Can therapeutic alliance be taught?

A fantastic discussion today on Twitter (@menhealuk) today about therapy. It is well known, and backed up with research, that the therapeutic alliance (the bond between the client and therapist) is the most important factor in efficacy measures. Common sense also tells us this is probably the case, because if you don’t trust or like your therapist then how can you open up to them, and move through the often difficult process successful therapy?

Therapeutic Alliance

My claim is that the therapeutic alliance (the skill of bonding with others), can’t be taught. Do you think teachers can be taught to teach? Or that partners can be taught to be good partners? Or that you could learn to be a better parent? You might say yes, however I’ve known teachers with lots of training and experience, and who have been universally awful, and amazing teachers who have had zero or little training. In short, I feel that people skills can’t be taught to a high enough level. It’s the same for almost anything. i.e. some children at school are naturally good at sports, maths or music. You can’t take people who are naturally bad and make them great. You can make them ok and sometimes good, but never great. This truth hurts our egos though, does it not? Don’t we all want to believe that anybody can be great at anything if taught well? However deep down, we know this claim is complete nonsense. The claim is pushed by the education industry, because if word gets out, their profits will diminish.

I’ve been on quite a few counselling courses. Almost anyone was allowed on the course. People who were terrible at counselling, were allowed to stay if they were academic, nice, or enthusiastic. Sadly none of those last three criteria guarantee that you’ve got what it takes to be a good therapist. Maybe for art or singing classes it’s more ok to let someone think they’re a great artist or singer when they’re not (see X-Factor for people falsely believing in their talents). Also see the Dunning–Kruger effect.

I wonder if there is research that measures people’s skilfulness as a therapist before and after their training. Some research already shows that people with no training do as well or better, as therapists with lots of experience and training. I dropped out of counselling training after spending a few years doing it, when I learned this! Most people don’t have the integrity or academic skill or honesty on counselling courses to look at the research on all sides of the therapy debate, i.e. does it really work? does training make a difference? People teaching counselling, certainly don’t like hearing all sides. A definite case of cognitive bias! However who can blame them, they’ve invested a large part of their time and savings in being trained as a therapist, and spent many years in the profession.

Most people would scoff at the idea that parenting skills could genuinely be taught. Maybe some logic can be taught, but can empathic skills really be taught, I don’t think so. Most first time parents I know read loads of parenting books before their first-born. However when it came to it, they threw almost all the information away by the time their second-born came onto the scene!

So why do we think that the therapeutic alliance can be taught? I’ve been on counselling courses where we were taught to be authentic! (Hardly anyone gets the irony in attempting to TEACH authenticity, I hope you the reader see the problem!). Most counselling training seems nonsense.

What we really need is to test people’s innate therapeutic skills before any training occurs. i.e. test the untrainable skills BEFORE you start training the rest. The only training that should occur on a therapy training course, should be skills that are trainable (obvious I hope). The training should also be evidence-based (see the article: The need for empirically supported psychology training standards). It should be proven that that particular training makes the raw intuitively skilled person, and makes them a lot better.

Most people aren’t having this debate at all, and most counselling course completely fail to understand any of this. Another factor is that therapists’ efficacy should be measured properly over many years, to see how they stack up. If it turns out they are poor therapists, then they should be struck off, or if it’s thought their poor skills belong to the set of trainable skills, then retrain them properly this time. If the poor skills they have are the untrainable skills, then forget it. It will be a painful lesson for them, but a lot less painful than all the clients they have probably unintentionally damaged.

Back to you the reader now. Do you think ALL therapist skills can be trained? Or only some skills? If so which skills are trainable, and which skills are not trainable? Should a student be disallowed from becoming a therapist if they lack the untrainable skills?

Richard Branson says:

Most skills can be learned, but it is difficult to train people on their personality

Copyright MEN HEAL 2016.

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