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A friend of mine passed a literature review to me recently on effective psychotherapists and what affects their client outcomes the most.  Surprisingly, factors like client diagnosis, age, level of impairment and therapist licensure, theoretical orientation, and experience were not found to be the statistically significant in client success.  More than anything else, including psychotropic interventions, the relationship the therapist shared with the client was the number one catalysis for change.  The therapists who are able to form those sort of relationships with clients are not born, but are created, through constantly looking for feedback from their clients, establishing the baseline for their success, and using focused practice to improve specific skills.  Because the high learning curve at the beginning of working as a mental health professional, many workers experience a high learning curve at the beginning of their careers, but then plateau. Unfortunately, most mental health professionals then consider time in the field, as opposed to measurable client success and satisfaction rates, makes them successful clinicians. Their tell their clients their baseline, and through that honest exposure, open themselves up for feedback and lower the rate of client dropouts.  Many “supershrinks” are intuitive about the areas that they need to improve, but tools do exist to measure client success and establish a baseline.  One of the tools mentioned in the article was a web page for behavioral health professionals to input their data and find out their baseline.

I thought this article was interesting for a number of different reasons, but notably the statistical insignificance that various interventions played in client success. It would be so easy if all we needed to do was find the square shaped peg to fill the square shaped hole caused by some particular mental illness. However, this article seems to point out that there is no particular peg to fill a particular hole. In fact, it seems to be the very permeable and changing factor of relationship that not only empowers, but also pushes, change.

Miller M., Hubble M., and Duncan B. (2007). Supershrinks What’s the secret of their success? Retrieved December 8th, 2008 from Psychotherapy Networker Website:

February 2017
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