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What makes therapy a success?

Writer's picture: Olga ShchedrinskayaOlga Shchedrinskaya

What actually works in counselling?

Is it possible to predict the treatment outcome? Are there techniques or modalities that work better than others?

The authors of "The heart and soul of change: What works in therapy" Hubble​,​ Duncan & Miller​ ​got an answer! They declare that there is a combination of a few factors significantly impacting an outcome:

1. Therapeutic Technique 2. Expectancy and Placebo 3. Client Factors 4. Therapeutic Relationship


Based on their research, it is estimated that "the therapeutic relationship contributes a hefty 30% to outcome in psychotherapy, making it a far more critical factor than either therapeutic technique or expectancy.

Clients who are motivated, engaged and connected with the therapist in a common endeavour will benefit the most from therapy.

Their participation is, of course, largely a result of the bond or alliance that clients form with the helping professional; studies show that the consumer's participation in therapy is the single most important determinant of outcome. What is​ ​more​, several studies have found that clients' ratings of that bond or alliance, rather than the therapists' perceptions are more highly correlated with outcome" (Hubble, Duncan & Miller, 1999).

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