Research Describes 14 Qualities and Actions of an Effective Counselor (Part 2 of 2)
woman in therapy
In case you missed it, in my last post I summarized some findings from the American Psychological Association about the characteristics of an effective counselor. You can check out the APA's own write-up of the research here. According to the APA, an effective counselor has 14 key qualities that contribute to successful treatment. This time of year, when a lot of people are looking for counseling, these are great things to keep in mind when looking for help. Of course, counseling seems simple on the face of it, but there's actually a lot going on in your counselor's mind in session, not to mention the ton of stuff going on in the relationship between you and your counselor. All that to say, great outcomes are the product of a host of variables in counseling, I don't think it's too far of a stretch to say that these therapist qualities make successful treatment more likely. So, what are these qualities? Let's quickly recap the first five before diving into the back nine. A good counselor:
is good with people as he has great interpersonal skills
helps the client feel understood and accepted
forms a strong therapeutic relationship with the client
understands and explains why the client is experiencing distress
has a plan based on that understanding (i.e., she knows what the heck she's doing)
Okay, let's jump in to the deep of the pool and round out this list. Here are my thoughts on the other nine qualities an effective counselor must have, according to the APA.
6) An Effective Counselor is "Influential, Persuasive, and Convincing" When Presenting the Plan
Not gonna lie, I gagged a little inside when I first read this. While anyone who goes to counseling would want, I think, his counselor to be influential (after all, aren't you essentially paying for his influence in your life?), I'm not sure many of us would sign up for a "convincing" therapist. Obviously, there's a bit more to this quality than the title, so let's break this down a little.
man looking out to sea thinking about counseling
A Short Digression
But before we do that, I feel obligated to acknowledge my bias, because I think it's particularly evident in this counselor quality. I use short-term therapeutic approaches all the time, but I also work and theorize from a psychodynamic or psychoanalytic perspective. I think the unconscious mind influences our thoughts, feelings, and decisions, so I find these theories really helpful. Presenting a plan in a convincing way in short-term treatments can work wonders. I do cognitive-behavioral therapy to help a struggling addict finally put an end to sexual behaviors that are harmful. I use EMDR to help a with a client heal her trauma. In these treatments, presenting a plan in such a way that communicates, "Hey, here's what I think is going on, and so EMDR is going to help you" is usually beneficial. Indeed, it often does inspire hopefulness in the client. "Sweet," he may say to himself, "we can finally do something about this shit." Damn straight, son. And yet when I'm doing deeper work, I think that being convincing or persuasive can impinge upon the client's autonomy and restrict the options available to her. I always want the clients working with me to be free to experience a greater range of emotions, to experience less rigidity in their thinking and behaviors, and in these ways to have more freedom and choices with regard to how they live their lives. I believe that these are among the hallmarks of mental health. Being winsome in the ways that the APA describes has its place, mostly in short-term treatment or at the very beginning of a treatment that starts with symptom reduction and management. However, being "convincing" or "persuasive" at the wrong time in treatment can, I believe, run the risk of implicitly annihilating the client's subjective experience, that is, communicating that her version of reality is less true than ours. And that's a one-way ticket to the implosion of a good therapeutic relationship. I could go on here, but I think you get my drift.
Back to What Makes a Counselor Effective
Okay, so what does the APA actually say here? It's short, so I'd encourage you to take a look at it and decide for yourself what to make of it:
The therapist presents the explanation and the treatment plan in a way that convinces the client that the explanation is correct and that compliance with the treatment will benefit the patient. This process leads to client hopefulness, increased expectancy for mastery, and enactment of healthy actions. These characteristics are essential for forming a strong working alliance.
It sounds good, doesn't it? And it's true, I think that a good counselor will do just this, but as I said, it's much more likely to occur in short-term treatment that's probably focused on symptom reduction (e.g., cognitive-behavioral therapy or EMDR). Notice too that the counselor makes this speech about the treatment plan before the actual treatment really gets going (that is, before the plan is implemented). In longer, psychodynamic treatments, the counselor's "plan" and influence is still present but in a very different way. Usually, the psychodynamic therapist will offer what are called "interpretations," which can be anything from incisive insights about your relationship with mother to brief reveals of the counselor's thoughts and feelings. These interpretations can be hints about how the counselor is conceptualizing what's going on with the client, i.e., the "plan." Sometimes, these interpretations are right, and when they are, you'll feel understood. If they're wrong and don't line up with your experience, you'll feel that too. As always, you should always feel free to ask the therapist what's on her mind.
7) An Effective Counselor Keeps an Eye on How You're Doing
As treatment unfolds, a good counselor is going to be tuned into you to see how you're doing. Are you getting better or are you deteriorating? Are your symptoms going away, staying the same, or what? Oftentimes, due to the nature of therapy, you may feel worse before you feel better. That's because you're digging into your emotional "stuff," probably stuff that you haven't shared with anyone and that's often painful. Again, I think that longer-term psychotherapy can be (but not always) less concerned about short-term fluctuations in symptoms because therapists in this camp are trying to get at the underlying thoughts and feelings (which are often out of our awareness) that drive the symptoms. Resolve that stuff and you won't need your symptoms anymore, the thinking goes. The bottom line is that therapists who embody this quality best are really attuned to what's going on in their clients. Whether it's with assessments or short "how's-your-depression-today" kind of tests or good, old-fashioned listening, a good counselor will be able to track your progression in therapy.
_ _
Okay, so this got a little long. Longer than I anticipated. We didn't even get close to finishing the fourteen qualities, did we? It's all good. Sounds like a job for next time. Please join me for my next post. And Happy New Year!