At its most basic, a therapeutic conversation involves opening up to another person (in this case the therapist) about what is most troubling in one’s life. The therapist is trusted to respond as empathically as they can and to keep the conversation private. Empathic, trusting and disclosing relationships of this kind are the basis for emotional growth no matter whether this occurs in therapy or outside therapy. In feeling valued and understood, we are more hopeful that there are solutions to our problems, we are more likely to see new perspectives on our problems, and are more likely to involve ourselves in new opportunities for learning. In fact, the more one has access to relationships of this kind in one’s personal life, the more protected we are likely to be from psychological problems in the first place, and the less likely we are to need professional help.

Professional therapy adds to this in a number of ways. Firstly, the therapy situation has boundaries which protect the ‘therapeutic’ nature of the conversation. The therapist is and remains outside the client’s social and family life, the therapeutic time is clearly defined and protected from intrusions, and the therapist focuses on the client’s life (rather than talking about their own life, for example). These boundaries aim to create and concentrate the conditions for emotional growth in the therapeutic relationship. (Of course it is also necessary for the client to use those conditions to help them face their difficulties). Secondly, the therapist offers their knowledge of tried and tested methods for resolving psychological problems associated with the approaches to therapy in which they have been trained. For example, the therapist can offer the client techniques for managing or exploring troubling situations, offer new understanding of the problem, use the therapeutic relationship to support new learning about the client’s self, feedback on the client’s progress and so on.

We hope that this brief, simple explanation of therapy is helpful. The ‘therapy world’ in the early twenty first century can be somewhat confusing. There are at least 400 different brand names of therapies in existence (e.g. cognitive behaviour therapy, psychodynamic therapy, cognitive analytic therapy, etc.). However, researchers who have compared different models of therapy tend to find that there are no differences in effectiveness between different approaches to therapy. It is therefore likely (a) that different approaches suit different people and (b) that in spite of the differences, there are some core psychological processes that are present to a greater or lesser degree no matter what kind of therapy is being used. Such processes are likely to include feeling more hopeful that there is a solution to one’s problems, facing and mastering feared situations, becoming more accepting of one’s emotional experiences and so on. We do know that the quality of the therapeutic relationship is one important element in most successful therapies (which is why it makes sense to ‘monitor’ this formally at the end of each session).