How does therapy work?

Therapy or Psychotherapy, also known as talking therapy, works in a number of ways. I would like to explain how it does, as in what effects and utility therapy can have. Whether it works for you will depend on other factors which I will cover another time. Understanding it's utility allows you to make better decisions on what kind of therapy you want to try.

Most literature will distinguish between therapy and therapist, as each is considered entities in their own right to have different influences on therapeutic outcome. For example, we can  talk about the ‘therapeutic space’, the private nature of a conversation set in a particular time period, without taking the therapist’s skills and demeanour into account. For now though, I will use the terms interchangeably, the assumption being when you enter into therapy, it is with both the space, the process, the intervention and the therapist (be that a psychologist, psychotherapist, or counsellor) that we are wanting to understand the effects of. Collectively they (therapy and therapist) work in a number of ways to help people, and that is what I’d like to unpack in this post.

I would say that there are five main ways therapy works. While not all therapy forms embody all mechanisms, having an idea of the ways therapy works, can give you an idea of what type of therapy you should be aiming for.

Psychoeducation - being informed 

Some forms of therapy rely on something we call Psychoeducation. It is the dissemination of knowledge about psychology, the human experience, interpersonal dynamics, how and why thoughts, feelings, bodily sensations and behaviours occur, and also information about how to navigate and manage our experiences. Therapists who adopt psychoeducation in their practice, are likely to give handouts with models and ‘tools’ to explain your experience. For example, if you have panic attacks, you might be told (or ‘educated’ on) what is going on physiologically in your body. This knowledge in turn can help reduce the occurrence of panic attacks or inform you of ways to manage them so they don’t escalate. Psychoeducation focuses on our cognitive component. It appeals to our minds and rational brains. We like to have answers to what is going on with us, it gives us knowledge. If you follow me on instagram you'll see some examples of psychoeducation.

Relationship- using the social engagement system to heal and grow

Central to all therapy forms is the therapist's ability to be accepting of what their client talk about and non-judgemental. Therapists utilise the social engagement system to help their clients. We are born with this system, it's what we conduct our social lives through. It is the invisible energy between two people that fosters trust and openness when used correctly. While many people find kindness and warmth uncomfortable, meeting another person who is accepting and willing to listen to what you have to say is in and of itself healing. The therapeutic relationship appeals to our emotional and physiological components; how we feel in the body, and influences our mood and feelings. Change here is visceral.

Reflection and insight - observational space

As with any profession not all therapists are equally good at therapy, some will be better than others; better informed and trained. Regardless of this, having a space to talk about your experiences and being able to reflect on them increases the opportunity for making better and new decisions. (A good therapist  will help draw out insights in a way that is useful and relevant to you). It is based on the principle of Johari’s window, that states we have blind spots and subconscious areas which influence us without our awareness. Therapy requires you to reflect and think about yourself. It requires you to reflect on your relationships and bidirectional influence to others. This requirement is known as ‘psychological mindedness’. It enables your mind to bring information about yourself and others into focus which in turn empowers your decision-making. Change takes the form of insight and ‘ah ah’ moments. I find quite often the answers are found ‘within’ and with the correct questioning and line of enquiry, people know best about their lives, it’s just not always clear to them. Change here comes in the form of insights and a sense of enlightenment.

Journeying - accompanied support

Some people seek therapy when they reach an impasse in their lives or there is a transition period that is tricky to get through. Therapy, or more so the therapist, accompanies their client on that journey of life, as a confidant and support purely there for them. It is not uncommon for people to feel that they can’t fully express themselves to family and friends. Or that family and friends don’t fully understand or ‘get’ what they are going through. A therapist can be that person who can be called upon and trusted to walk through this difficult time in life. Therapy here works on the attachment bond, a biopsychosocial system, that can provide a sense of a ‘safe haven’ and security. It allows people to get through, overcome and grow from their circumstances. This is why sometimes therapy lasts for years. 

Mental health maintenance - ongoing self-care

Therapy offers a space whereby the client is able to get things off their chest, allowing for reflections and processing of thoughts, feelings and experiences. It’s not uncommon for people to not be listened to in their daily lives. We humans have a tendency to be eager to be heard and state our minds rather than listen to what others have to say. This means we often feel unheard and seen. Therapy can be that outlet to have uninterrupted conversations. Therapy in this instance is part of ongoing mental health care, and maintenance of psychological well-being. The aim for therapy is not necessarily change, but more maintenance of well-being. Perhaps similar to a debrief meeting and psychological supervision. For example, as a practicing psychologist under the HCPC and BPS, all psychologists, including me, are required to attend regular supervision (where I see another psychologist and talk about my therapy practice).


Therapy can be an amalgamation of the above or focus on one or two aspects, but understanding the differences can help you figure out what type of therapy you need. What are you looking to achieve? What do you need right now?

Feel free to book a session with me today of you are ready to work on your mental health and wellbeing.