Patti E. Hard,

M.S., L.M.F.T., C.A.D.C., A.A.S.E.C.T.
Licensed Marriage & Family Therapist, Certified Sex Terapist, Certified Alcohol & Drug Counselor  |  Lexington Kentucky


Therapy What to Expect

A client once asked me, “How do you form relationships with clients?” This question becomes even more interesting in light of a 1990’s study of over 10,000 clients. The outcome data from this study about what works in therapy indicates that technique accounts for only 15%, and that the therapeutic relationship is felt to be twice as important as technique. 

So, with research verifying what we therapists may have intuitively known, how is such a relationship formed? What the therapist, as a person, brings to the relationship is foremost. Whether the therapist is male, female, young, old, strong, tender, wise, firm, astute, or has any number of other traits of human personality determines a great deal in respect to the relationship. The characteristics of the therapist then mix with the therapist’s ability to tune in, listen, attend to, empathize, and acknowledge the client. Some interesting research shows that empathy, in particular, cannot be taught, and that empathetic ability in therapists varies tremendously. In fact, it is the client’s rating of the therapist’s empathy that truly counts.

This outcome data further points out other important relationship factors. First, is the ability for client and therapist to set mutually agreed upon goals. These goals can be as general as “I just want to feel better” to as specific as “I want to learn how to deal with my spouse better.” Second, is the client has to view the therapist as flexible in approach. A client needs to feel the therapist is responding to him as an individual rather than as a textbook case. Third, and even more interesting, is the therapist’s ability to accommodate treatment to the client’s motivational level of change. If the client is only “browsing”, and has not “hired” the therapist yet, then the therapist who can help him “browse” will forge a better relationship than the therapist who begins to interact as if he is a “customer”. We all know that if we are browsing for a new car, we do not want someone pushing a buy on us. The same applies when forming therapeutic relationships. Conversely, if the client is ready to go, the therapist who can get on board with him quickly will form a strong alliance. 

Good therapeutic relationships are also forged by the therapist’s ability to enter the client’s world, whether it is that of someone prominent, a professional, a tradesperson, a student, a teen, or a child. The ability to enter many worlds, know the languages, cultures, expectations, and norms is helpful. 

Lastly, and equally important, who the client is as a person determines the unique aspects of the therapeutic relationship. These qualities of the client mix with the therapist’s qualities, forming a unique and valued relationship.


Men's Experience of Therapy

Men are becoming more receptive to therapy. This follows a long tradition where such receptiveness was uncharacteristic. Cultural changes probably have helped to make it more acceptable for men to seek therapy. Perhaps therapists are also becoming better able to respond to men’s specific needs. Therapists have learned over the years that men contain feelings, as opposed to expressing them openly and have learned to respect this process. 

Typically men are uncomfortable with being vulnerable, asking for help, and letting someone (especially a stranger) in on their private business. Often men also dislike being out of control, owning up to faults and apologizing. Therapists who understand these issues can very quickly help men feel comfortable. Once assured going to therapy does not equate to being a wimp, they become appreciative of the learning process.

Further, men are very surprised to discover both that they are wrong about some things and that they are right about some things. While at times this information is humbling, it is mostly illuminating and helpful.

Finally, men know that things do not feel good, but often they do not know why. Both feeling better and understanding why they felt bad enable men to become more open to the therapeutic process. Often men need to learn how to communicate in other ways than through anger. The therapeutic process can help teach men these alternatives. Men have been socialized to be highly capable professionally, but are often unskilled emotionally and relationally. Therapy helps men learn other roles besides their work role. It helps them to give up “doctoring”, lawyering” and “managing” in their personal lives and learn an equally rewarding relationship role.



Patti E. Hard, M.S.  |  1517 Nicholasville Road, Lexington, KY 40503  |  859-278-4364