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Effective Psychotherapists Must Focus on Trustworthiness, Says New Book

  • January 18, 2022
  • Patients and Families

While there is broad agreement—among therapists, students, and patients alike—that trust is important in psychotherapy, author Jon Allen, Ph.D., argues in a new book, “Trust in Psychotherapy,” that it deserves a closer look, and we should shift the focus.

While therapists are inclined to focus on patients’ problems with trust, Allen suggests that therapists should give equal attention to becoming trustworthy to their patients. Cultivating trusting psychotherapy bonds—especially for patients who have experienced developmental trauma in close relationships—is complex, challenging, and a critically important topic, Allen suggests.

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Psychotherapy, or talk therapy, is a way to help people with a broad variety of mental illnesses and emotional difficulties. Psychotherapy can help eliminate or control troubling symptoms so a person can function better and can increase well-being and healing. There are many different types of psychotherapy, such as cognitive behavior therapy, interpersonal therapy, supportive therapy, dialectical behavior therapy and psychoanalysis. Therapy is sometimes used in combination with medication. (Learn more about psychotherapy and finding help.)

Allen suggests we can trust (or not trust) psychotherapy overall or specific types of psychotherapy, just as we might trust in medication, surgery or other treatments, and that this trust is often based on reputation or research. Alternatively, he suggests, we can trust in the person providing the treatment: the person conducting the therapy, prescribing the medication, or performing the surgery. Of course, ideally, we would trust both.

Getting to that point of trust can be difficult for some. Many people “have learned from past relationships to distrust well,” Allen suggests, “they overgeneralize from the past to the present, failing to trust others who are trustworthy.” The current environment, with pervasive misinformation and conflicting information coming at us daily in the media and social media, may also contribute to an increased general perspective of skepticism and distrust.

Trustworthy therapists can provide significant help, Allen writes. Research has found that individual differences in psychotherapists influence the results of therapy more than the specific methods they use. Therefore, Allen suggests we should shift efforts from developing therapies to developing therapists, with a particular emphasis on the factors that make a therapist trustworthy.

“Psychotherapy goes best when trust is reciprocal, that is, when the patient and therapist are trusting of each other and trustworthy to each other—as it should be in any close relationship," Allen writes. While the book addresses trust in psychotherapy relationships, Allen highlights that “the major value of doing so is fostering discerning trust as well as trustworthiness in relationships beyond psychotherapy.”

Allen is clinical professor of the voluntary faculty in the Menninger Department of Psychiatry and Behavioral Sciences at the Baylor College of Medicine, a member of the faculty emeriti at the Center for Psychoanalytic Studies in Houston, and an adjunct faculty member of the Institute for Spirituality and Health at the Texas Medical Center.

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