I find that really interesting, WM. Could you give an example to help me understand better? What is something the therapist might "do" for a person that the person doesn't need help with? (I am not sure I have had experience with a therapist "doing" something for me like this. For example, my therapist gives me unconditional positive regard when listening to me. It's not quite the same to give oneself UPR, although something similar that is self-directed could be valuable too--UPR almost requires the "doer" of this to be "other" and not oneself.)

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There are also not enough mechanisms for helping the client find a good client-therapist fit

I do agree with this. I am not sure there are any mechanisms for this (beyond early recognition by the therapist and referral to another practitioner). The client begins with a therapist and often continues for quite some time even if the fit is not good (or even not "good enough"). Often the client will eventually get discouraged and quit, feeling "therapy was not helpful" or realizing some small gains but never the huge life changes that therapy can help bring about.

Here is one idea for how a good fit might be promoted. This comes from a study on counseling for alcoholism. Alcoholic clients were assigned to 3 different types of one-on-one psychotherapy treatment. One of the three was an individual psychotherapy based on "12 step" programs (like AA). The second was a CBT-based therapy, and I can't remember the third approach. The results showed that it was not the type of therapy that was the most efficacious but the therapist-client relationship (no surprise, as other studies outside of the addiction world have also showed the relationship's primacy). What was interesting about this study was that one component was to assess the strength of the therapeutic alliance very early on using standard instruments. As has been shown in other studies, the early strength of the relationship (after only 3-6 sessions), as assessed by these instruments, is an outstanding predictor of the strength of the alliance much later in therapy. As an intervention, spin-offs from this study involved using the instrument early on to assess the relationship and then switching the client to another therapist if the alliance was weak. This allowed the client not to linger in therapy with a therapist who was not a good fit. (I can't remember how the therapist was picked that the client was switched to.)

I thought this was a very interesting intervention and might be applied in all areas of psychotherapy, not just addiction counseling.

I think the client, especially one new to therapy, often does not know how important the therapist relationship is to success of therapy and so doesn't think to change practitioners. I know that with my first therapist, this never occurred to me. She was a nice lady, but I had no idea the relationship with a therapist could be so much more, and no idea that this could be important for the therapy's success. Maybe if would be helpful in therapy to assess the alliance in this way early on and recommend a change if there is not a good fit.