Nidotherapy is not for the faint-hearted, but neither is it for the exceptionally sophisticated of therapists. It also cannot be learnt easily as a technique in the same way that some psychological therapies can. Of course, there are technological aspects of the treatment, and these are dealt with elsewhere in this book. This chapter is concerned with natural qualities that have become part of a therapist's repertoire in ordinary life. There are three general requirements without which little progress is likely to be made no matter how much formal training is received. The first is openness. In studies of normal personality patterns openness is one of the so-called ‘big five’ personality factors (Costa & McCrae, 1992). It describes the ability to be open to new experiences, willing to step outside one's own immediate setting and its requirements, and willingness to accept the feelings of others as equally valid as your own. This is not the same as being gullible or naive, as although at times openness may lead to the person being manipulated to some extent, openness grounded in reality and linked to awareness of circumstances prevents too much uncritical acceptance.

The second requirement is achieving trust. This is particularly important with people with long-term mental health problems. Time after time conventional psychiatric input makes vague promises that are often poorly delivered. This is why one frequently gets complaints along the lines of ‘You people are all the same. You come along full of promises, giving me hope that something's going to be done, and then in the end let me down, making all sorts of excuses as to why you failed. Is it surprising then that I don't trust you?’ A central component of achieving trust is not to promise things that you cannot deliver. When demands are made early on in assessment it is much better to answer ‘I don't know’ than make empty assertions that you cannot back up or blanket refusals when you are unaware of the full situation. Trust is easier if it is completely reciprocated, but there are many occasions when the nidotherapist may feel that the patient cannot be trusted in many different respects. This does not obviate the need for everything possible to be done to engender trust in treatment.

Enabling skills is also an essential part of the style of the nidotherapist.