How does therapy work?

By David S. Robbins, MA
December 30, 2008

I have sat in the seat of the therapist and the client and my essential thoughts about counseling and psychotherapy is that it works (I wouldn’t be in this line of work if it didn’t.)  There are a few ingredients that need to be present for this to happen.

1. Good chemistry between the therapist and client – the therapeutic relationship has to feel like a comfortable place where you can begin to relax and open up. I say ‘begin to’, because any good relationship needs time to develop a ground of safety and trust.  You will probably have a sense of some comfort initially in a beginning consultation or over the phone with your prospective therapist. Studies have shown that the best indicator for a positive therapeutic experience is the quality of relationship between the therapist and client.

2. A desire to change – This will come from you, you may have specific things you want to work on, or a general feeling of stuckness or that something is missing.  I personally feel that goal direction is important in therapy, and your therapist should be able to guide you in a process to become more clear about how you want your life to change and what issues might be beneficial to work on to support movement towards this goals.  Though therapy is process oriented, I’ve found in my work with clients that process work that is aimed at accomplishing certain goals agreed upon between you and the therapist creates a more satisfying and positive experience for both parties – and is more effective overall.

3. Willingness to turn towards your suffering, fears, and stuck places –
This means, with the support of your therapist you gently and compassionately begin to explore the feelings and thoughts associated with the wounding and/or issues you have chosen to address in therapy. You can be prepared for this by learning certain skills and strategies for managing overwhelming feelings and thoughts. If you feel rushed into this process, or unsafe  – this is a good sign that you may not be ready or the relationship with your therapist is not strong enough.

4. Bringing your insights, growth,  and healing into your life –
This is accomplished by taking the information, the wisdom that emerges, and the changes that have occurred in your body/mind during therapy into the rest of your life.  This can be accomplished by using the skills, and techniques that you have learned in the safety of your therapist’s office into your life.  Often this generalization of change into our lives happens naturally, but it is almost always useful  to look specifically at this and create an intentional strategy to make it happen.  I work with clients to tailor the skills and techniques we have learned into specific strategies to remove obstacles, or move through the fear and suffering to change the way they relate to the people and the situations of their lives. This includes strategies for creating the life you envision and moving from just surviving to thriving.


5. Therapy that fits for you
– Often therapists who receive training in a certain type of therapy i.e. gestalt therapy, cognitive behavioral therapy, solution-focused therapy, EMDR, etc. will  use a cookie cutter style to work with all clients.  Though all of these styles of therapy are valid and extremely useful (I personally have trained in all of these), it is important that therapy be specifically tailored to each individual client’s needs. Therapists who are more dedicated to sticking their training than honoring your unique needs and your unique journey will ultimately not offer you the most therapeutic experience. I strive to create a unique and healing experience for each client so that they can move past obstacles and experience a sense of well being and satisfaction with their life. I consider this a ‘relationship focused therapy’ that utilizes the many tools of psychotherapy, but is not wedded to one way of healing. Everyone’s path is unique and your therapist should strive to meet you there.

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