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Psychotherapists travel with their patients on a life-changing journey. Since this trip may involve unpleasant memories and complicated emotions, clear guidelines are needed to stay on track. At the Institute for Individual and Group Psychotherapy (IIGP), we have found that three basic elements are needed for a successful journey.

1. SAFETY
The first thing patients must experience is a feeling of safety, to know on a gut level that they are accepted as a person with their problems. They must know their confidentiality will be protected and that they will be treated competently and respectfully at all times.

2. ACKNOWLEDGMENT
The patient needs to be both seen and heard. With a growing sense of trust, heart-felt emotions can be openly expressed. Regardless of the topic at hand, the patient needs to know that the therapist will welcome and understand those emotions and be unafraid with the patient.

3. NON-ACTING OUT-AGREEMENT
“I couldn’t help myself because my emotions just got the best of me.” It’s something so commonly heard and said that most people don’t think to question its validity. What we refer to as a “contract,” a non-acting-out agreement, is a tool used to hold patients accountable for their actions, especially when the feelings are strongest. Feelings are not a good guide for action. “I couldn’t help what I did” is not acceptable.

To ensure a rewarding and effective experience for a patient, the proper setting is essential. Safety, acknowledgement of feelings, and taking responsibility for one’s actions are keys for success on the psychotherapy journey.

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Fortunately, effective psychotherapy can provide more than symptom relief. Psychotherapy with a well-trained therapist offers a life-long relief for anxiety and depression. It can help people to change their attitudes, their self-defeating behaviors and their relationships. Effective therapy helps people to live more content, productive and satisfying lives. And when parents recover from depression, the prospects for their children improve dramatically as well.

So why isn’t psychotherapy more widely used? Two reasons. First, physicians and patients occasionally find immediate symptom relief with medication. Some believe that this short-term relief is as good as it gets. They may not recognize that a lasting solution is even available. Second, few graduate programs in psychiatry, social work or psychology provide in-depth training in psychotherapy. The emphasis is on evidence-based, short-term intervention. The result? Too few clinicians know how to treat anxiety and depression, and many patients get inadequate treatment.

The key to effective psychotherapy is the therapist. Who the therapist is as a person- not only what he or she knows – is of utmost importance. He or she is the instrument that largely determines the outcome of therapy. In order to develop effective therapists, our training must be intense. Typically, Fellows participate in 3-7 years of “on-the-job” training under the direct observation of experienced mentors. The Institute for Individual and Group Psychotherapy is the only program that provides such a demanding “apprenticeship” over this length of time. Is it really worth all this effort? We see positive results in changed lives every day.