“Can you help me?”

This is the question I am most often asked in initial consultations.

It’s a tempting question to ask, and an understandable one. I’m afraid, though, that if you ask me this question, my answer may very well be unsatisfying.

I can answer other questions easily – questions like, “Have you worked with people like me?” or “Have you worked with people who struggle with the sorts of problems I face?” and “What kind of success have you seen in your work with these problems?” The answers to these questions are likely to be “Yes (though of course, there is no one quite like you),” “Yes (though your particular constellation of problems is certainly unique),” and “A wide variety, ranging from no success at all to substantial change and improvement.”

Therapy and analysis are highly personal endeavors. If you and I work together, it will be the first time either of us is doing this particular work. I’ve never worked with you. You’ve never worked with me. The success we see together will be a function of the relationship we build together. I can’t possibly predict the likelihood that your treatment will lead to the results you desire.

This isn’t a cop-out. It’s honest disclosure.

Substantial research indicates that the greatest predictor of therapeutic success for almost all of the problems for which people seek therapy is the quality of the “therapeutic alliance” between the patient and the clinician. This matters far more than training, experience, or methods.

For this reason, I make no claims about “success rates,” or likelihood of success in any given treatment, and I encourage you to assess any such claims or predictions cautiously.

The best predictors of “success” – of a treatment’s leading to results valued by a patient – are your commitment to our work together and the relationship we build over time. Neither of these things typically is immediately apparent, but rather, they become evident over the course of our work together.

If you’d like to give it a shot, contact me.

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