In 2024, for about 8 months or so, I worked with a new therapy coach. She completely changed the way I view therapy. Her name is Alyssa Di Bartolomeo and she's a researcher whose speciality is process coding motivation.

I know, that’s a confusing phrase. Think of it like this: she’s training me to be a Sherlock Holmes of motivation. Turns out by learning to read the subtle signs and hints clients give, we can detect how motivated clients are to change.
It’s now obvious to me that motivation is a foundational force in therapy. Learning to work with motivation, while not the only thing, is probably the biggest bang for your buck. It’s the 20% that you learn that takes you 80% of the way forward.
There are three reasons I believe this.
First, (most) therapy problems are motivation problems.
To be a better therapist it's helpful to know where most therapy problems come from. Most therapy problems come from an inner part that believes the problem is useful.
People who are angry often feel that giving up their anger will let people walk all over them. People who are anxious often feel like giving up their anxiety is like giving up their alarm system. People who are depressed feel like you're asking them to see the world unrealistically if you encourage them to be more positive.
The problem, of course, is anger, anxiety, and depression cause pain, so our clients are often split. Part of them wants to get out of pain, but another part of them has good reasons for keeping their problem.

We often try and deal with these problems with behavioral interventions. This causes predictable problems.
Bulldoze backlash.
With external problems you can bulldoze your way through. I have many days when I sit at my desk and think “I don’t want to do notes.” And then I crank up the dubstep and scream at my computer and do the notes.
But with internal problems this often doesn’t work. With internal problems, if we bulldoze through we just heighten the internal split, causing even more emotional pain.
For instance I once heard about a woman who was morbidly obese. She went through this intensive medically supervised weight loss program and over the course of a year lost a ton of weight. Then, in a few months, gained it all back.
“How?” asked her doctor, “did you gain all this weight back in a few months? It took you a year to lose it. It shouldn’t be possible to gain this much weight so quickly.”
"I think I've been sleep eating." The lady said.
"Why have you been sleep eating?"
“Well, I realize now I’d used the weight to keep men away. When I was skinny I felt too vulnerable. It’s like my walls were gone.”
Part of her wanted to be healthier and part of her felt the best way to avoid men was to be obese. Instead of resolving this conflict she focused on losing the weight and the weight came back with a vengeance.
Compliance.
There’s something else that happens when we don’t respect this split. Sometimes clients just comply.
We all know that client. She comes in complaining about her boyfriend and how awful he is. He calls her stupid and cheats and then lies and when he’s caught he makes excuses. She cries and cries and at the end of the session she says, “I don’t know what to do.”
Well, heck, it’s not that hard. You think. “You should leave him,” you say.
“I know. I know,” she says. You talk about what leaving him would look like. You can see it on her face. She’s a little hopeless, but you’ve gotten through to her. She knows what she needs to do.
Then next week she comes in and complains about her boyfriend, again. And round and round you go.
In these moments clients agree with us about what needs to be done, but when they go to actually do it, they can’t do it. Because the other part of them, the part of them that has good reasons to keep doing what they've been doing, hasn’t been dealt with. They comply with us without dealing with the internal split.
Summary.
Because of this much of therapy isn’t really about the problem (anger, anxiety, depression, etc) but rather about how we handle the parts that want different things.
Hence motivation is the foundational force in therapy.
Second, therapy interventions only work if the client is motivated.
In just about every other field, the intervention works regardless of what you want. If I strap you down and force a syringe of morphine into your veins in about 30 seconds you’ll start feeling real good.
Interventions in therapy don't quite work like that. Most of what we're dealing with is internal issues. Internal issues are often best dealt with using internal interventions like mindfulness, EMDR, hypnosis or other experiential work. However, these can't be forced. When we try to force internal interventions to work we run into one of two problems.
Low experiencing.
Remember that teacher you had in school who was really engaging and dynamic? Every class felt like it flew by. You couldn’t get enough. You stayed after class to ask questions. That class felt qualitatively different than your other classes.
Compare that teacher to your worst teacher. The teacher who would lecture for an hour, then you’d look at the clock and see that it’d only been 60 seconds and you’d wonder, "how the heck am I going to make it through this class?"

In both of those classes we tend to focus on the teacher, but you were also different. Your attention was different. Your level of engagement was different. This same dynamic plays out in counseling and it’s what researchers call experiencing. This level of engagement is what makes experiential interventions work.
How’s this play out in therapy?
Say you’re working with a trauma client and you mention EMDR.
"Well, sure," he says, shrugging. "I'll try it."
He seems disengaged, but you decide to do the EMDR sets anyway. You finish and ask the client, “what did you notice?"
He might say, “I didn’t really notice anything.” And of course. He wasn't really engaged in the experience. So it didn't work.
That's fundamentally different than the trauma client who comes in and you say, "Hey let's do some EMDR."
"Sure, I'll do anything," he says, perched on the edge of his seat.
Experiencing tells us that the client's level of engagement is predictive of success, and much of that is due to how motivated the client is.
Negative reactions.
When we try to force internal interventions to work we run into a second problem.
Negative reactions.
We do hypnosis and the client begins to have a panic attack. We do EMDR and the client dissociates. We do psychedelic assisted therapy and the client has a bad trip.
These negative reactions happen because while part of the client wants what we’re offering, another part of them doesn’t.
This is also the definition of most "complicated/complex" diagnoses. Complicated grief, complicated trauma, complex PTSD. All of these are negative reactions clients have when a part of them doesn't want to give up their problem. These reactions are a form of protest.
Summary.
Now this doesn't mean that clients are to blame. As therapists we know that problems are merely ways clients have learned to protect ourselves.
For example I've worked with multiple women who were afraid to have sex with their husbands because they were sexually assaulted when they were younger.
These women don't want to be afraid. They aren't to be blamed for their reaction. Rather they've learned that sex is not safe. So while part of them believes sex ought to be part of their relationship, another part has learned the hard way that sex is dangerous.
You don't motivate these clients by pushing them or convincing them. They do this enough to themselves. Our job is to work with the part of them that is afraid until it doesn't have to be afraid anymore.
Hence motivation is the foundational force in therapy.
Third, you can only do interventions if clients are motivated to do them.
When you look at the outcome literature, there’s this weird thing that happens. Exposure therapy works as well as EMDR which works about as well as Family Therapy.
Most interventions and models are equally effective.
How? That doesn’t make sense.
Subjective wellbeing.
I think it’s because the therapy measures are measuring subjective wellbeing. A lot of things can change your subjective wellbeing.
For instance, if you can get your anxious client to take their medication regularly or exercise 3 times a week or actually join a breathwork class or do the EMDR, would they feel better?
Probably.
Now you may believe their anxiety is due to their childhood trauma which hasn’t been resolved. But the relief a client can feel from exercising regularly might make enough of a difference that the client considers therapy a success.
Who are we to say anything different? After all, what we’re seeking to change is their internal subjective wellbeing.
So for any given client, there are a whole host of things which will make them feel better, if they actually do any one of them. There’s another side to this though.
Persuasion is hard.
I’ve studied motivation for years now, and I can tell you it’s very hard to persuade people to do things they don’t want to do. You can easily coerce someone into doing something they don’t want to do. That’s quite easy. You just threaten to harm them. But to make someone want to do something they don’t want to do is actually very hard, and it takes a long time and often control over the context.

For instance, say you don’t like broccoli. Well I could persuade you into liking broccoli. All I have to do is three things.
First, I can’t force you to eat broccoli. That will only fuel your hatred of broccoli.
Second, I need to make sure you have tons of access to broccoli, so I could make it an option for breakfast, lunch, and dinner.
Third, I have to limit better tasting options. So do something like remove all sweets and spices from your pantry. Even better if I serve you the same meal every day for every meal, say a plate of carrots.
After a while you’ll try broccoli just to have variety in your food, and, over time, you’ll probably grow to like it.
Therapists don't have that kind of control. Mostly what we have is our words. So persuading people is very hard. If someone doesn't really want to do something, they aren't going to do it.
This means the only interventions available to you are the ones clients are willing to do.
Any of which will make them feel better.
Hence, motivation is the foundational force in therapy.
Conclusion. To Be a Better Therapist Remember Three Things.
For all these reasons motivation is a foundational force in therapy. Better therapists know that:
Therapy problems are motivation problems.
Therapy interventions only work if the client is engaged.
You can only do interventions if clients are motivated to do them.
This is NOT to say that ALL of therapy is ONLY motivation.
No. It's not. No more than all of therapy is attachment or trauma or anything else. But client motivation is the foundation on which everything else rests. If we don't have it, nothing else matters.
Hence, motivation is the foundational force in therapy.
Best,
Dr. Jordan Harris is the co-founder of Private Practice Incubator, a consulting firm which teaches counselors how to launch a solo practice.
If you'd like to learn more about launching your practice visit us here.
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