What do laypersons believe characterises a competent psychotherapist?

Article in review: Kühne, F., Heinze, P.E. & Weck, F. (2020). What do laypersons believe characterises a competent psychotherapist? Couns Psychother Res., DOI: 10.1002/capr.12343

Summary

Factors such as stereotypes, negative attitudes or anxieties about mental health providers can have an impact on a person’s motivation to seek psychological treatment. This study sought to explore from the mind of laypersons from two countries what makes a competent therapist. The research found that in interpersonal behaviour, personality variables and professionalism were the most important characteristics of a competent psychotherapist.

Perceptions matter

A survey by the WHO found that for people with mild to moderate mental illness, that attitudes towards treatment such as perceived ineffectiveness were more often barriers to care than structural reasons. Further, around 30% of severely ill patients dropped out of treatment due to negative experiences with care providers. Many, especially older people do not have a full understanding of how psychotherapy differs from psychiatry or counselling. When requiring treatment, a person may also be affected by the comments or thoughts of friends and family and misconceptions amongst not only patients but those close to them could impact willingness to seek treatment.

Study method and participants

A cross-sectional study was conducted by gathering responses to online surveys. The survey took on average four minutes to complete and was completed by both English and German-speaking participants in both paid and voluntary conditions.

Participants submitted demographic data, as well as reposting to questions about any previous knowledge or experience of psychotherapists. They then answered open-ended questions on their view of psychotherapeutic competence- “what makes a good/ competent psychotherapist and how do you recognise that a psychotherapist is not competent? The data was analysed to determine trends, with key categories being formed. Subsamples were also considered to assess significant differences from within the samples.

A total of 375 valid responses were collected – 64.2% being female and the mean age of 33.2 years. More than 50% (53.4%) had no experience with psychology or psychotherapy, while 30.4% had personal experience as a patient or with the family and 53% had professional experience.

Findings

More than 90% of participants agreed or strongly agreed that competent psychotherapists should be open, listen well, be reliable, show empathy and behave responsibly. They also largely agreed that training, knowledge, adherence to legal and scientific guidelines and life and therapeutic experience were important. Being a researcher, appearing educated or having a PhD was less important. While figures varied by subgroup, the overall rankings of characteristics of competent psychotherapists were:

• interact openly/without prejudices with patients
• are listening well
• are reliable
• are empathic
• behave responsibly
• attend advanced training
• know a lot about psychology
• adhere to legal requirements during training
• adhere to scientific guidelines during treatment
• have a great deal of life experience
• offer different forms of psychotherapy
• have treated many patients
• conduct their own research
• appear intellectual and well-educated
• have a doctorate degree

English speaking participants found it significantly more important that the psychotherapist adheres to legal requirements and scientific guidelines. English speaking participants also valued more highly the therapist’s knowledge, experience and own research.

For participants that did not have experience with psychology or psychotherapy, it was less important that the therapist interacted open and without prejudices, likewise, those without experience thought it less important that the therapist behave responsibly.

It is crucial for psychologists to work towards credibility and be responsive to the layperson’s concepts of what makes an effective and professional treatment.