What Makes Therapy Good: The 4 Pillars of Counseling

An old brick building with four white columnsWhat is good therapy? I recently wrote about tips for identifying the best counselor for you. I’d like to shift the focus a bit and talk about the role of relationships and what I call the four pillars of counseling: trust, respect, positive regard, and open-mindedness.

While these concepts may seem straightforward, fostering them within a healing therapeutic relationship can be challenging depending on the quality of previous relationships you’ve experienced, whether you’ve been able to form trusting relationships in other areas of your life, how open you are ready or able to be, and how truthful you can be with yourself. I believe these things form the foundation of the relationship needed to help you meet your goals.

I’ve been a counselor for a long time, and I’ve had counseling with many different therapists. Some of it was very good and helpful and some wasn’t. None of it was bad or meant the therapist wasn’t qualified. I believe the connection between the counselor and the person seeking support is the most important part of a therapeutic relationship. Creating a strong relationship with a counselor is affected by personality, age, gender, race, life experiences, and other factors. There must be a good fit in order for therapy to be effective.

While the relationship between the counselor and the counselee is important, the relationship you have with yourself is equally important. From the moment we are born, our relationships begin to form everything about us—from our beliefs to our behaviors, traditions, and rituals. The strength of our earliest relationships directly impacts the strength of our relationships in the here and now, which directly impact the relationship with the counselor you choose to work with.

When relationships in early life aren’t nurturing and supportive—which can happen for many reasons, including abuse, neglect, or the inability of parents to emotionally bond with a child—the impact can be long-lasting and prevent people from developing healthy connections. It can take a long time to experience trust in a relationship if you have experienced broken relationships or abandonment, especially in childhood.

Whatever the challenge in a relationship, the first step of therapy must be to identify and name that pain. That takes courage, regardless of how scary it may feel.

Whatever the challenge in a relationship, the first step of therapy must be to identify and name that pain. That takes courage, regardless of how scary it may feel.

Good therapy addresses the pain that brought you into therapy and helps you develop solutions to the issues you are experiencing. It focuses on the goals you have set and the challenges and limiting beliefs that may prevent you from reaching those goals. Recognizing these beliefs can occur when there is trust and respect between you and the counselor. If you sense the counselor is open to your challenges, you may be more open to addressing them using tools the counselor provides.

When early life relationships are inadequate, a person’s ability to trust can be severely impacted. Without trust between a counselor and a person in counseling, therapy can be ineffective. It is the counselor’s responsibility to work with you to develop trust though open-mindedness, communication, consistency, and compassion. Your responsibility is to try to meet the counselor in this process as best you can.

Because you are so deeply impacted by your relationships, both past and present, you must examine them as a part of the therapy you seek even if you believe they are unrelated. We are interconnected to everyone we have ever interacted with in a good or not-good manner. Like it or not, our relationships help determine who we are and how we are in the world. This truth must be acknowledged and honored in order to begin the journey of healing in counseling.

© Copyright 2016 GoodTherapy.org. All rights reserved. Permission to publish granted by Deb Del Vecchio-Scully, LPC, NCC, CMHS, GoodTherapy.org Topic Expert Contributor

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

  • Leave a Comment
  • Beck

    August 2nd, 2016 at 7:28 AM

    Just knowing that there is someone who gets what you are going through and actually has the tools to help? That makes a good therapist

  • Ella

    August 2nd, 2016 at 9:53 AM

    Though this does not address at all those with mental illness. In other words, while the relationship is essential, you don’t address at all the population of people who had positive early relationships but have depression, bipolar, etc. Clearly, therapy in these cases is indicated, though your focus on early trauma does not take them into account. Additionally, I agree that the relationship is important, but I’m concerned that you imply that all therapists are competent and the relationship should be the major defining characteristic and this is absolutely untrue. This is only true if you presume all therapists are competent and ethical, which is sadly not at all the case. I would
    Caution those who find a therapist to be kind and warm and funny – but incompetent, or unethical. Everyone deserves effective, honest, competent and ethical treatment. You do not need to trade one for the other, and the relationship can never count more than competency or ethical practice. Ever.

  • Mike

    August 2nd, 2016 at 11:57 AM

    I agree that it could be more difficult to establish a good working relationship with a counselor if you already have doubts about how you feel about your own self.

  • Clarke

    August 3rd, 2016 at 7:42 AM

    Who am I to say what is related and what isn’t to this pain I feel right now?
    I might not think that there is any correlation to what happened in the past but a good counselor is going to help me peel through though layers of hurt and see how things might be interrelated that I might not have known before.

  • alex c

    August 4th, 2016 at 11:17 AM

    I say if you look forward to meeting with this person then you have a winner.

  • Angela

    August 6th, 2016 at 7:58 AM

    This is the one thing in life right now that I can be proud of, that therapy has made me a much stronger and really a happier person overall.

  • Jared

    August 8th, 2016 at 4:38 PM

    What do you think about online reviews? Good or bad way to find a counselor?

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