The 9 attributes that the therapy professional must have (according to science)

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

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

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The effectiveness of the patient-therapist relationship

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

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

1. The extra-therapeutic change (40%)

It refers to those aspects specific to the patient and the context in which it develops; the personal and social circumstances that surrounds him.

2. The common factors (30%)

They include the elements that all types of therapy share, independently 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 should be based: feelings of liking, respect and reciprocal trust between both parties.

3. The techniques (15%)

They are related to the specific components that make up a specific therapy class. 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.

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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 in a high percentage of the causes that motivate the psychological change are involved 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 their own interpersonal skills and those of a more technical nature .

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

1. Have an adequate level of intellectual competence .
2. Have a dynamic, persistent and energetic attitude in the professional practice.
3. To show flexibility in the management of theories, techniques and methods, as well as the acceptance of different equally valid lifestyles.
4. Act based on a balance between support and patient protection.
5. Guided by constructive and positive motivations, showing a sincere interest for the patient.
6. Have a sufficient level of self-knowledge about their 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 interfence of personal aspects of the figure of the psychologist in the development of therapy. This phenomenon is known as countertransference.
9. Strictly comply with ethical and moral principles collected in the professional deontological code (confidentiality, referral to another professional, supervision of the case and avoidance of the establishment of non-professional relationships between both parties).

Factors that favor the therapeutic relationship

Apart from the capacities previously indicated, Bados (2011) mentions another series of aspects related to the therapist that facilitate the establishment of an adequate link between this and the patient:

2. Cordiality

A moderate expression of interest, encouragement, approval and appreciation are related to the establishment of a more favorable work environment. At this point, it is also possible to find a balance in the manifestation of the physical contact issued, since these types of gestures can easily be 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 specific therapy are decisive. The results of Howard's research (1999) seem to indicate that the dominance of the latter aspect over the former is more associated with a good result of the intervention.

Cormier and Cormier (1994) expose the following samples of nonverbal behavior as a reflection of professional competence: ocular contact, frontal disposition of the body, fluidity in the speech , pertinent questions that stimulate thought and verbal indicators of attention.

4. Trust

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

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5. Attraction

A certain level of perception of the therapist as an attractive correlates positively with the result of the treatment, as shown by Beutler, Machado and Neufeldt (1994). This attraction is based on the degree of kindness and cordiality elicited by the professional , as well as in the perception similar aspects between this and the patient (Cormier and Cormier, 1994).

Actions such as eye contact, the frontal disposition of the body, the smile, nodding, the soft and modulated voice, the samples of understanding, a certain degree of self-disclosure and the consensus on the structure of the therapy increase the patient's interest for their 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 the 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 guarantee a certain level of autonomy in the patient , as well as the feeling of being guided and supported in the treatment process.

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Professional attitudes that help progress

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

1. Empathy

It is defined as the ability to understand the patient from the perspective that the latter has and, very relevant, the fact of knowing how to communicate. Therefore, previously the therapist must be competent in the understanding of cognitions, emotions and behaviors as the patient would process them, not interfering with the professional's perspective . The second point is the one that will really make the patient feel understood.

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2. Unconditional acceptance

It refers to the acceptance of the patient as he is, without judgment, and to value him as a person worthy of dignity. Truax and Carkhuff (1967, cited in Goldstein and Myers, 1986). Different elements make up this type of attitude, such as: high commitment towards the patient, desire to understand it or manifest a non-valued attitude .

3. Authenticity

This attitude involves showing yourself as you are, expressing your own feelings and inner experiences without distorting them. Acts as a spontaneous smile, make comments without double entender or the expression of some sincere personal aspect they indicate authenticity. However, an excess of spontaneity is not recommended; It seems to be relevant that the personal revelations on the part of the therapist are oriented to the benefit of the patient and the therapy exclusively.

4. Active listening

It consists of the capacity to receive the interlocutor's message (based on verbal and non-verbal language), its proper processing and the issuance of a response that indicates that the psychologist is giving all his attention to the patient.

• Related article: "Active listening: the key to communicating with others"

Attitudes that hinder the progress of the sessions

Finally, a series of actions have been gathered that can have the opposite effect and damage the favorable evolution of psychological therapy. This list reflects the main behaviors that the psychologist should avoid manifesting before the patient:

• Show insecurity about the interpretation made about the problem consulted
• Maintain a cold or distant attitude, be critical or authoritarian.
• Ask too many questions .
• Interrupting the patient hastily.
• Tolerate and incorrectly manage emotional expressions of crying on the part of the patient.
• Desire to be appreciated by the patient and get your approval .
• Try to eliminate the patient's psychological discomfort too quickly
• Imbalance the approach between the simple and the more complex aspects of therapy.
• Avoid dealing with conflicting issues for fear that the patient may emit 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 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.

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