How does psychotherapy work?

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How does psychotherapy work?

Most people can see the benefits of talking to someone; otherwise, we wouldn’t have the old saying ‘A problem shared is a problem halved’.

I’m Jennifer Rose, a UK counsellor, psychotherapist and Mental Health Recovery worker.  My blog is not intended to be a substitute for professional advice, diagnosis, medical treatment, or therapy. Always seek the advice of your physician or qualified mental health provider with any questions you may have regarding any mental health symptom or medical condition.

In my last blog post, I explained that there is research to show how various types of therapy have been shown to be effective for certain issues. For example:

  • Psychodynamic therapy has been linked to good outcomes for people with depression or a diagnosis of personality disorder (Fonagy, 2015).

  • Family and systemic therapy has been linked to good outcomes for people with substance misuse issues (Liddle, 2016).

  • Cognitive behavioural therapy has been linked to good outcomes for people who are experiencing panic attacks (Otte, 2011).

I also said that there is a growing evidence base to suggest that the relationship between the therapist and client has the biggest impact on how well the therapy works. For example:

  • A review of the current research showed that nineteen of twenty studiesfound therapist effects critical (Johns et al, 2019).

  • Exploration of fifty years of psychotherapy revealed that strong therapeutic relationships are vital to the success of treatment Orlinsky, Rønnestad, & Willutzki, 2004). 

  • The differences between established models of psychotherapy do not significantly alter outcomes, supporting the suggestion that the therapeutic relationship is more important (Seligman, 1995; Tasca et al, 2019). 
     

But is there more to it than that?

Yes! Successful treatment is the result of three factors working together:

  • Evidence-based treatment that is appropriate for your problem
  • The psychologist’s clinical expertise
  • Your characteristics, values, culture, and preferences

So, how does therapy work?

It is hard to give a simple answer to how therapy works, because at least two of the three factors involved will be unique – you and your therapist.  Plus, the answer will change depending on the types of therapy being used (see my blog post about the 400+ different types of therapy!)

What we can be sure of is, that when people begin psychotherapy, they often feel that their distress is never going to end.

Psychotherapy helps people understand that they can do something to improve their situation.


That leads to changes that enhance healthy behaviour, whether it’s improving relationships, expressing emotions better, doing better at work or school, or thinking more positively.

Therapy works by giving you...

  • Opportunities to reflect – Through exploring your feelings, how you behave and what you say in therapy, your therapist can help you to reflect on important relationships in your life. In psychodynamic therapy, you will explore how your life is influenced by your past. This can help you to see situations and people more objectively.

  • Opportunities to process trauma - This is when stressful events that you experience or witness make you feel unsafe, helpless or vulnerable. Your therapist will work with you to reflect on what has happened to you and how it might be affecting your life today. The focus is on compassion, listening and understanding, rather than making a diagnosis. This can help you to process trauma, so it has a less negative impact on your mind and body.

  • New ways of seeing – a therapist is trained to help you explore and understand your thoughts and feelings.  This can allow you to see situations, relationships and yourself more clearly.

  • New ways of being - As you start to discover new ways of seeing, you can open up new ways of thinking, feeling and behaving. You become more conscious of things that have held you back, giving you the opportunity to make different choices and stop damaging patterns of behaviour.

  • New ways of coping – Your therapist will support you in finding new ways of coping, often teaching you evidence-based techniques.

I do hope that has been helpful - is these anything I missed?  Let me know in the comments.

Jennifer Rose
P.S: If there are any questions you would like me to address, please do let me know.  In the meantime, why not follow me on my socials?


Click here to go to the Socials page of my website, where you can find the links to all my social media.

Sources

Fonagy, P. (2015) The effectiveness of psychodynamic psychotherapies: An update. https://doi.org/10.1002/wps.20235

Johns RG, Barkham M, Kellett S, Saxon D. A systematic review of therapist effects: A critical narrative update and refinement to review. Clin Psychol Rev. 2019 Feb;67:78-93. doi: 10.1016/j.cpr.2018.08.004. Epub 2018 Aug 25. PMID: 30442478.

Liddle, Howard. (2016). Multidimensional Family Therapy: Evidence Base for Transdiagnostic Treatment Outcomes, Change Mechanisms, and Implementation in Community Settings. Family Process. 55. 10.1111/famp.12243.

Orlinsky, David & Rønnestad, Michael Helge & Willutzki, Ulrike. (2004). Fifty years of psychotherapy process-outcome research: Continuity and change.


Otte C. Cognitive behavioral therapy in anxiety disorders: current state of the evidence. Dialogues Clin Neurosci. 2011;13(4):413-21. doi: 10.31887/DCNS.2011.13.4/cotte. PMID: 22275847; PMCID: PMC3263389.

Seligman ME. The effectiveness of psychotherapy. The Consumer Reports study. Am Psychol. 1995 Dec;50(12):965-74. doi: 10.1037//0003-066x.50.12.965. PMID: 8561380.

Tasca, Giorgio & Angus, Lynne & Bonli, Rupal & Drapeau, Martin & Fitzpatrick, Marilyn & Hunsley, John & Knoll, Megan. (2019). Outcome and progress monitoring in psychotherapy: Report of a Canadian Psychological Association Task Force.. Canadian Psychology/Psychologie canadienne. 60. 10.1037/cap0000181.

 

 




 

Life doesn't always follow the path we expected. Grief, loss, anxiety, change, and life's unexpected challenges can leave us feeling uncertain, overwhelmed, or wondering where to turn next. I created the Therapy Roadmap as a gentle way of making sense of these experiences. Rather than seeing therapy as simply solving problems, the Roadmap uses familiar landscapes—such as rivers, bridges, forests, and quiet places to rest—to explore the emotional journeys we all encounter at different times in our lives. Wherever you find yourself, each place offers an opportunity for understanding, reflection, and growth. Through these articles, I share compassionate insights, practical guidance, and reflections inspired by the Therapy Roadmap, with the hope of helping you feel a little less alone and a little more confident about the next step on your own journey. Whether you're simply curious, seeking support, or considering counselling, you're warmly welcome here. Take your time to explore the path ahead, and if you feel ready to take the next step, I'd be honoured to walk alongside you.

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