47% of New Zealanders will experience mental distress in their lifetime and 77% of people know someone who has experienced or is currently experiencing mental distress (1).
Wow! that’s high. No wonder our search for mental wellbeing is more important than ever.
We know that talk therapies work, right? They’ve been widely accepted as important since the 19th century. I’m picturing those movie scenes with someone reclined on a couch. But why do some people get better while others don’t? Why is it that some therapies succeed while others seem to fail?
Before you invest your time and money, consider these factors.
The 4 Factors Behind Successful Therapy
Research by Asay and Lambert (2) identifies four key factors that contribute to the success of therapy:
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Relationship (30%)
The relationship between you and your therapist, coach or practitioner is one of the most important factors of a positive outcome in your therapy. It equates to 30% of the success. Feeling supported, safe and understood is vital for success. These relationships often take time to form and it’s essential that you as the client provide feedback to your therapist about your needs and experiences.
What does that mean? I explain it to my clients in the first session that feedback is important. I give the example of how some people like when they are talking for the coach to acknowledge they are listening “mm-hmm” or “ah-ha” sounds make them feel heard. For others it can be distracting or annoying. This seemingly small piece of feedback is significant.
It helps your coach or therapist give you what you need, and on a deeper level it helps you practise expressing your needs, safely and honestly.
So, in your own therapy or coaching, don’t hesitate to share what’s working, what’s not, or what you need more of. Maybe you feel hesitant to come to a session, or perhaps you’re angry about a question that was asked. All of this is rich, valuable material for the process.
Choosing the right therapist matters and so does building the relationship. It takes time, but when you invest in that relationship, you’ll reap the rewards.
When looking for a coach or therapist, ask yourself:
- Do I trust this person?
- Do I believe they genuinely care about me?
- How do I feel when I’m with them?
- Do I resonate with their approach?
Take your time. Attend a workshop, watch videos, or read their work to see if they feel like the right fit for you.
2. Extratherapeutic Change (40%)
Most people think the biggest changes in therapy happen because of the therapist- the techniques, the questions and the tools.
But research shows that around 40% of what actually creates change comes from outside the therapy room.
It’s called extratherapeutic change, and it means that so much of your growth comes from you - your strengths, your motivation, your relationships and your life.
It’s the part of you that chooses to keep going. It’s the conversations therapy inspires but that happen with friends or family outside the session. It’s the small changes you make - morning walks, journaling or choosing differently.
Therapy (and coaching) helps you see things more clearly, but the biggest transformations often happen in the in-between moments. When you apply what you’ve learned, reflect and keep showing up.
Carl Rogers, a famous psychologists, called this the actualising tendency - your innate drive to heal and grow, no matter your circumstances. He once described it as a potato sprouting in the dark: even in less-than-ideal conditions, it still reaches for the light.
That’s what we all have within us. The ability to grow, to change and to find the light again.
Before engaging in talk therapy, set yourself up for success. Create the time, set aside the investment and give it your all. Both inside and outside of the sessions.
3. Expectancy and Hope (15%)
Do you believe therapy is going to work? You don’t need to be 100% certain, but holding even a small expectation that therapy can help makes a difference. This is why forcing someone to go to therapy isn't very helpful.
When you’re losing hope, tell your coach or therapist. This connects back to the importance of the relationship and giving feedback. When my clients lose hope, I often tell them “That’s okay. I’ll hold it for you until you can hold it again.”
Hope becomes the foundation of your healing journey. Don’t underestimate it.
4. Techniques Used (15%)
You might assume this would be the most important factor, but surprisingly, it’s not.
According to research by Lambert (1992) and Norcross & Lambert (2019), the specific therapeutic techniques contribute only about 15% to the overall effectiveness of therapy.
This is fascinating because so much emphasis is placed on finding the “right” type of therapy. But just like no single diet works for everyone, no single therapeutic approach is the holy grail.
Many paths can lead to healing — what matters most is what works for you.
Talk therapy offers us a powerful path to healing, but its success relies on more than the therapist or the tools. You are a crucial part of the process.
Reaching out for help matters, you don’t have to do this alone. But it’s equally important to have supportive tools like journaling and mindfulness in your toolkit. Practices that help you access the healing power already within you, both during and in between sessions.
If you’re feeling the nudge to start therapy or coaching, trust it. Like the potato sprouting in the dark, you’re being drawn toward the light.
Find someone you trust. Create the space in your life to give this work your full attention. That might mean saying no to certain things for a season so you can invest your time and energy in healing. It might mean adding small, nourishing habits like walking, journaling and breathing to your routine to support your process.
If this piece has left you with questions, or you’d like to explore coaching let me know. You can download my coaching packages and pricing here.
I’d love to hear from you.
x Daisy
Mental Health Foundation of New Zealand. (2022). Mental distress prejudice and discrimination in Aotearoa: Key statistics 2022. https://www.mentalhealth.org.nz
Lambert, M. J. (1992). Implications of outcome research for psychotherapy integration. In J. C. Norcross & M. R. Goldstein (Eds.), Handbook of psychotherapy integration (pp. 94–129). Basic Books.
Norcross, J. C., & Lambert, M. J. (2019). Psychotherapy relationships that work: Volume 1: Evidence-based therapist contributions (3rd ed.). Oxford University Press.