What Really Works in Therapy: What the Research Says

Barry Duncan, Mark Hubble and Scott Miller, the authors of "The Heart and Soul of Change" assembled the leading outcome researchers in the world, who reviewed four decades of research to find out what really works in therapy. 

Four common factors contributed to success regardless of the orientation, discipline, or job title of the helper.

These four factors and their percentage are as follows:

• Client Factors: Accounted for 40% of change.  The client is the most important contributor to successful outcome.  Client resourcse that influence a successful outcome are persistance, openness, faith, optimism, supportive family member or religious community.

• Relationship Factors: Account for 30% of change.  This is called the "alliance", which is the partnership between the client and the helper, where there was a strong agreement on the goals and tasks of therapy.  Client's positive ratings of the alliance are the best predictors of success - more predictive that diagnosis, approach, therapist, or anything else.

• Expectancy/Placebo: Accounted for 15% of change.  This is the client's belief of being helped and the hopeful expectations that accompany the method.

• Model/Technique Factors: Accounted for 15% change.  Despite all the rhetorics around the power of models, not one has demonstrated any superiority over any other.

My aim in therapy is to build a solid working relationship with my clients and to formulate goals that my clients want to work towards.  Each counselling session is monitored by session and outcome measures so that progress can be measured.