Psychotherapy is a collaborative process between a therapist and client. We each have a part in this process, including establishing goals, developing an approach to meet those goals, and overcoming obstacles that prevent attainment. We each need put forth the effort combined with the skills and expertise necessary to make therapy work.
The most important predictor of successful psychotherapy is the relationship between therapist and client. Nothing else comes close. If we have a good fit, then this allows us to work effectively. If I can provide an environment in which you feel comfortable and have confidence, then you are more likely to examine your issues critically to determine what you need. You are then more willing try new ways of approaching those difficult areas in your life. If what you have been doing has been getting you good results, then there is no need to see me. We need to develop new ways to approach your problems.
Sometimes exploration of your issues is enough. Often we need to do more. This might mean that we conduct psychological assessment to understand your personality more thoroughly. Most of the time it means using cognitive approaches that look at the ways in which you think about the world. Most of the time it means using behavioral strategies to change some of the ways in which you act and to improve your coping skills. Although I generally see the world through a cognitive behavioral approach, we use what you need at the time in what I hope is a highly personalized approach. As more than one study (e.g., Cuipers, van Straten, Andersson, & van Oppen, 2008) has shown, no one type of therapy is substantially more effective than any other type of therapy. Instead, what matters is addressing what you need at the time depending on your attitude, beliefs, and skills.