What Makes Therapy Effective? (And What AI Cannot Replace)
- Feb 16
- 4 min read
Updated: Feb 17
Written by Julia Elstrodt, Psychotherapist
Julia Elstrodt is an Ivy League-educated psychotherapist who helps people overcome trauma, reconnect with joy, and find wholeness. She works in private practice and in collaboration with charities supporting survivors of domestic violence, modern slavery, and other forms of gender-based violence.
For decades, people have asked and studied what makes therapy effective. With so many schools of thought, methodologies, and perspectives, it can be hard to know what works best. What hundreds of studies over the years have indicated is that our approaches don’t necessarily matter. What makes therapy effective is the therapeutic relationship.
Theory vs. Experience
My greatest teacher always said that young therapists were their own demise. We have so much theory to explain things, but no personal experience to back it up yet. It can drive us into existential crises.
I can attest that this is true. My degrees, lectures, and all box-ticking exercises are not what made me the therapist I am. My personal experience did.
There is an inherent understanding when someone feels you truly recognize their pain. There is a strengthening of trust, a bond in humanity, and vulnerability.
We attract what we know
It is interesting to witness, as therapists, how much we attract clients with needs or shortcomings similar to our own. In my experience, it is what builds a practice and expertise. That personal resonance is power.
A therapist is not all-knowing, up on a pedestal, providing a diagnosis. A therapist is as human as you are, fighting their way through their own suffering, in hopes of helping others do the same and vice versa.
We can help with what we know. In my practice, I have attracted several survivors of different sorts of sexual violence or abuse.
I would not be able to fully understand them if I had not gone through my own experience of it.
I would not be able to know when to listen and when to provide positive reassurance.
I would not know what that kind of abuse does to your mind, psyche, and soul.
I would not understand the shame, the guilt, or the intricacies involved in resolving toxic relationships.
Do my experiences and humanity get in the way of my work? Absolutely!!
I often get caught in projections and assumptions. I need to constantly check myself. Which leads me to my next point: mutual growth.
We grow together
Naturally, I have witnessed my own growth as I help my clients. More impactful, however, is the growth I have experienced in those who help me.
When in a client position myself, I am inspired to see my therapists question themselves, be open, reflect, and grow alongside me in the process.
That is the ultimate beauty of therapeutic relationships. Witnessing mutual growth, in my experience, inspires deeper trust and authenticity. When our therapist is human, we are allowed to be human too.
It is not about perfection, but about transforming our pain into something valuable that we can use to help society at large.
Supporting studies
To name one, a large meta-analysis published in the Journal of Consulting and Clinical Psychology in 2018, examined data from nearly 30,000 clients, finding a consistent, moderate relationship between the strength of the therapeutic alliance and positive treatment outcomes, regardless of therapeutic approach. The authors concluded that “the alliance is one of the most robust predictors of psychotherapy outcome.”
Additional research on counselling effectiveness, such as a 2024 study examining client-counsellor relationships and outcomes, consistently points to therapist qualities such as emotional attunement, responsiveness, and presence as central to outcome qualities that are inherently relational and embodied.
Across different diagnoses, treatment settings, cultures, and delivery formats, the same conclusions emerge: when people feel emotionally understood, collaboratively engaged, and relationally safe, therapy is more likely to help.
This matters especially in a moment where AI promises mental health advice without the “messiness” of human relationships, without transference, psychological history, emotional bonds, or unpredictability.
AI does excel in accessibility, 24/7 support, and providing basic cognitive-behavioral tools, which I believe we need to value. But it cannot understand the inherent difference between “fixing” and “transforming.”
When AI says yes
Most of us know by now that AI agrees with us, it doesn’t challenge us. I do expect that to change.
AI is evolving at an exponential rate, as we know, and I do hope it can learn how to help us better. I do believe it can evolve to think more critically.
Nevertheless, as it stands, AI is designed to say yes and agree with anything we say, pointing us further in that direction. That has its dangers, as we have witnessed in the news in extreme cases.
Therapists have somatic empathy
There is an interesting phenomenon that happens when you are a therapist in tune with your own body and with the energy in the room, it is called somatic empathy.
I did not know this had a name and felt relieved to know so. It’s not a burden to feel what our clients feel, but a very effective tool to help them navigate their transformation.
The most common and interesting symptom of somatic empathy is when a client is dissociated. As therapists, we may feel deep exhaustion take over us, sometimes even leading us to fall asleep. That exhaustion is not our fault or wrongdoing, it is our bodies sensing our client’s dissociation. How brilliant is that?
I have learned to allow my feelings guide the conversation, with very positive results. Therapy works because it is relational, not technical. It lives in presence, shared humanity, embodied knowing, and the courage to stay with discomfort long enough for transformation to occur. AI may support, guide, and even soothe, but it cannot replace the alchemy that happens when two nervous systems meet, recognize one another, and grow together.
Read more from Julia Elstrodt
Julia Elstrodt, Psychotherapist
Julia Elstrodt is a psychotherapist specializing in trauma and embodied awareness. Knowing her vocation from the age of eleven, she has dedicated her life to the art of healing. Her work is rooted in the psychology of C. G. Jung, bridging the worlds of psychotherapy and spirituality. Shaped by the lived experience of profound trauma, Julia is deeply committed to supporting healing in both individuals and communities.
