What Actually Makes Therapy Work? It's Not What You'd Guess.
We’ve spent this whole series exploring different types of therapy (CBT, ACT, DBT, Schema Therapy, & EMDR), what they’re about, who they help, and how they can be adapted for neurodivergent folks. If you’ve been following along, you might be wondering, “Okay, but which one is actually the best?”
Here’s the honest answer. After all that, the research actually points to something that isn’t really a therapy approach at all.
It's Not the Model, It's the Relationship
Decades of research have shown that the biggest factor in whether therapy helps isn’t the type of therapy itself. It’s the relationship between you and your therapist, what’s often called the therapeutic alliance.
That means things like trust, working together, feeling understood, and mutual respect between you and your therapist. The therapy style does matter, but the relationship itself often makes an even bigger difference.
Study after study has found the same thing, the better the relationship between you and your therapist, the better therapy tends to work. This holds true for all sorts of people, problems, and therapy styles.
What This Means If You're Telehealth-Based
If you’ve ever wondered if therapy over video can really compare to being in the same room, fret not! Studies show you can build a strong connection with your therapist over video, and clients often feel just as connected as they do in person, even across different groups (Simpson and Reid, 2014).
So, the screen isn’t the big barrier people sometimes think it is. What really matters (aka trust, safety, and connection) can still happen through telehealth, too.
For Clients: Don't Just Choose a Model, Choose a Person
With all this in mind, if you’re looking for a therapist, it can help to shift your focus a bit. Instead of just asking, “Do they do EMDR?” or “Are they trained in ACT?”, try asking yourself:
Do I feel comfortable speaking with this therapist?
Do I feel emotionally safe?
Do I feel heard and understood, even in the first few minutes?
A therapist’s training and approach do matter, and that’s why we’ve spent time breaking down each one. But none of it really works without a solid relationship underneath. Therapy works best when you feel safe. Safe enough to be honest, to not have all the answers, to make mistakes, and to just be yourself, whether you’re in the room or on a screen.
At Very Helpful Chats, our clinicians use a mix of evidence-based approaches, but just as importantly, we care about the relationship you build with your clinician. If you’ve read this series and found yourself drawn to a certain approach, that’s a great place to start. But don’t forget to ask yourself the other big question: does this feel like someone you could really trust, open up to, and feel understood by?
If you’re curious to see what this could look like for you, reach out and have a chat with us. We’d love to see how we can support you.
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