How to Find Your Therapist

Research shows that as many as 80% of psychotherapy patients are successfully helped, but some researchers see that statistic as inflated, and at best, as a crude indicator of success that fails to differentiate how much one was helped, or in what ways. That percentage also leaves an appreciable number of individuals whose difficulties remain unchanged, or some who are even worse off than before they entered therapy.

Entering psychotherapy can be one of the most important, life altering decisions you may ever make. There are several reasons why some do not find the relief they seek from psychotherapy. A basic one is that, while grounded in empirical principles, psychotherapy is anything but a precise science. It is a complex, quintessentially human endeavor, and every therapist and every therapy has limitations. All things considered, some therapists are more intuitive, and others more creative than others, and thus more effective. Further, therapy is a collaborative effort, and much of the variance in outcome depends on the “match” or “fit” between you and your therapist. When a poor fit occurs, the potentials of therapy will be compromised. Unfortunately, too, some people’s personality problems are so rigidly entrenched that they do not yield to the most conscientious therapeutic efforts, even with supplemental medications. For these reasons and others, the process of therapy and its outcome are sufficiently uncertain that any therapist who guarantees success beforehand, no matter how skilled he or she may be, is overdue for a professional ethics check.

Because, in the end, a therapist’s license, while necessary for the protection of the public, sets a relatively low bar for actual competency, prospective therapy patients need to be thoughtful and even cautious in entering therapy. Licensure, alone, permits a wide range of therapists to practice, from extremely limited to unusually competent ones. Here it is worth mentioning so-called therapy websites that operate like real estate brokerages or dating apps that propose to bring people together. Offering low-cost therapy, sometimes via texting, these online services have grown in popularity, especially during the Covid-19 pandemic when they received a huge boost from mainstream therapists also going online. The American Psychological Association has pointed out that texting is an unproven therapy. But the real issue is that these websites are businesses, designed primarily to scale volume and profits, rather than to offer high level psychotherapy services. High quality can too easily become subordinated to achieving financial goals. Paying their therapists substandard rates, which is the typical online model, for example, is not the best way to attract therapists of the highest caliber. Professionals tend to agree that many online websites offer a different animal from traditional psychotherapy. If you’re looking for effective psychotherapy, these websites are not your best bet.

Your decision to go into therapy likely was not made easily. And your choice of a therapist deserves even greater consideration. That is a major point I want to make here. A far more promising way to go about entering therapy, the one endorsed by most practitioners and clinics, follows a personalized, highly individualized selection/referral process. Like a business or even a marital partnership, your relationship with your therapist will contribute to the shape of your future. You owe it to yourself to maximize your chances of being among the 80% of patients who achieve success, and that depends on your selection of a compatible therapist and his or her competencies. Such an important decision is best not left to therapy platforms that seek impersonally to turn profits, but to thoughtful clinicians who take pride in their professionalism and make considered referrals based on individual contact, clients’ clinical needs and therapists’ proficiencies.

Objective

My goal here is to help you navigate the process of entering therapy, to master what has understandably been called “the therapy maze,” and to assist you in choosing a therapist who is most likely to be helpful to you. We will cover five relevant considerations: (1) the type of therapy, (2) therapists’ education and training credentials, (3) therapists’ professional experience, (4) therapists’ personal and professional qualities, and (5) what to expect and watch out for. This is a fairly lengthy read, but given the stakes, well worth your time.

Let me state initially that I have written more here than many people will be inclined to read. Yet, because I regard therapist selection as extremely important, I experience an obligation to address the topic well. I encourage you to read my advice in its netirety. It is the product of many years of clinical experience and having to distinguish sense from nonsense in a field often disposed to the latter.

Types of Therapy. Many people approach psychotherapy by first asking, which therapy approach is right for me? Often, they focus on the choice between the two best known therapies—cognitive-behavior therapy (CBT) and psychodynamic/interpersonal therapy.

Let’s start by comparing these two approaches. Both are currently dominant, although they concentrate on different levels of personality and processes of change. CBT focuses on coping at the level of behavior and conscious thinking. Contemporary psychodynamic therapy, in contrast, seeks transformational personality change, facilitating it mainly by working with primary relationship patterns and avoided, or unarticulated, thoughts, feelings, and other mental experiences—what analysts sometimes call “the unconscious.”

Traditionally, CBT has been the more active, directive, focused approach of the two, with therapists often working with session-by-session agendas and homework assignments. Their aim is to help patients become more rational in their thinking and adaptive in their behavior. Psychodynamic therapy is less structured, offering patients a more open-ended, if guided, in-depth exploration of important material they bring up (or neglect to bring up) for discussion. The therapist helps focus on and clarify what is important and/or avoided, as related to patients’ identified problem areas. In the best of outcomes, internal shifts occur, resulting in new and liberating ways of seeing oneself, others, the world, and the future.

The difference between these two therapies seems apparent: CBT operates at a more surface level, while psychodynamic therapy reaches the individual in depth. Yet, you may be surprised to learn that the distinction is not always that clear. A colleague of mine who conducted research comparing CBT and psychodynamic therapists discovered that with some therapists, it was difficult to identify which approach they were using. Advanced clinical psychology graduate students with no knowledge of which type of therapy was being used, were asked to observe both kinds of therapists at work. If not with the providers, the student observers were, however, quite familiar with the two methods, CBT and psychodynamic therapy. These judges were asked to identify each individual therapist’s approach. As it turned out, they made a surprising number of errors, and when they were wrong it was usually because a therapist’s personal style significantly shaped and sometimes overshadowed the technical differences between the approaches.

CBT is often promoted as a short-term therapy involving perhaps six to twelve sessions. That is misleading. In fact, CBT was originally developed as a short-term therapy by Albert Ellis and advanced as such by Aron Beck, two pioneers. But over the years, like many other initially short-term methods, it evolved into a longer-term approach. Six to 12 sessions may sometimes be effective, especially when treating narrowly defined symptoms like simple phobias. And there are also “packaged” methods of CBT of approximately 15 or 20 sessions that attempt efficiently to treat certain focused problems, like insomnia or anger management. But short-term CBT is not the method most often chosen in practice. There, more frequently, we see pervasive patterns or complex problems requiring additional sessions. A recent, mindfulness-based extension of CBT, Acceptance and Commitment Therapy, called by its acronym, ACT, focuses on modifying individuals’ relation to their internal events, rather than helping them become more rational.

Because psychodynamic therapy was derived from psychoanalysis, it is often thought to be a long-term therapy that takes years to be effective. That, too, is a misconception. It is true that most personality difficulties have origins in one’s childhood, but it is not always necessary to delve into them deeply, or “peel the onion,” as early psychoanalysts used to say. It is helpful to investigate and understand the role of the past as it affects the present, but detailed exploration or re-experiencing of childhood events only becomes essential when strong personality damage results from powerful past events, like trauma, that stubbornly resists therapeutic efforts.

There are also short-term forms of psychodynamic therapy, and they are usually proposed for about 12 to 20 sessions. Anecdotally, my own clinical experience over the years as a psychoanalyst and psychodynamically-based integrative therapist has confirmed that there are many patients who, after six months or so of once-a-week sessions (about 20 sessions), feel they have gotten what they came to therapy for and move on. Others remain in therapy longer, sometimes wanting to increase the number of weekly sessions because they see value in a more intensive growth experience.

It is also noteworthy that studies comparing the various forms of psychotherapy, including CBT and psychodynamic therapy, typically find equivalent success rates after a year or so. Both approaches can successfully reduce symptoms of anxiety and depression. It also has been found that the longer many patients remain in therapy, the more benefits they gain. A 2020 study published in the Journal of the American Medical Association suggests that some patients with complex disorders continue to change during the year after psychodynamic therapy ends. It is not clear yet whether this applies to CBT or other therapies. But it may be that psychodynamic therapy is the gift that keeps on giving.

To simplify the task of choosing between these two therapies, first, ask yourself, is my problem focused and well delineated? Do I have a defined symptom or symptoms, like insomnia or anger eruptions, for example, that I want to reduce or eliminate? Is it a matter of my learning to change my behavior and/or to change a fixed or habitual way of thinking? Such concerns are often amenable to CBT. Or do my issues feel vague, ambiguous, mystifying in a sense, perhaps a feeling that something is missing, that I’m not firing on all cylinders, or that I’m repeating a pattern of unsuccessful relationships or career missteps that despite my awareness, I cannot really understand or change? If the latter, psychodynamic therapy may be best because it explores you and your life more intensively.

Further complicating one’s choice of therapies is that other approaches that are less popular now, like Humanistic Therapy (Client-Centered, Gestalt, and Existential), and therapies that have more recently come on the scene, some related to trauma treatment, can also be generally beneficial. Examples of these relative newcomers are Accelerated Experiential Dynamic Psychotherapy (AEDP), Eye Movement Desensitization and Reprocessing (EMDR), Internal Family Systems Therapy (IFS), and newer body-based therapies—Sensorimotor Psychotherapy (SP) and Somatic Experiencing (SE). I have already mentioned another recently developed therapy, ACT, which can be extremely helpful.

I will not go into all these therapies here. But responsible websites (like www.emdr.com for EMDR and www.ifs-institute.com for IFS) can give you a preliminary feel for these lesser-known therapies, how they work, and whether they might seem right for you. If they appeal, you can then follow up. In the absence of personal advice, you can refer to “certifying” organizations and websites that attempt to identify practitioners who have achieved adequate training standards EMDRIA, for example. A limitation of these sources is that all capable practitioners do not necessarily register with these organizations. And as we will see next, education and training, while important, are not the only factors to consider in finding your therapist.

The Role of a Therapist’s Education and Training. What are the Different Kinds of Therapists? There are significant training differences among licensed mental health professionals. A therapist who has studied longer and more thoroughly than another, who has learned more about how people become who they are and how to help them change, and who has logged relatively more supervised clinical hours as part of that training, offers you a therapeutic advantage. Basic education and training are most influential during the early stages of a therapist’s career, yet they provide a foundation for a practitioner’s further growth and development.

Before going further, let’s nail down the relevant terminology.  There are many kinds of psychotherapists, this being the most general category of mental health service providers. Among them, specifically, there are marriage and family therapists, mental health counselors, clinical social workers, clinical and counseling psychologists, psychiatrists, and others. In addition to licensure by one’s state, a therapist can attain a higher level of training by completing a certificate at an authorized training facility (state or otherwise authorized). Therapists with the lengthiest trainings are psychiatrists (M.D.’s), psychologists (Ph.D.’s), and clinical social workers (MSW’s) who have completed postgraduate psychoanalytic training, entitling them to call themselves psychoanalysts.[1] Between college and institute training, these professionals will have spent more than a decade training.

Consider the differences among therapists’ training. In New York State, for example, credentialing for Licensed Marriage and Family Therapists and Mental Health Counselors requires a specialized master’s degree and 1,500 clock hours of supervised experience. To be licensed, Clinical Social Workers require a master’s degree and 2,000 clock hours of supervised experience. A special category, Licensed Psychoanalysts (LP’s), currently exist in only two states. They have generic master’s degrees plus completion of certificate training at an accredited psychoanalytic institute, including 1,500 clock hours of treatment conducted under supervision. Psychologists require a doctoral degree taking three to four years or more including two years (4,000 clock hours) of supervised clinical experience. The longest training is of psychiatrists (M.D. plus four years of full-time psychiatric residency). Psychiatric training is comprehensive and does not concentrate on outpatient psychotherapy, alone, but also on learning about medical and psychiatric research and inpatient and medication management. Although not necessarily the best trained psychotherapists overall, psychiatrists are the most qualified to treat severe (like psychotic) disorders and others requiring medication or inpatient care. A division of labor has evolved recently, with many psychiatrists electing to consult on medication and nonmedical therapists on conducting psychotherapy.

As I mentioned earlier, licensure is an important, yet minimal requirement, and few therapists end their formal learning with passing a licensing examination. Usually, licensed therapists are required to take Continuing Education (CE) courses to renew their licenses anually, and many but not all practicing therapists find additional learning opportunities through conferences, workshops, online trainings, ongoing study groups, even the learning associated with teaching new material. Find a conscientious, lifelong student of the field. They are likelier than others to have broad and deep knowledge, highly developed skills, and awareness of recent developments.

In many respects, postgraduate (post-master’s degree or postdoctoral degree) certificate training programs for licensed mental health practitioners represent the most advanced levels of training and act as “equalizers” among the mental health disciplines. These programs can be likened to the advanced fellowship training some physicians undertake after completing their residencies. After completing a psychiatric residency, for example, a physician might further undertake institute training in psychoanalysis or fellowship training in consultation-liaison psychiatry, a specialty requiring unique skills for dealing with medical and pediatric problems occurring in a hospital setting.

Probably, the most rigorous psychotherapy trainings (usually several additional years) are offered by psychoanalytic institutes that are either chartered by the various states’ Education Departments or recognized by accrediting psychoanalytic associations. However, there are other postgraduate psychotherapy training programs representing the wide range of psychotherapies we have discussed. Some are more intensive than others, although rarely, if ever, are they more intensive than psychoanalytic training. P

Although postgraduate training is variable in quality, completing study of an approach in a recognized certificate program is generally a dependable indicator of a therapist’s competence in that therapy.

What is the Role of a The Therapist’s Experience? When you appreciate that many clinical social workers are better therapists, overall, than psychiatrists or psychologists, for example, you realize the need to look beyond therapists’ formal training. One question you might ask is, how much professional experience has a prospective therapist had, and has she or he worked with people with my specific problem?

Many therapists become specialists, working with syndromes like eating disorders, or using methods, like couples therapy or EMDR. Qualified specialists must be trained and experienced in their area of expertise. Yet some who make such claims have studied the syndrome or therapy method only superficially or not at all, making false claims of expertise in order to attract referrals. Such claims, being unregulated, are unprofessional at the very least. But the burden of validating the legitimacy of a practitioner’s claims of expertise in an area of specialization falls to the consumer. The best way to do so is with direct questioning: How much formal training have you had, hours of supervision, or patients treated with this problem?

It is also notable that the quality and relevance of supervised clinical experience is not uniform. Some therapists’ early work settings are loosely supervised by lower-level professionals, while others are intensively supervised by experts who can substantially extend one’s clinical knowledge and skills. During one’s training, high-powered settings like medical centers, universities, postgraduate training institutes, and established and well-run social agencies likely offer the most instructive work experiences. In any event, supervision during one’s training has its greatest impact on beginning therapists, acting before additional training accounts for a clinician’s further professional development.

You might also wonder, do therapists become more effective as they gain experience through practice over the years? You would assume so, but that is not necessarily the case. Research shows that all therapists do not become more effective by virtue of experience, and some even decline. But there is evidence that gifted therapists and those who continuously examine their work with an eye toward improvement are most likely to improve with experience. That is another reason to seek a therapist who is highly conscientious about ongoing learning.

Gender, Age, Religion, Ethnicity, Sexual Orientation, and Other Therapist Characteristics. Some prospective therapy patients have a sense that the race, gender, sexual orientation, age, or other characteristics of their therapist will make a significant difference. Many such preferences are to be respected, if only to accommodate patients’ comfort levels and to leverage positive expectations that can sometimes affect outcome. Yet, one’s judgment also can be misleading. For instance, consider a man who says, “I don’t want to work with a woman therapist. Women are too hard for me to get along with.” There is a good chance that this man might work more productively with a woman than with a man based on that very bias or experience. His personal difficulties getting along with women are likely to be activated during the work of therapy with a woman, and when they come up, a skilled therapist can employ them to  benefit the patient.

Given the effects of intercultural miscommunication, implicit bias, and the potential for microaggressions, it is understandable why race, or racial difference, is a concern for many patients. It seems to me that racial differences are a two-edged sword, offering much potential growth for both the patient and therapist who work to overcome their preconceptions and bridge the racial gulf that separates them. But racial differences also can pose an unnecessary, added burden to the work, and mismanaged, can become a disruptive threat to the therapy relationship. Racial differences between patient and therapist comprise a complex topic that only recently has begun to receive the clinical and scholarly attention it deserves. Some similar concerns pertain to religious differences, especially for the devout.

Another subjective preference for certain patients is their prospective therapist’s age. Some prefer to work with a therapist their own age, feeling reassured by the assumption that as a contemporary, the therapist understands and is living through similar challenges. Others prefer to work with a younger person, someone recently trained and freshly motivated, or up on the latest trends. Still others prefer to work with older persons whom they presume possess wisdom harvested from lifelong experience. Many LGBTQ individuals prefer to work with therapists of like sexual orientations, believing they probably will better understand their developmental, subcultural, and other experiences. And such matching concerns are real. Yet, for many people, therapists’ personal characteristics matter little. They have one uncomplicated criterion–a therapist who can help them.

Personal and Professional Qualities. Research has demonstrated that the personal qualities of the therapist play a more significant role in outcome than the approach used.  It is quite telling that the most effective therapists are found to be unusually successful no matter which form of therapy they are practicing. Therapists are not merely technicians. So, your emphasis needs to be on finding the right person.

Years ago, my late colleague and thesis advisor, David F. Ricks (1974), coined the term “supershrinks” to describe exceptional therapists who stood out among the rest. In a study that examined the long-term outcomes of “highly disturbed” adolescents who were later examined as adults, he found that a select group, treated by a particular therapist, fared notably better than the rest. In the same study, boys treated by the “pseudoshrink” demonstrated alarmingly poor adult adjustment. Ricks’s study quite dramatically confirmed that just as there are highly skilled as well as substandard architects, engineers, and surgeons, for example, that is also the case with psychotherapists. Parenthetically, I might add that a flaw of much psychotherapy research is the assumption made that all therapists are equivalent in competence. The 80% success rate mentioned earlier would be higher of the pool of therapists studied included only those whose therapeutic qualities excelled.

How Much Does the Therapist as Person Matter? To answer in a nutshell, a lot. This observation finds considerable support in psychotherapy research that shows consistently and across many different therapy approaches that a good therapeutic relationship, or alliance, is an unusually strong predictor of a favorable outcome. And it is effective therapists’ personal qualities that enable them to form strong and effective therapeutic alliances.

Charles Truax, an associate of the famous psychologist, Carl Rogers, made the claim in the 1960’s that, “Basically, the personality of the therapist is more important than his technique. Conversely, however, techniques can be quite potent in the hands of a therapist who is inherently helpful.” The psychoanalyst, Harry Guntrip, echoed this view and went a step further when, in 1975, he asserted, “Good therapists are born not trained, and they make the best use of training.” I dedicated an entire book to this topic in the late seventies. We need not engage the nature-nurture question to observe that some therapists have superior intrinsic aptitude, or talent, when they arrive for training. That has been confirmed time and again, including in a 2019 review article that appeared in the journal, Psychotherapy Research. The authors concluded that “more effective therapists are characterized by interpersonal capacities that are professionally cultivated but likely rooted in their personal lives and attachment histories—such as empathy, verbal and nonverbal communication skills and capacity to form and repair alliances.” It becomes apparent that the person your therapist is, plays a crucial role in your therapy’s success.

What are the personality qualities of individuals like Ricks’s supershrinks? The noted psychotherapy researcher, Bruce Wampold, probed the qualities of highly effective practitioners and identified what you might look for in an effective therapist. Their personality features typically include articulateness, perceptiveness, well-regulated emotionality and expressiveness, warmth and acceptance, empathy, and focusing on you, the patient. These therapists also are optimistic and inclined to recognize and acknowledge your progress. A sense of trust and confidence in these therapists results from their qualities of authenticity, flexibility, and self-reflectiveness.

What Should I expect? If you have never been in therapy before, once you have found a prospective therapist, do not immediately commit to work with that person before you have had a consultation with one or more others, to compare. Sit down with him or her in one consultation session or a few. Get to know him or her as an individual as best you can in the professional context. You can ask any questions; depending on style, the therapist may or may not answer them, but if not, notice the reason why not and evaluate how that response style works for you.

With the many factors we have considered here in mind, listen as well to what your “gut” tells you. You will know you are in good hands if you feel able to speak relatively openly, feel heard, understood, and respected, and, of course, safe. You also must feel confident you are in the presence of someone who knows what they are doing. An effective therapists should be able to help you make sense of your problem early on, and then propose a course of therapy that seems to you sensibly responsive to that understanding.

If, by the end of the initial consultation or consultations, you feel as I’ve described, and especially, have gained an understanding of the likely sources of your difficulties and the way out of the woods, you probably have hit a homerun. If this is your first consultation, determine whether it makes sense to look further to develop a more meaningful framework for evaluating and proceeding. If the homerun was real, your further experience will confirm it.

As your therapy moves on, and you hopefully progress, you must have a sense of movement in the right direction. If, instead, you develop a sense that things are not moving, that sessions seem to lack purpose, that there lacks a through line, momentum in the right direction, or that something is somehow “off,” it is essential to discuss that observation openly and directly with your therapist. Your intuition may or may not be valid and you are best able to figure that out, and then to make adjustments together. In the end, of course, you must trust your own judgment. Again, I refer to the famous psychologist, Carl Rogers, who put it this way, “As no one else can know how we perceive, we are the best experts on ourselves.”

It is a cautionary sign if you do not feel able to bring up your concerns with your therapist. And if your concerns are not resolved after you have addressed them together, you can discuss having a consultation about your therapy with another clinician. Your therapist should agree and be cooperative. If not, pick yourself up and move on. This may be a fine therapist for someone else but is clearly not right for you.

Conclusions and Recommendations. The “psychotherapy maze” can be quite confusing. There are so many therapists to choose from, ranging from those who are exceptionally competent to, well,  quacks, and seemingly, a therapist on every street corner, at least in urban centers. If you doubt that, just visit Psychology Today’s website and observe the overwhelming list of therapists located near you. While there, also note the very wide fee range among therapists, and the different ways they deal with insurance. The good news is you likely can find someone in your fee range.

If you are still unclear, invest in a consultation with an established therapist who has a solid reputation. At the very least, she or he can help you clarify your thinking, which likely makes the consultation a wise investment, and possibly offer you an appropriate referral or two. Some therapists offer free initial consultations. Note that while people often turn to their personal physician for a referral, one’s physician is not necessarily the best person to make therapy referrals. They may be fine at treating your physical ills but too often lack psychological savvy and a substantive understanding of what good therapy involves. Moreover, they are outsiders without “inside information” about the provider community.

To be practical, forget about finding the “best” or perfect therapist. You will be searching for a needle in a haystack, and extended “shopping” for a therapist is often motivated by anxiety about getting started. You might instead think along lines of the famous D. W. Winnicoott, who introduced the influential idea of “good enough” parenting into psychoanalysis. And although we certainly hope your therapist will avoid, even help repair the missteps of your parents, Winnicott’s notion is useful for guiding your search. To some people, “good enough” implies mediocrity. That is not at all my intent here. Rather, I am suggesting that there are many capable therapists out there who meet the standards necessary to help you.

Clearly, though, you need to be informed and cautious. In addition to what you have read here, gather information about psychotherapy and psychotherapists from those you know who have had their own therapy experiences. Reliable websites on the Internet are also rich with information about the approaches to psychotherapy. And certainly, you do well to examine a prospective therapist’s website very carefully.

I developed this essay to help you find a therapist who, hopefully, will make a difference in your life. I have said a good deal about such a therapist. Now I would like to shift to add a couple of caveats that focus on you. Therapists do not change people; they help people change themselves. Perhaps surprisingly, certain characteristics, motivation to change, for instance, and other strengths you as an individual may bring to therapy, are more powerful predictors of outcome than characteristics of therapists. Second, therapists, too, have preferences. The most desirable patient once was described as a YAVIS, the acronym for young, attractive, verbal, intelligent, and successful. We cannot all be that, of course, but most therapists would much prefer to work with someone who is prepared and committed to make sustained, thoughtful efforts to grow and change.

Psychotherapy is a team effort. In the end, it boils down to two ordinary people talking, one of them having trained to be helpful and to apply himself or herself on behalf of the other’s growth and wellbeing. A good “match” embodies a two-way street that occurs when you and your therapist both call forth one another’s strongest therapeutic resources. Working with a capable therapist, you can expect to get a great deal out of therapy—if that’s what you put into it.

References

Beck, A.T. (1967). The Diagnosis and Management of Depression. Philadelphia, PA: University of Pennsylvania Press

Castonguay, L., & Hill, C.E. (eds.) (2017). How and why are some therapists better than others? Understanding therapist effects. Washington, D.C: American Psychological Association.

Davanloo, H. (Ed.). (1978). Basic Principles and Techniques in Short-Term Dynamic Psychotherapy. New York: Spectrum Publications.

Ellis, A., & Harper, R. A. (1961). A Guide to Rational Living. Prentice-Hall.

Heinonen, E. & Nissen-Lie, H.A. (2019): The professional and personal characteristics of effective psychotherapists: a systematic review, Psychotherapy Research, DOI: 10.1080/10503307.2019.1620366 https://doi.org/10.1080/10503307.2019.1620366.

Lutz, W., Leon, S. C., Martinovich, Z., Lyons, J. S., & Stiles, W. B. (2007). Therapist effects in outpatient psychotherapy: A three-level growth curve approach. Journal of Counseling Psychology, 54(1), 32–39. https://doi.org/10.1037/0022-0167.54.1.32.

Lindgren, O., Folkesson, P. and Almquist, K. (2020). On the importance of the therapist in psychotherapy: A summary of current research. Int. Forum Psychoanal., 19(4):224-229.

Malan, D. H. (1979). Individual Psychotherapy and the Science of Psychodynamics. London: Butterworth.

Okishi, J., Lambert, M.J., Nielsen, S.L. and Ogles, B.M. (2003). Waiting for supershrink: an empirical analysis of therapist effects. Clinical Psychology and Psychotherapy, 10(4), 361:373.

Ricks, D. F. (1974). Supershrink: Methods of a therapist judged successful on the basis of adult outcomes of adolescent patients. In D. F. Ricks, A. Thomas, & M. Roff (Eds.), Life history research in psychopathology: III. University of Minnesota Press.

Rogers, C. R. (1951). Client-Centered Therapy; Its Current Practice, Implications, and Theory. Houghton Mifflin.

Seligman, M. E. P. (Win 1996). Good News For Psychotherapy: The “Consumer Reports” Study. Psychologist-Psychoanalyst, 16(1), 23-25. https://doi.org/10.1037/e404672005-011

Wampold, B.E. (Author), Norcross, J.C. and Lambert, M.J. (Eds.) (2019). Psychotherapy Relationships that Work, 3rd Edition.

Winnicott, D.W. (1953). Playing and Reality. London and New York: Routledge.

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[1] In certain states like New York, licensed psychoanalysts are those who have come from non-mental health background but completed psychoanalytic studies.