Keira Rakoff: What Makes Therapy Work?

Keira-2As part of an ongoing series, the staff at Union Square Practice will be sharing their thoughts on an important question: “ What makes therapy work?” This week, Keira Rakoff, Union Square Practice’s Mental Health Counselor, shares her thoughts.

The interesting thing about this question is that every clinician we’ve heard from so far has a different response based on their prior experience and perspective. After working with my own patients during my career in mental health, I’ve noticed some important aspects of what makes therapy work, which I’ll mention here.

But first, I wanted to think about the opposite question: what doesn’t make therapy work?

There are lots of answers here. Here’s mine: an inability to think that life could be any different than it is at this very moment. I believe that every single person has the power in their lives to change how they approach and deal with their problems, even if they can’t change what the actual situation might be. So the only thing I ask of my patients is that they are willing to walk into my office with an open mind and see that with my help, they can build self-confidence and strength within themselves.

Therapy should be a collaboration between therapist and patient, rather than a one-sided activity where the patient is expected to solve all problems without any assistance or focus. Many patients come to therapy because there is something in their lives that they feel needs improvement, or else because they are uncomfortable with their current emotions. As a therapist, I can’t physically insert myself into their personal lives and deal with the issues which my patients struggle with. But what I can do is be a helpful guide—even better, a catalyst for change.

Of course, not every aspect of your life that you want to change will happen overnight, and it’s important to be aware that not everything a patient hopes to accomplish will work out exactly as planned. But gradual changes made over a daily or weekly basis are the ones that prove to be the most effective. And my duty as a therapist is to help you develop the tools along the way to encourage this growth.

The other thing that I believe makes therapy work is that sometimes it’s just necessary to talk to someone who’s “on your side”, and to work through the problems of the week with them. My patients need to be able to trust me as a therapist, to feel like they can share what’s happening with them without reservations. And from my side, I can say that empathizing with each patient’s story and being completely nonjudgmental are essential to therapy. Trust and warmth can take time to develop in any relationship; this is even more important with a therapeutic relationship.

Our lives are so busy and hectic all the time; therapy should be a chance to slow down and examine the things that are really bothering us, instead of just looking at them as another set of things to check off an agenda. What makes therapy worthwhile and meaningful are the small, attainable goals that my patients and I can focus on together over the course of our sessions.

If you have any more questions about how therapy works or doesn’t, feel free to contact via Twitter @KeiraRakoff!