What makes therapy work?

A peer’s mantra reassures me as I grow in my counselling career: “Therapy’s a conversation — just a conversation.”

Therapy is a conversation — except, given its emotional character, it’s not just “conversation,” is it? Sometimes, the “wrong” thing is said; maybe it’s some confusion, an irrelevant tangent by the counsellor, or a challenge to the client’s expectations.

Such sticking points happen in ordinary conversation, don’t they? Yet in a sometimes-unfriendly world with so much misinformation, the stakes can feel higher in therapy.

So, what makes such high-stakes emotional work possible? Most counsellors are highly skilled, experienced, and well-intentioned, so, in theory, most can help. That said, we’re imperfect humans with biases! So what I think makes therapy work, at its core, is something else: trust. For you, I mean: trust that I hold the insight you need; trust that you can be yourself; and, finally, that, in being yourself, I’ll honour your authenticity and acknowledge when I haven’t.

Another peer once told me that, when therapy works, it’s a courageous act of giving and receiving. The client reveals their life, which the counsellor witnesses with curiosity and compassion, and the counsellor gives their curiosity and compassion, which the client receives. Through such transparency and safety, change becomes possible.

The road of therapy is winding. We’ll encounter surprises and navigate obstacles as we shift from the present to the past and back again. That’s okay. Therapy is a living, creative process that will gradually seep into your life, improving it over time like a seed that blooms into a flower.

By using my skills and being transparent, accountable, and empathetic, I continually strive to earn my clients’ trust. If trust is flagging, I want to talk about it and whatever is in the way so we can get back on track. For their confidence in me, I admire and appreciate my clients. After all, to trust is an intentional choice, a leap of faith made when every moment of therapy is unique and unpredictable, bringing discovery, challenge, and triumph, in turn.

Thus, therapy, like life itself, is a journey built upon trust.