What is non-directiveness in psychotherapy?

There are many different types of approaches to psychotherapy. These approaches can often be categorized under main types. One of the most important ways to classify a type of therapy, is according to whether it is directive or non-directive.

A ‘directive’ is an authoritative instruction. Many activities that therapists might do in therapy are instructions like this:

“Shall we try a breathing exercise”

“I propose that you do this homework assignment”

“Perhaps you could try to solve the problem in this way”

Psychotherapists are much more active in directive therapy types. They may often lead sessions, such as by choosing topics for the client to focus on, gathering information through active questioning, or by guiding clients through activities.

Many clients expect something like this when they come to therapy. Therapists are often (though not always) portrayed on screen or in literature as authoritatively guiding their clients’ thoughts and actions.

Many clients are also influenced by a prominent idea about psychotherapy that we call the medical model: the idea that the client has some kind of illness symptom (similar to a medical problem), and that the therapist should accurately diagnose this symptom, and then choose activities that ‘target’ those symptoms to provide relief.

Psychotherapists usually have to learn this medical model way of thinking during their training, and certain therapy approaches are strongly aligned with this medical metaphor (CBT, or cognitive-behavioural therapy, is a good example).

Some therapists (and some clients) perceive a limited usefulness of this idea of targeted techniques to specific problems. Psychotherapy research also raises meaningful questions about whether therapy really works like that. Almost the entire history of psychotherapy research suggests that the specific techniques used by a therapist have a very small role in the outcome (though such findings remain contested). Research suggests that the type of relationship built between client and therapist, matters much more.

Non-directive therapies, are usually based on a different philosophy about how therapy works.  Psychotherapists using a non-directive type of therapy let the client lead in therapy sessions. The therapist is still active to a degree, and offer some guidance at times, but the core of the technique allows the client to decide what to focus on, and to lead the exploration of what is in their mind.

Tracking is the name of a core skill that therapists use while a client explores themselves in this way. Tracking involves the therapist following the clients lead (not taking the lead themselves), and ‘reflecting’ to the client what they see the client experiencing as they speak. When it is done with competence and real attunement, the client may begin to experience themselves in a way that is often new for them, and sometimes surprising in its power. Tracking is not all that non-directive therapists do, but it’s a big part of the process.

People who have never experienced such therapy may sometimes express confusion, or even scepticism about tracking and non-directiveness. Some may feel that clients make sacrifices to attend therapy, of money and time, and that they should rightfully expect the authoritative expertise of the therapist, as we well might expect from a medical doctor. Others may wonder why the conversation follows whatever the client wants to focus on about, rather than focusing on the initial problem the client brought to therapy.

No psychotherapy can guarantee success. But on average, psychotherapy shows some moderate level of benefit for clients. Interestingly, therapy that is directively focused on the initial problem raised by the client, does not necessarily create superior improvement in those problems than approaches that follow whatever the client brings to therapy. It’s another hint that psychotherapy doesn’t necessarily work the same way as medical treatment does.

Sometimes I compare it to seeing a personal trainer at the gym. You may start gym hoping it will improve your insomnia. Even though the gym process isn’t focused on your sleeping behaviour, it may nonetheless help. Even if it doesn’t have a big impact on your sleep, it may bring many other positive benefits to your life, to your health, your confidence, your social life, feelings of pleasure in your body. It may even become part of your identity, and a core part of the meaning in your life.

In a similar way, many clients have good experiences in non-directive therapy. Sometimes the problem that brought them to therapy shows positive progress (and at a similar rate to more directive therapy). But even when it doesn’t, sometimes the process ends up solving other problems that we start to realize were much more important. Sometimes the process of coming to understand who you are, brings us powerful spiritual meaning that makes some of our struggles seem less important in our experience of life than they used to.

So why does it work?

One reason is that clients are heard. Over the years I have heard many stories from people about a therapist they saw who was quick to offer opinions, feedback, advice or tasks to a client who was feeling misunderstood.

Non-directive therapies usually focus on the person, not the problem. The therapist meets the client where they are, to understand what they are experiencing in the here and now. It’s the difference between a person who talks to you about a specific behaviour you have, and a person who talks to you about you.

There is more to say. Psycho-analytically oriented therapy has its own theories about how people change, even as they take the lead in therapy. Another blog post will say more about the technique of free association, in which the client leads their own self-exploration, and why it works.

Dr Patrick Connolly makes use of non-directive techniques in therapy. If you are interested in psychotherapy with Dr Connolly, you are invited to send an enquiry here.

Note: this information provided is for general information and education only. Reading the blog does not create a therapist-patient relationship. This content is not a substitute for professional mental health advice, diagnosis, or treatment. Readers are advised to call emergency services if they are in crisis. Any actions taken based on the content are at the reader’s own risk