What creates change?

This morning we had supervision for the family therapy team, and we discussed the question: what creates change?

This is a difficult question because so many families come to us, some change and some don't. Sometimes we think we are doing fantastic and therapeutic work and nothing happens. Sometimes we think we are doing nothing in particular and people get better anyway...

Is change to do with the therapy? The therapist? The "readiness" of the person? The therapeutic alliance? Something else?

The studies show that the person coming brings 40% of the change with them. The alliance/relationship between the therapist and client accounts for another 20% and the therapy being used about 10%, which leaves 30% still unaccounted for...

The other conversation we had was about how our own experiences of change impact on our professional model of change. Once again I was struck by how different people are in how they see the world, even among the therapy team. Vash talked about how the experience of difference changed her, John about how seeing the need for change in his life helped him make changes. Lisa said the most important factor for her was insight into how and why she acted as she does, in order to change it. Other factors mentioned were readiness, motivation and seeing the level of dysfunction/problem rising beyond what is acceptable - the "last straw" effect.

I guess we are all combinations of motivation, insight, experiences and needs, but there is something else as well. That indefinable spark of "free will" that lets us decide to change, or not...