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  • Writer's pictureSarah Hindle

What Makes Therapy Work?

Updated: Jul 31, 2023



For those new to therapy, or perhaps holding some healthy scepticism, the question may have crossed your mind; 'how will talking about my problems actually help me?' While therapy itself can take many forms, there are some common 'ingredients' that cut across therapeutic approaches; elements we know from the treatment literature are important for the reduction of symptoms and positive outcomes. While this is not meant to be an exhaustive list, these elements are definitely worth seeking out for your own therapy experience.


Three ingredients of therapy that really work:


1. Alliance: Being able to connect with your therapist means feeling emotionally safe, understood, supported, and seen. It takes some time to develop rapport, as is the case when building any new relationship. While much of this comes down to the the skill of therapist, the extent to which you can also develop an alliance with your therapist, working together on your treatment goals, is often the extent to which you will improve. The treatment literature indicates that the therapeutic relationship is more fundamental to change than which actual modality is chosen.


2. Formulation: A good therapist will gather information so they can co-formulate the origins of your challenges with you, how they are maintained, and the extent to which what you are experiencing maps onto a clinical area. This granular approach allows connections to be made between your experiences and the broader clinical literature, where change processes have been thoroughly explored and evaluated. A good therapist will always be re-formulating and honing interventions for the very best outcomes.


3. A neuroscientific framework: Did you know that across most major therapeutic modalities grounded in the science of neurobiology, wellbeing is associated with the connection of separate areas of brain function? With an integrated brain that holds balance between both rational/thinking and physiological/emotional systems, we are more flexible, less reactive, and more present, empathic, and resilient. Therapy provides an opportunity to slow down and re-integrate these broad systems, building synaptic connections and stronger neural pathways, and importantly, a strong 'observer' self (which Dan Siegel calls 'Mindsight') able to bring knowledge developed in therapy forward into every day situations.


This is all possible through talking.


Amazing, isn't it?



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