In the world of psychotherapy, the right fit between therapist and patient can make all the difference. True fit goes beyond a shared background or personality—it’s about aligning on a deeper level, where trust, understanding, and openness can foster meaningful growth. At Bay Psychology Group, Inc., we believe that successful therapy doesn’t stem from rigidly following one model or set of techniques but rather from tailoring our approach to each individual’s unique needs. Flexibility, rather than dogma, guides us, and creating the best therapeutic fit is our priority.

1. The Importance of Fit Between Therapist and Patient

Therapeutic “fit” is a strong predictor of positive outcomes in therapy, influencing everything from patient engagement to treatment effectiveness. If the therapist and patient aren’t aligned—whether because of differing perspectives, approaches, or values—it can hinder progress, even if both are committed to the process.

At Bay Psychology Group, Inc., we dedicate the first several sessions to building this essential therapeutic connection, ensuring that both therapist and patient feel aligned in style, goals, and approach. We encourage open dialogue and ongoing feedback to make adjustments if something isn’t working. Both patients and therapists are empowered to speak up if the fit isn’t right, creating a collaborative atmosphere that prioritizes individual needs over rigid adherence to a single method.

2. The Risks of Rigid Adherence to Models and Methods

Therapists trained in a single model, whether it’s Cognitive Behavioral Therapy (CBT) or a specific psychological approach, may sometimes rely too rigidly on that model at the expense of the patient’s unique needs. Over-relying on any one method can risk turning therapy into a formulaic process, missing cues and opportunities that don’t fit the framework.

For instance, if a therapist strictly follows CBT, they may focus heavily on symptom relief—helping patients manage anxiety through thought-challenging or behavioral exercises—without exploring the deeper emotional roots of that anxiety. While CBT can be incredibly effective for managing specific symptoms, not all patients benefit from a symptom-focused approach. A patient struggling with feelings of emptiness or unresolved grief, for example, may find that CBT techniques alone leave them feeling unheard or misunderstood.

At Bay Psychology Group, Inc., our therapists are trained in a range of therapeutic modalities, and we encourage flexibility in our approach. We believe that therapy should be adaptive to each person’s journey, and we work to ensure that our methods align with the patient’s goals, whether they need symptom management, deeper emotional exploration, or both.

3. The Role of Capitalism in Promoting CBT and Medication – and the Need for Balance

In the U.S., healthcare is often driven by financial motives, which affects the types of mental health treatments that are widely available and promoted. CBT, for instance, has become the “gold standard” largely due to its structure, which fits neatly into time-limited insurance models. CBT sessions are usually shorter, goal-focused, and standardized, which makes it easier for insurance companies to evaluate, approve, and reimburse.

While CBT can be transformative—particularly for specific issues like phobias, panic attacks, or intrusive thoughts—it isn’t universally effective. A patient struggling with complex trauma, for example, might benefit more from a relational, in-depth psychodynamic approach that addresses the layers of unresolved grief, anger, and loss often underlying trauma. However, because psychodynamic therapy is typically longer-term and harder to measure quantitatively, it is less often covered by insurance.

Medication, similarly, is often promoted as a quick fix. While medication can be life-changing for those who truly need it, it can also be overprescribed by general practitioners who may not have the specialized training to understand the nuances of mental health beyond symptom relief. Most Americans’ psychological care is managed by their primary care provider, who, due to time constraints and limited psychological training, may simply prescribe an antidepressant or anti-anxiety medication instead of exploring therapeutic options. This trend can lead to an over-reliance on medication at the cost of deeper, more sustainable psychological growth.

At Bay Psychology Group, Inc., we respect the value of both CBT and medication. In fact, many patients can benefit from combining medication, or CBT techniques for immediate symptom relief with psychodynamic work for lasting, foundational change. We believe the key lies in balancing these approaches, using each thoughtfully according to the patient’s needs, and resisting the pressures of a healthcare system that often prioritizes short-term solutions over holistic, enduring growth.

4. The Impact of Training Programs and Medical Education on Therapy

One of the biggest challenges in mental health care today is the tendency of training programs, particularly in the U.S., to emphasize certain models over others. Many psychology and medical programs teach that CBT is the only evidence-based method for treating mental health issues, often dismissing other modalities as unscientific. This bias can lead to a rigid allegiance to CBT or brief interventions among new practitioners, creating a divide that can be hard to overcome. This has led to misconceptions being repeated by both patients and doctors, and this may prevent many from seeking treatments that could greatly help them.

This issue is compounded in primary care. Family medicine and general practitioners, who often serve as the first point of contact for mental health issues, receive minimal training in psychology. When they do, it’s often biased towards symptom-focused treatments, like CBT and medication, because these are brief, measurable, and easy to “prove.” Unfortunately, this narrow focus means that many patients never get beyond the basic treatment of their primary care provider and don’t have access to therapeutic options that explore their unique personal history or deeper issues.

At Bay Psychology Group, Inc., we actively work to bridge this gap by training our therapists to recognize and respect a range of therapeutic modalities. We believe that depth-oriented approaches, particularly psychodynamic therapy, have immense value in supporting patients’ psychological growth, as they allow for greater flexibility, exploration, and understanding of each patient’s unique experience.

5. Academia and Professional Bias

The educational bias toward CBT and pharmaceutical treatment isn’t confined to medical school curricula. Many undergraduate psychology programs and graduate training environments in the U.S. present psychoanalysis as outdated, elitist, or even irrelevant. This perception stems partly from psychoanalysis’s own troubled history, as the field initially catered to a limited demographic, often embodying patriarchal, heteronormative, and classist biases. Psychoanalytic theory once carried elitist overtones, giving rise to a stigma that still colors its reputation today.

Unfortunately, this outdated portrayal fails to capture how psychoanalysis and psychodynamic therapy have evolved. The field has grown significantly, becoming more inclusive, culturally sensitive, and attuned to diverse populations. But this evolution is rarely taught in undergraduate or medical school programs, limiting awareness of the contemporary value psychodynamic therapy holds.

6. Why Bay Psychology Group, Inc. is Psychodynamic – But Not Dogmatic

Bay Psychology Group, Inc. is rooted in psychodynamic therapy, but this doesn’t mean we believe it’s the only approach. Rather, we find psychodynamic therapy uniquely suited for fostering deep change because it allows us to address both immediate symptoms and the underlying factors contributing to those symptoms. Psychodynamic therapy provides the flexibility to explore the patient’s entire psychological landscape, incorporating their past experiences, relationships, and cultural background into treatment.

Our commitment to psychodynamic therapy stems from its adaptability and depth, but we are not dogmatic about it. We encourage open dialogue with our patients about their needs, preferences, and progress. From the beginning, our approach emphasizes fit and flexibility, and we ensure that our patients feel free to share if something isn’t working. This approach allows us to refer out when appropriate, collaborate with other providers, and tailor our care to each person’s unique journey.

Our Process: Creating Fit and Flexibility from Day One

At Bay Psychology Group, Inc., the first few sessions are designed to assess fit and align our therapeutic approach with each patient’s goals. We encourage patients to share openly about their needs and experiences, so we can make adjustments early in the process if something doesn’t feel right. Our therapists are trained to be flexible, incorporating a range of therapeutic techniques and respecting the patient’s feedback.

We also collaborate with other providers when beneficial, recognizing that some patients may need additional support beyond what we offer. By referring out or working with complementary therapies, we aim to support our patients in every way possible without confining them to one approach.

Conclusion: Flexibility as a Foundation for Effective Therapy

As psychoanalytic thinkers like Andre Green and relational theorists suggest, flexibility is essential for mental health. Rigidity in therapy—whether in thought, behavior, or approach—can lead to stagnation, while flexibility fosters growth, change, and healing. At Bay Psychology Group, Inc., we prioritize a flexible, responsive approach to therapy that respects each patient’s individuality and the complexity of their experiences. By focusing on fit, flexibility, and collaboration, we aim to provide a therapeutic environment free from dogma, supporting our patients in achieving genuine, lasting change.

If you’re considering therapy and want to explore a personalized, adaptive approach, we invite you to reach out. At Bay Psychology Group, Inc., we’re here to help you find the path to healing that’s right for you.