Many authors have been in charge of determining which are the characteristics and competences that a good professional of psychology applied to therapy should possess.

As we will see, not everything is based on theoretical knowledge of intervention techniques; other more interpersonal aspects have a considerable influence on the success of therapy.

The effectiveness of the patient-therapist relationship

The practice of the profession of clinical psychologist involves the mastery of two very different types of knowledge. On the one hand, it requires considerable theoretical learning of the different therapeutic intervention techniques that correspond to the psychological current applied by the professional (cognitive-behavioral, psychoanalytic, phenomenological-existentialist, contextual, etc.).

The second type of competence is centred on the internalisation of a series of personal skills that will be decisive in the type of therapeutic bond established between patient and psychologist . Thus, the latter will mark to a significant extent the effectiveness of the treatment carried out. In Lambert’s (1986) renowned research on the factors involved in therapeutic success, the following proportion was found among the different factors involved:

1. Extraterapucial change (40%)

It refers to those aspects that are specific to the patient and the context in which he or she operates; the personal and social circumstances that surround him or her.

2. Common factors (30%)

They include the elements shared by all types of therapy, regardless of the psychological current applied. This proportion reflects the quality of the therapeutic relationship between both parties. In this sense, Goldstein and Myers (1986) defend the three main components on which a positive therapeutic relationship must be based: feelings of pleasure, respect and mutual trust between both parties.

3. The techniques (15%)

They relate to the specific components that make up a particular kind of therapy. This percentage reflects the interaction between the patient and the theoretical-practical components used by the professional, that is, how the patient internalizes the methods and contents of the intervention.

4. The placebo effect (15%)

It is linked to the patient’s expectations and the credibility that the psychological intervention generates.

Attributes of the Professional Therapist

As can be seen, a high percentage of the causes that motivate psychological change involve variables that depend on the skills derived from the professional. As Cormier and Cormier (1994) pointed out in their studies, the efficiency of this figure is based on a balance between one’s own interpersonal skills and those of a more technical nature .

According to the authors mentioned, the characteristics that an efficient therapist should possess are the following:

  1. Possess an adequate level of intellectual competence .
  2. To have a dynamic, persistent and energetic attitude in the professional practice.
  3. Show flexibility in managing theories, techniques and methods , as well as the acceptance of different equally valid lifestyles.
  4. Acting on a balance between supporting and protecting the patient
  5. To be guided by constructive and positive motivations , showing a sincere interest in the patient.
  6. Have a sufficient level of self-knowledge about one’s own limitations and strengths (theoretical and interpersonal).
  7. Self-perception of sufficient professional competence.
  8. Internal psychological needs resolved and capacity for self-regulation that prevent the interference of personal aspects of the figure of the psychologist in the development of therapy. This phenomenon is known as countertransference.
  9. Strictly comply with the ethical and moral principles included in the professional code of ethics (confidentiality, referral to another professional, supervision of the case and avoidance of the establishment of non-professional relations between both parties).

Factors favoring the therapeutic relationship

In addition to the above-mentioned skills, Bados (2011) mentions another series of aspects related to the therapist that facilitate the establishment of an adequate link between the therapist and the patient:

2. Cordiality

A moderate expression of interest, encouragement, approval and appreciation are related to the establishment of a more favourable working climate. At this point, a balance must also be found in the manifestation of the physical contact emitted, since this type of gesture can be easily misinterpreted by the patient.

3. Competition

In this area, both the degree of professional experience of the psychologist and the mastery in the administration and application of the contents included in the concrete therapy are decisive. The results of Howard’s (1999) research seem to indicate that mastery of the latter aspect over the former is more associated with a good outcome of the intervention.

Cormier and Cormier (1994) present the following samples of non-verbal behavior as a reflection of professional competence: eye contact, frontal body disposition, fluency in speech , pertinent and thought-provoking questions, and verbal indicators of attention.

4. Trust

It seems that this factor depends on the perception generated by the patient from the combination of phenomena such as: competence, sincerity, motives and intentions, acceptance without value judgments, cordiality, confidentiality, dynamism and security and, finally, the emission of non-defensive responses (Cormier and Cormier, 1994).

5. Attraction

A certain level of perception of the therapist as attractive correlates positively with the outcome of treatment, as demonstrated by Beutler, Machado and Neufeldt (1994). Said attraction is based on the degree of kindness and cordiality aroused by the professional , as well as on the perception of similar aspects between him/her and the patient (Cormier y Cormier,1994).

Actions such as eye contact, frontal body positioning, smiling, nodding, soft and modulated voice, signs of understanding, a certain degree of self-revelation and consensus on the structure of the therapy increase the patient’s interest in his or her psychologist .

6. Degree of directivity

An intermediate degree of directivity or structuring of the therapy is recommended, where a balance can be found in aspects such as the facilitation of instructions to be followed, the presentation of the contents of the tasks and topics addressed in the sessions, the resolution of doubts or the confrontation of certain ideas of the patient. All this seems to guarantee a certain level of autonomy in the patient , as well as the feeling of being guided and supported in the treatment process.

Professional attitudes that help progress

In the 1960s Carl Rogers proposed the fundamental pillars on which the attitude of the therapist towards the patient should be based: empathy, unconditional acceptance and authenticity. Later, the ability of active listening was also considered very relevant.

1. Empathy

It is defined as the ability to understand the patient from the perspective that the latter possesses and, very relevant, the fact of knowing how to communicate it. Therefore, the therapist must previously be competent in understanding cognitions, emotions and behaviour as processed by the patient, without interfering with the perspective of the professional . The second point is what will really make it easier for the patient to feel understood.

2. Unconditional acceptance

It refers to the acceptance of the patient as he is, without judgment, and to value him as a person deserving of dignity. Truax and Carkhuff (1967, cited in Goldstein and Myers, 1986). Various elements make up this type of attitude, such as: high commitment to the patient, desire to understand him/her or manifesting a non-valuable attitude .

3. Authenticity

This attitude entails showing oneself as one is, expressing one’s inner feelings and experiences without falsifying them. Acts such as a spontaneous smile, making comments without double meaning or the expression of some sincere personal aspect indicate authenticity. However, an excess of spontaneity is not recommended; it seems relevant that personal revelations by the therapist should be oriented to the benefit of the patient and the therapy alone.

4. Active listening

It consists of the capacity to receive the message from the interlocutor (attending to verbal and non-verbal language), its adequate processing and the emission of a response that indicates that the psychologist is paying full attention to the patient.

Attitudes that hinder the progress of the sessions

Finally, a series of actions have been brought together that can produce the opposite effect and harm the favourable evolution of psychological therapy. This list reflects the main behaviors that the psychologist should avoid manifesting to the patient:

  • Show uncertainty about the interpretation made of the problem consulted
  • Maintain a cold or distant attitude, be critical or authoritative.
  • Asking too many questions .
  • Interrupt the patient in a hurry.
  • Tolerating and mismanaging emotional expressions of crying by the patient.
  • Wish to be appreciated by the patient and get his approval .
  • Trying to eliminate the patient’s psychological discomfort too quickly
  • To unbalance the approach between the simple and the more complex aspects of the therapy.
  • Avoid dealing with conflicting issues for fear that the patient may have an intense emotional reaction.

Bibliographic references:

  • Bados, A. and Grau, E. (2011). Therapeutic skills. University of Barcelona. Barcelona.
  • Cormier, W. and Cormier, L. (1994). Interview strategies for therapists: Basic skills and cognitive-behavioral interventions. Bilbao: Desclée de Brouwer. (Original of 1991).
  • Lambert, M. J. (1986). Implications on psychotherapy outcome research for eclectic psychotherapy. In J. C. Norcross (Ed.),Handbook of Eclectic Psychotherapy. New York: Brunner-Mazel.