Predictors of Positive Outcomes in Therapy and How to Get the Most Out of Therapy

What makes therapy effective? Can we predict if there are going to be positive outcomes in therapy? If so, what are the indicators? These questions have been asked by many a researcher, therapist, and client alike. So, if you are asking yourself these questions as you are looking for a therapist, you are not alone. If you had to guess, what would you guess? Would you guess, the experience of therapist, the theory or interventions used by therapists? Something else? Well, you might be wrong. Overall, the prevailing evidence shows that the number one predictor of positive outcomes in therapy is the therapeutic relationship. Therefore, the relationship between the client and therapist. Is that what you guessed? Let’s take a deeper look. 

As mentioned above, the most critical predictor of positive outcomes in therapy is a strong therapeutic alliance. This relationship needs to be collaborative, trusting, and empathetic. This includes having a secure bond and an agreement on the treatment goals. A mutual level of engagement is part of a strong therapeutic alliance. This means that both therapist and client are active and equal participants in the process. 

Let’s briefly discuss some client factors. Some factors that impact positive outcomes in therapy include the client’s motivation to change, openness to new information, and belief in the therapy’s effectiveness. Homework completion was another consistent predictor of positive treatment outcomes. What the homework looks like is something that is part of the treatment plan creation. 

Now some of the therapist qualities that impact the effectiveness of therapy include empathy, unconditional positive regard towards the client, genuineness, and the ability to adapt approaches. Empathy refers to the ability to understand another person’s perspective and emotions. It’s absolutely important that you do not feel judged by your therapist. Your therapist should treat you with unconditional positive regard, understanding, and affirmation. Keep in mind, depending on your therapy goals, a therapist may communicate perspectives you don’t agree with and offer challenges to your thinking. Typically, these practices are intended for growth, impact, and positive change. If you ever feel put off by something that your therapist has said or done, then it is encouraged that you tell them. 

Some other major indicators include positive feedback in sessions 3-5, client motivation, high outcome expectancy, goal consensus, and the therapist’s ability to tailor treatment to the client’s specific needs. 

Your therapy goals are more likely to be met if they are known to your therapist. It’s worth spending time clarifying and defining your therapy goals. This may be done before entering therapy, or alongside your therapist in a collaborative way. Goals may shift and adapt throughout the therapy. It’s also helpful if the therapist communicates realistic expectations for the process of therapy and mutual participation. 

 According the 16 meta-analyses conducted by the American Psychological Association (APA) Task Force, positive therapy outcomes can generally be predicted by three main factors (DeAngelis, 2019; Misic, Birkenbach, & Attia, 2023) which are therapeutic relationship, goal consensus, and empathy (discussed above). But an interesting finding is that the therapist experience had no bearing on the outcomes of the therapy. Therefore, therapists who have been practicing for many years were not necessarily more effective than therapists at the beginning of their career. 

Seven Tips for Getting the Most Out of Your Therapy 

Unfortunately, making progress in therapy is not as simple as just showing up. Therapy being another item on the ‘to-do list’ has the same effect as attending a workout class and laying on the mat the entire time. If you’re not working the muscles, you’re not building them.  

Below are things that you can do to help get the most out of your therapy sessions: 

• Show up on time, be consistent, and create an environment free from distractions. We’re more able to access our emotions and be reflective when we’re physically and mentally present. Do what you can to minimize outside noise and turn off notifications before a session. 

• Identify goals or think about what you want to get out of therapy. A therapist is there to help you clarify what is important to you and set realistic, meaningful goals. Don’t be afraid to consult with them or explicitly tell them, “This is what I want.” 

• Be willing and open to receiving new information and reflective when presented with new information. A sense of curiosity, willingness, patience, and openness go a long way in creating meaningful change. 

• Be honest with your therapist. Any good therapist welcomes feedback and questions about the work that you do together. If you’re concerned about something, or frustrated with progress, you can talk about it with your therapist. Therapists are not mind readers; they cannot help you with something that you have not told them. 

• Put in the practice. Real change happens between sessions. It’s when you take what you experienced or learned from a therapy session and contemplate it or apply it in your life. Trials and errors are common and normal parts of learning. 

• Be willing to feel your feelings. A therapist can help you develop safe ways to feel your feelings and contain them. Processing painful events oftentimes requires you to make room to feel and thinking about your feelings is not feeling your feelings! 

• Acknowledge the reality that there is no magic wand “fix” for feelings. Therapy and learning how to think differently, responding differently, and feeling is a process. Change is most often non-linear and subtle before it becomes significant. 

Now, hopefully, you can put some of this into action in your own therapy and experiences. This is meant to be a starting point but change and therapy is a process and work. Please be patient with yourself as you try to make long-lasting changes.  

https://actionpsychotherapy.com/psychotherapy/3-strong-predictors-of-positive-therapy/  

https://www.sciencedirect.com/science/article/pii/S0272735824000849 

*This article is meant to be informative and not a replacement for treatment. Please consult your provider for treatment recommendations.