Does “Goodness of Fit” in Therapy Matter?

January 30, 2024 - by Helen Veazey - in Health

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Finding a therapist can be a daunting task. Beyond whether or not they take your insurance, are taking new patients, and have experience working with people like you, it is important to consider whether or not your therapist is a good fit. This article will explore why goodness of fit is so important to a successful therapy, and how to identify it. At Bay Psychology Group, we strongly believe in the importance of goodness of fit. We actively support patients in finding a therapist that is the right fit for them.

What is goodness of fit in the context of therapy?

Goodness of fit refers to the alignment between a therapist’s therapeutic approach and style and a patient’s needs and values. Such an alignment will likely make a patient feel more comfortable with and understood by their therapist. The goodness of fit contributes to a strong therapeutic alliance, or emotional bond between patient and therapist, and is a key factor in treatment success. Cultural competence, a therapist’s ability to be responsive and culturally sensitive to a patient’s background, is also an important element of goodness of fit. Not only is the goodness of fit a part of finding the right therapist, but it is also one of the best predictors that a treatment will be successful. 

The responsibility for determining goodness of fit falls to both the therapist and also the patient. Therapists must consider if their therapeutic approach and style will effectively meet their patients’ needs. A patient must determine whether they will be able to feel comfortable enough with a therapist to engage meaningfully in therapy.

Therapeutic Alliance

A therapeutic alliance is defined as “the emotional bond between patient and therapist and as the agreement between them on the goals and tasks of treatment.” Several studies have demonstrated that therapists and patients have a relatively similar perception of the strength of their therapeutic alliance, with therapists tending to rate the strength of the alliance slightly lower than their patients. An important aspect of goodness of fit, a strong therapeutic alliance was proven to be directly connected to positive outcomes in therapy in a recent study of 14,000 treatments. This underscores the importance of considering the strength of the bond between patient and therapist and addressing it within therapy if it begins to feel weak.

Cultural Responsiveness

Cultural Responsiveness in a therapeutic context refers to the idea that “expertise or effectiveness in treatment can differ according to the client’s ethnic or racial group.” In other words, therapists who are culturally competent adapt their treatment, and do not use a “one-size-fits-all” method in working with their patients. In addition to a strong therapeutic alliance, cultural responsiveness on the part of the therapist is another key element of goodness of fit. Therapists who are adaptable and sensitive to their patient’s cultural backgrounds are more likely to establish an effective therapeutic relationship. Recent studies have found that like a strong therapeutic alliance, culturally responsive treatments lead to better therapeutic outcomes, highlighting the importance of considering cultural responsiveness in determining goodness of fit in therapy.

Questions to ask yourself when determining if a therapist is a good fit for you:

  • Do I feel comfortable talking to this person about my life? If not, do I feel that with time I will feel more comfortable talking to them? 
  • Do I get the sense that my therapist understands me?
  • Does it feel like my therapist is invested in my growth?
  • Is my therapist considering important parts of my identity in our work together? 
  • Does my therapist seem to be adapting their treatment in response to my unique needs?
  • Do I feel that there is a strong emotional bond between my therapist and me?
  • Does my therapist share my goals for treatment? 

What if my therapist is not a good fit for me?

If you do not feel that your therapist is a good fit for you, you should bring this up with them. While it may feel nerve-racking, and you may worry that your therapist will take it personally, know that it is your therapist’s job to ensure that your treatment is working for you. They may discuss ways to adapt your work together to meet your needs, or they may offer to support you in finding a therapist that feels like a better fit. 

At Bay Psychology Group, our therapists do their best to ensure that your treatment is working for you. Through intentionally discussing goodness of fit, and providing additional resources as necessary, we are dedicated to helping you find treatment that is effective and responsive to your unique needs.

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