The Blog

Should There Be A Guarantee In Therapy?

London is quite possibly the therapy capital of the planet. And with millions of therapy appointments every year and there being thousands of different kinds of therapy, should the consumer be offered a guaranteed of therapy working?

London is quite possibly the therapy capital of the planet. And with millions of therapy appointments every year and there being thousands of different kinds of therapy, should the consumer be offered a guarantee of therapy working?

Benjamin Franklin once said, 'there's only two things guaranteed in life, death and taxes'. And it's a sad truism that sometimes therapy doesn't work and indeed can't work with everyone all of the time. Indeed a famous therapist called Roger Callahan apparently used to say 'show me the therapist with a 100% record and I'll show you a therapist who doesn't see that many clients'. So, I thought I'd explore the idea of there being a guarantee in therapy.

I personally don't know of any therapist offering a guarantee to a client. There are certain problems like panic attacks and phobias, where with developments in treatment via tools like Havening, it's possible to achieve a probability of therapy working to up to 80-90%. However, there is still a chance of a treatment not working.

Reasons why there can't be a guarantee:

People are individuals. If there were a one-size fits all therapy that worked for all, everyone would only use that form of therapy. However, we're hugely complex individuals. And if I, or any other therapist had a cast iron guarantee, we'd be billionaires as we would have a cure.

As a practicing hypnotherapist, I can only talk about my area of expertise. However, if you look at reports on studies on CBT for example, from Oliver Burkeman in the Guardian and Oliver James in the Daily Mail, you can see that there's no way that even the 'go to' form of therapy offered on the NHS offers a guarantee. And if the premise of a specific therapy is unable to offer a guarantee, how can a therapist offer a guarantee?

Therapists are also not allowed to offer guarantees if advertising, as the advertising standards authority (ASA) doesn't allow it. And in today's digital economy, Google will penalise your site if you make any such guarantee. As such, it's not in therapist's interests to fall foul of Google. Indeed, I go one step further and explicitly write throughout my site 'please be aware that whilst we give you 100% effort and skill, we can't guarantee a success as results may vary from person to person. In fact, we suggest running a mile from therapists offering guarantees.'

Reasons why there shouldn't be a guarantee

Offering a guarantee is misleading and gives false expectations. Sometimes it takes a lot of effort to achieve a breakthrough. And in some ways, a guarantee could somehow imply that no effort is needed in order to help fix a problem.

I think all reputable therapists will try to give 100% and therapy is a bit like being in the Red Arrows. Think of the pilots flying at hundreds of miles an hour towards each and one pilot being the therapist and the other the client. Both pilots must work in unison to ensure the manoeuvre happens correctly. However, if therapeutically only one side is putting all of the effort in, then the therapy is less likely to work. It's impossible to legislate for the effort that the client puts in.

For some clients, some of the time, the notion of what's called a 'secondary gain' exists. This is where a client will get more benefit from having the problem, than they do in not having it. Oftentimes this can be the form of some kind of attention. If the problem goes away, they don't get the attention. Therefore, the client will hold onto the problem.

A therapist I know responds rather directly to people enquiring about guarantees telling potential clients that 'if they want one, they should buy a toaster from John Lewis'. Therapy is not a production line, with the exact replica product being created time after time.

One could argue it's a little self-serving and a cop-out for a therapist to say there shouldn't be a guarantee. However, if you do your research well, as you can read about here and here, you can definitely increase the likelihood of finding both a good therapist and a form of therapy (hypnotherapy in my case) that is more likely to work for you.

There are some amazing therapies and therapists (and plenty less good too).

However, if you want a guarantee, I simply urge you not to see a therapist.