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Therapy 101: How Does Therapy Work?

Therapy 101: How Does Therapy Work?

Therapy works, but how? You go to a therapist, talk to them about your problems, and your life starts to change. You don't just feel better— you get better. The same things don't upset you or throw you off balance as easily. Your mood and energy levels improve and you start doing things you couldn't do before. It can seem mystical, even spooky. What exactly is your therapist doing that makes therapy so powerful? Why is going to therapy different from just venting to a friend?


Therapy has a mystique, but it's not as mysterious as it seems. It's a process that therapists can review and repeat. You can benefit from understanding this process, too, because you'll get more out of therapy when you know what to expect. In this article, we'll shed some light on the basics of the therapeutic process so that you can walk into your first session with more confidence.

Therapy Is a Skilled Profession

Like any other trade, therapy requires a specific skillset to do well. A carpenter learns one set of techniques while a therapist learns another. And a therapist relies on their tools just as much as a carpenter does. When therapy works, there's a technique, tool, or skill that made it work. When it doesn't work, it's because the therapist didn't have the right tools or skills for the job.


Different therapy methods address different issues and needs, and having a well-stocked toolbox allows a therapist to work with a wider range of clients. While good therapists use specific therapeutic methods, they also know they need to flexibly and creatively respond to each client. Stiffly applying a favored technique is not effective therapy. Experienced therapists can track and adjust the way they relate to clients over time, tailoring the therapeutic process to each person.


It can take time for the effects of therapy to become apparent. Just like home renovation clients become impatient when they don't understand the scope of a project they hired a contractor to do, therapy clients get frustrated when they have unrealistic expectations of what a therapist can accomplish in a certain time frame. Unfortunately, while most people continue to work on home improvement projects until they're done, many people drop out of therapy when the work they're doing can't get done as quickly as they wanted or expected.


It's easier to replace a door than remodel an entire house; in the same way, some therapeutic tasks can be accomplished in weeks, while others can take years. Knowing how therapy works and how to track your progress can help you stay in the game until your self-improvement project is done.


A Therapist's Tools

You don't need to know all of the different therapy methods to understand the general principles of therapy or the basic tools your therapist uses. Important tools in a therapist's toolkit include:


  • Empathy and emotional intelligence
  • Good listening and observation skills
  • Knowledge about how the mind works
  • Personal knowledge and self-awareness
  • Training in specific therapeutic methods
  • Skills in building and maintaining relationships


To analyze and interpret, therapists must first observe. Therapists pay close attention not only to what you say, but also to what you don't say. They're trained to notice and interpret your body language, posture, facial expression, and tone of voice as well as your words. Depending on the method they use, they'll respond to what they hear and see in different ways.


Traditional analysts might say, "Tell me more," as they furiously scribble on their notepads, while cognitive behavioral therapists might point out where your beliefs are irrational or destructive. Many therapists are eclectic and use a balance of active listening and feedback, choosing the right time to interject with the most helpful interventions they've learned from a range of different methods.


Therapy is designed to help you understand and change how you think about yourself or a problem you're facing. By helping you examine your beliefs—especially what you believe about key events in your life— a therapist can help you change your story. Over time, you start to realize that maybe that one thing that happened doesn't mean you're a loser or that you can never be loved. Maybe things can be different.


The better a therapist knows themselves, the better they can get to know you. No matter how open-minded we are, we all have unconscious biases that affect how we understand and respond to other people. Good therapists are able to recognize when they're filtering what they're hearing through their own biases or reacting to their own personal triggers. Good therapists learn how to decenter these reactions, which helps them develop a more refined capacity to empathize.


The human mind is complicated, but the more we study it, the more we understand it. To be good at what they do, therapists can't just wing it, no matter how naturally empathetic they are. They have to know what they're doing. They have to spend time studying psychology and understanding not just how minds work—but how they change. Nearly all therapeutic methods are rooted in the understanding that relationships are the central engine of psychological change.


The Importance of the Therapeutic Relationship


The relationship between client and therapist is at the heart of every therapy method. You'll do better with a good therapist with whom you have a good relationship than an expert therapist you don't click with. You need to trust and feel comfortable enough with your therapist to open up and share things with them that you usually don't share with others.


The transformative power of being understood is one of the major drivers of change in therapy, and to feel understood by someone, you have to have a deep relationship with them. One of the reasons therapy takes time to start working is that relationships take time. The closer you and your therapist become, the more easily and accurately you'll be able to read one another.


With your therapist's help, you can start to understand the psychological patterns that keep you stuck. But therapy isn't just about recognizing your patterns. As important as these insights are, the feelings therapy evokes do a lot of the work. Think of them as veins that carry healing emotional nutrients to the parts of you that need repair. These feelings will be more powerful, and you'll express them more freely, when you trust and feel close to your therapist.


This is why it's important to choose well and change therapists if you're not connecting with one. It's also why it's important to give therapy the time it needs to start working. You can usually sense within the first few sessions whether you'll be able to build that kind of relationship with your therapist. It's not that different from when you meet someone that you know is going to become a good friend. You don't have to try as hard to explain or justify yourself, and you feel a palpable sense of relief in how easy it is to talk to them without feeling judged.


The Goal of Therapy

The goal of therapy is to help you change your thoughts, emotional reactions, and behavior in the ways you want to change them. Sometimes these changes are complex, but sometimes change in therapy is as simple as helping you accept something in yourself or others that you couldn't accept before. Sometimes it's more about figuring out what you want, who you are, and how you want to change (if at all) than it is about taking immediate action on a specific issue.


While many people go to a therapist because they want to change their behavior, it's usually not because they don't know how. It's because there's too much internal resistance for them to make those changes without help. From unhealthy relationships with food to unhealthy relationships with other people, we can often see the problem with what we're doing, but have difficulty when we try to change our patterns. A therapist can help people overcome these inner obstacles.


Most therapeutic methods help you become more aware of how you think and react and learn other ways to interpret and respond to your life. Some methods target emotions directly by facilitating cathartic emotional experiences. Regardless of the methods your therapist uses, the heart of therapy is your relationship with them. As you feel understood by your therapist, you start to understand yourself better, too. Your emotions flow more freely, and you start to heal.


If you feel ready to take the plunge and start therapy, you can use the search tools on OpenCounseling to find a local therapist or try online counseling with our sponsor, BetterHelp. There are more options for therapy than ever before, and the right one for you might be just a call or click away. You'll be surprised how quickly therapy can change your life.

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Stephanie Hairston, MSW
Posted on 06/21/2020 by Stephanie Hairston, MSW

Stephanie Hairston is a freelance mental health writer who spent several years in the field of adult mental health before transitioning to professional writing and editing. As a masters-level clinical social worker, she provided group and individual therapy, crisis intervention services, and psychological assessments. She has also worked as a technical writer for a medical software company and as an editor for a company that appeals denials of insurance coverage for behavioral health treatment. As a writer, she is motivated by the same desire to help others that brought her into the field of social work and believes that knowledge is one of the most essential recovery tools. She strongly believes in the mission of OpenCounseling and in making therapy accessible for everyone.