What is Good Therapy

Good counseling relies on the three foundations of mental health treatment.

At Community Practice, we think good counseling relies on three foundations of mental health treatment.

1. Establishing Trust

Another way to describe establishing trust is answering two questions:

“Can I work with this person?”
“Is there somewhere for this relationship to go?”

The relationship between a therapist and client is an important part of treatment. Before techniques, worksheets, or treatment plans can accomplish much, there needs to be enough trust for two people to work honestly together.

2. Providing High-Level Empathy

High-level empathy is the ability to understand what another person is experiencing and then communicate that understanding back to them.

Sometimes being deeply understood feels like finding a missing piece of a puzzle. A good therapist doesn't simply listen to the words being said. They work to understand the emotions, experiences, relationships, and patterns underneath them, then communicate that understanding back to the client.

3. Employing Evidence-Based Therapeutic Interventions

This is the fun stuff. This is the part that people often find most enjoyable.

These are techniques that have been researched and founded in science for their ability to cause people to heal and mend from complex mental, emotional and behavioral illnesses. Some of these interventions are as simple as talking through a CBT (cognitive behavioral therapy) worksheet with someone experiencing depression in order to identify the negative thoughts that are the drivers of depression. Other interventions can be more dynamic such as doing role play with a family where the family members switch roles and act out scenes to help foster communication and understanding.

Therapeutic interventions are the tools we actually use to help create change. Good therapy shouldn't consist only of talking about the same problems week after week. Therapy can involve learning, experimenting, practicing new behaviors, examining old patterns, improving relationships, and trying different approaches to discover what actually helps.

No single intervention works for every person or every problem. Good therapy is multifaceted. A therapist should have a variety of tools available and work collaboratively with the client to determine which ones are useful.

What We Actually Do in Therapy?

Therapy can involve more than talking about problems. Depending on your goals, your therapist may use a variety of exercises, assessments, conversation prompts, and practical activities.

Some examples include:

Understanding Thoughts & Emotions

These approaches can help identify patterns in how you think, feel, and respond to situations.

  • Cognitive Behavioral Therapy (CBT) exercises

  • Identifying negative thought patterns

  • Narrative Therapy

  • Virginia Satir's Iceberg

  • Virginia Satir's coping stances

  • Exploring resentments and gratitude

  • Myers-Briggs personality assessment

  • Exploring family patterns through a three-generation family tree

Relationships & Communication

Therapy can also be an active place to practice new ways of communicating and relating to other people.

  • Guided communication exercises for couples

  • Role-playing difficult conversations

  • Family role-playing and perspective switching

  • Exploring family roles and relationship patterns

  • Practicing healthier ways to express needs, emotions, and boundaries

Goals & Behavior Change

Sometimes the problem isn't knowing what you want to change—it's figuring out how to actually make that change happen.

  • Identifying personal goals and the daily steps needed to achieve them

  • Motivational Interviewing

  • Time studies to understand procrastination and how time is actually being used

  • Lifestyle checklists for areas such as health or finances

  • Developing plans to improve social life and relationships

  • Twelve-Step recovery principles when appropriate

Coping, Grounding & Everyday Life

Some interventions are simple skills that can be practiced outside the therapy room when difficult emotions or situations arise.

  • Breathing techniques

  • Grounding exercises

  • Developing a personalized coping-skills or “hobbies” list

  • Artistic expression

  • Identifying supportive people to contact

  • Planning healthy activities such as exercise, cooking, recreation, meetings, or time with friends and family

  • Developing practical strategies for getting through periods of intense emotion

Assessment, Safety & Additional Resources

Good therapy also means recognizing when additional information, assessment, or professional support would be helpful.

  • Suicide-risk assessment and safety planning, including tools such as the Columbia Suicide Severity Rating Scale when appropriate

  • Psychological or personality assessment when appropriate and within the clinician's scope

  • Identifying when another provider may be helpful

  • Coordinating or recommending care with physicians, physical therapists, psychiatrists, or other professionals