Couns Psychother Res. 2019;00:1–10. wileyonlinelibrary.com/journal/capr
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1 © 2019 British Association for Counselling and
Psychotherapy
1 | INTRODUCTION
What core skills are needed to be an effective psychotherapist?
Because of the large variety of existing psychotherapies, this ques‐
tion probably needs to be answered differently with regard to dif‐
ferent forms of therapy. Different forms of psychotherapy may have
widely different goals. For example, whereas some therapies aim to
solve acute problems in living, the aims of other therapies may be
increased self‐knowledge, or the development of personal potential.
Patients may use psychotherapy in very different ways, as seen
in reports about what has worked for them. For example, when
Adler and McAdams (2007) analysed the psychotherapy stories of
76 adult patients, they identified four different categories of nar‐
ratives, of which the two most salient involved the following main
themes: (a) the patient actively using the therapy to solve a personal
problem and to re‐assert personal agency; (b) the patient relying
on the therapist and the therapeutic alliance as the mechanism of
treatment. If patients make use of therapy in such different ways, it
Received: 13 August 2018
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Revised: 15 May 2019
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Accepted: 16 May 2019
DOI: 10.1002/capr.12244
SPECIAL SECTION ARTICLE
Three modes of psychotherapy and their requisite core skills
Lars‐Gunnar Lundh
Department of Psychology, Lund University,
Lund, Sweden
Correspondence
Lars‐Gunnar Lundh, Department of
Psychology, Lund University, Box 213, 221
00 Lund, Sweden.
Email: lars‐gunnar.lundh@psy.lu.se
Abstract
The field of psychotherapy suffers from the lack of an integrative meta‐perspective
on the large variety of existing psychotherapies and on the therapeutic skills involved.
In the present paper, it is suggested that the development of a more comprehensive
view of this field may be facilitated if we differentiate between three modes of psy‐
chotherapy, which require different therapeutic core skills: (a) an educational mode,
which requires teaching skills; (b) a reparative mode, which requires analytic‐concep‐
tualising skills to identify some kind of disordered functioning, in combination with
specific relational‐technical skills to repair this dysfunction; and (c) a developmental
mode, which involves engaging in a therapeutic relationship with patients to facilitate
their personal growth, and which requires non‐directivity skills. In addition, some
therapeutic skills (e.g., awareness and communication skills) may be more or less im‐
portant in all modes of treatment. Concrete manifestations of the three different
modes of psychotherapy are discussed in terms of five different theoretical perspec‐
tives on psychotherapy: the common factors, humanistic‐experiential, mindfulness,
cognitive‐behavioural (CBT) and psychodynamic perspective. The common factors
model is criticised as being insufficient in several respects. Finally, it is argued that if
personal therapeutic skills are essential to the effects of psychotherapy, then empiri‐
cal research on psychotherapy needs to be re‐oriented towards a person‐oriented
study of therapist skills in action, in the context of a study of the interaction between
therapist and patient.
KEYWORDS
psychotherapy, therapeutic skills, therapeutic relationship, integration