Renata Hackley: Exploring the Influence of Therapeutic Style

Exploring the Influences of Therapeutic Style

Examining the variables that may affect the therapeutic approach and your relationship with your therapist

By Renata V. Hackley, Psychotherapy Intern at Depth Counseling

Whether you’re new to therapy or a seasoned patient, it’s important to understand the significance of the therapeutic style, and to examine how the therapist’s style and tone can help or hinder an individual’s process. Some questions a client might ask themselves are: How does your therapist show up? Do they present in a way that is warm, affable, and compassionate or do they present in a more clinical and structured way? It’s key that the patient assess this in order to discern which therapeutic style will provide the most effective treatment.

What is therapeutic style?

Simply put, the therapeutic style is how the therapist interacts with the patient. It’s not solely about personality, but the tone and approach of the therapist. For some therapists, less is more. They listen and encourage more talking and free association from the patient. The therapist will intervene only when the patient gets stuck or asks for feedback. This allows for more freedom for patients to explore their mind while being in the supportive presence of an attentive but patient listener. Other therapists bring a more problem-solving attention to therapy, one that involves immediate responsiveness and co-discussion. Often, these styles vary depending on the circumstances of each patient. This is why it’s important for the patient to know which style best suits their needs.

There are other factors that characterize therapeutic style, beyond the patient’s needs. These include the stage of the treatment, the personality of the therapist, and whether the therapist chooses to integrate psychoanalytic therapy with other modalities. But what does all this mean and why is it important to know this as the patient?

Renata Hackley: Exploring the Influence of Therapeutic Style

Stage of treatment

The stage of the treatment is essentially where the patient is at within the course of the therapy. Whether it’s the beginning of long-term treatment or a few years into therapy, a person’s needs will change throughout the course of the work and therefore, what the person needs from the therapist will change as well. Therapists must find a balance between offering a more passive approach with a more directive intervention style. A trained therapist will know how to oscillate between different approaches through experience and trial and error, depending on the patient’s circumstances. This can look like empathy and active listening from the therapist, or, in contrast, it can produce moments of challenge or confrontation in ways the patient may not expect. As the patient, it’s good to understand this beforehand because the therapist may offer different approaches as they determine which will best suit the current circumstances. The patient’s needs aren’t static and are constantly changing, which then impacts the evolving relationship between the patient and therapist. This symbiotic evolution will help build trust and a stronger rapport throughout the course of the treatment plan.

Personality of the therapist

Each therapist has a range of authentic treatment styles, and they might find that different patients bring different versions of themselves to the fore at different moments in the work. How the therapist shows up often reflects a complex coordination between who they are and how they try to meet the patient’s needs in the intersubjective context of the session. You might find that your therapist’s personality fits your needs as a patient. Alternatively, you might feel that their personality challenges you. This can be good grist for the mill, as long as there is a trusting relationship in place. It really depends on what you personally are seeking from the experience of therapy.

Renata Hackley: Exploring the Influence of Therapeutic Style

Integrating psychodynamic psychotherapy with other modalities

All of the psychotherapists at Depth Counseling specialize in psychodynamic psychotherapy, putting a unique focus on emotion, relationship patterns, and out-of-awareness motivations. Still, we have broad general training and often integrate this approach with other modalities. This might mean combining efforts of psychotherapy with techniques from CBT or DBT. In some cases, the psychodynamic therapists at Depth Counseling will work with an external provider to provide DBT skills training or EMDR to patients outside of their weekly Depth session.

Therapy does not have to be so binary, but of course each method and approach should be handled with care and intentionality. A trained therapist will know how to introduce additional interventions with great consideration. On occasion, some interventions may feel uncomfortable or can even create adverse feelings. While this may feel at times overwhelming or too difficult, finding that balance between having a positive therapeutic relationship while allowing yourself to be challenged can lead to further self-discovery and healthy exploration. Knowing your limits is part of that journey, and a trained psychotherapist will guide you along the way to ensure the work being done is helping and not harming you. Ultimately, the patient should come to therapy with an open mind, curious to learn more about any integrations that may be used.


Therapeutic style and approach have a direct impact on the growing relationship that develops between the patient and therapist. While some aspects of the therapeutic relationship may evolve and grow organically (which is wonderful), it’s good for both patient and therapist to be aware of the variables that contribute to the relationship, not only to gain better insight, but as a means of adjusting and changing with the patient’s needs over time. There is a rhythm between therapist and patient, one that progresses, fluctuates, and ultimately gives power and meaning to the relationship. It is through this meaningful, evolving dyad that change and growth can become possible. It takes time, patience, understanding, and a willingness to explore.


McWilliams, Nancy. Psychoanalytic Psychotherapy: A Practitioner’s Guide. The Guilford Press. 2004.