What Happens in Therapy?
One of my responsibilities at Brentwood Baptist Church is to assess the need for therapy and make an appropriate referral for those in need. I am often asked, “What is therapy and how does it work?”
The word “therapy” comes from the Greek word, “Therapeuo,” which means, “to heal.” It assumes that there is some mental or emotional or relational issue that will respond to treatment leading to healing. The therapist will listen to the complaints of the client to determine the issues and form a treatment plan. The client and the therapist work together to establish therapeutic goals and from those goals, interventions are recommended. In cases where mental illness is involved, e.g., anxiety, depression, bi-polar disorder, etc., the therapist will recommend that the client also consult with a medical doctor for appropriate medication.
Once the treatment plan is established, the therapist will meet with the client on a regular basis to see how well the interventions are working and whether the client is reaching the therapeutic goals. In most cases, a weekly meeting is recommended. It is during this weekly meeting that an alliance is established between the client and the therapist.
The therapeutic alliance between the client and the therapist is critical for the success of the treatment. In this alliance, a safe place is created for the client to explore issues that have created the disturbance that led to the therapy. In some cases, old trauma wounds are uncovered; dysfunctional relationship patterns are revealed; the causes of depression or anxiety begin to emerge; the need for forgiveness or acceptance is manifested; illogical and harmful thought patterns are exposed; old anxiety defenses begin to break down. This process can be very painful and difficult and the relationship with the therapist is tested. The client will ask questions of the therapist like, “Is this a person who can be trusted?” Or, “Is this a person who can handle what I bring to the session?” If the answer is yes, the therapy will continue towards healing. If the answer is no, there is little chance that the therapy will lead to any kind of healing.
If the therapeutic alliance is strong and the work progresses, one outcome that can be expected is insight. The client will begin to gain insight into why they do what they do, why they have these disturbing emotions, why they behave and respond in the ways that they do. Without insight, the client may do everything that the therapist recommends, but there is little chance of lasting change or real healing. But if the client gains insight into themselves, there is a good chance that lasting change will happen and the emotional or relational disturbance that led the client into therapy will be resolved and the therapy can be considered successful.