← Mental models for therapists
Therapy needs two people who can work together. Whether the alliance causes good outcomes or merely reveals a patient who could form one is an open question.
Their wordsPsychotherapy cannot help if the participants cannot work together.
Their wordsIt is true that a good therapeutic alliance predicts good outcome. But anyone can develop an alliance with someone who can already form good relationships. Measures of the therapeutic alliance may simply be a proxy for the patient's preexisting capacity for healthy relationships.
Mental modelEmpathy and validation
Their wordsThe phrase "your feelings are valid" does not invite curiosity or deeper self-understanding, which is the point of psychotherapy. It is the mirror image of "stop whining and get a grip." One sounds warm and one sounds harsh, but neither deepens self-awareness.
Their wordsThe emotional and relational dynamics are not an intrusion upon the work of prescribing. They are a part of the work itself.
Their wordsIt turns out that therapists who perform well on the FIS establish stronger relationships and are more effective (2). More to the point, the evidence shows FIS-related skills are trainable and that such training leads to better results (3, 4, 5).
Mental modelEmpathy and validation
Their wordsIn 30+ years of working with narcissistic men mostly - yes, it is possible for people to change. And even narcissists can change. Now, I don't really believe anyone changes completely, but it is possible to get meaningful change.