest 15% to clinical success.
These are surprising findings, especially in view of the counseling profession's strong and continued emphasis on methodology. Theories and methods come and go, but few professionals have questioned the primacy of methodology itself. As each new approach fails to live up to its promise, attention simply shifts to an even newer technique. These days, for example, it is the rare practitioner who aspires to train as a classical Freudian analyst, but almost every therapist lines up to learn about Thought Field Therapy or EMDR or Somatic Experiencing.
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