Skip to main content

Verified by Psychology Today


What Do Psychotherapists Actually Do?

3 therapeutic techniques that facilitate problem-solving.

Key points

  • Effective therapy offers more than just a nice person to talk with. Well-trained therapists utilize problem-specific techniques.
  • Therapy begins with diagnosis, that is, helping clients identify their specific troubling emotions and distressing life problems.
  • Therapists then guide clients with techniques that reduce their distress and facilitate problem-solving.
(c) pressmaster/fotosearch
What do therapists actually do?
Source: (c) pressmaster/fotosearch

What do therapists actually do to accomplish healing in this project that we call psychotherapy? This post offers a glimpse into several of the techniques that as a clinical psychologist I use most frequently.

What is the basic tool that virtually all therapists utilize?

Therapists ask questions. Questions help clients to see the problems they face with increased clarity. Questions also can guide the way to finding new solution options.

At the same time, not all questions prove to be equally helpful. In general, the best questions begin with either How or What, with an occasional When, Where or Who. These words indicate an open-ended question, that is, a question that invites exploration. By contrast, questions that begin instead with Do you, Have you, Are you invite simple yes-no answers and therefore have far less power to prove helpful.

What are the main categories of techniques that therapists use?

To help clients gain relief from their problems and the negative feelings they have been generating, some therapists use Cognitive-Behavioral Therapy (CBT) techniques. These interventions lead to new "cognitions" (thoughts) and behaviors (habits) that can enable clients to become more effective in dealing with the problems they face.

Other therapists use psychodynamic techniques, that is, techniques that explore the earlier-in-life experiences that have made a person prone to feeling mad, sad, or scared.

Integrative therapists, of which I am one, use both of these therapy approaches. In general, looking back to understand the sources of current problematic thoughts, feelings plus discovering new understandings and action options offers a winning combo.

What is the role of emotion in therapy?

Unpleasant emotions mainly arise in response to problems in living. Therapists work therefore to

  • replace negative emotions with an emotional sense of well-being and
  • help their clients find solutions to the problems in their lives that had given rise to their emotional distress.

In my most recent book, Prescriptions Without Pills, I clarify that each negative emotion arises from specific problematic ways of responding to challenging situations. And each calls for different therapy techniques.

Anger arises when we are not getting something we want, or getting something we don't want. Anger in these situations powers fighting, that is, it enables us to force others to give us what we want.

One therapy technique: Pause to calm down. Then ask, "What do I want? And what would be a more effective and less costly way to get that than via anger?"

A second technique: Do a Best Possible Light visualization. Ask, "If I look at my anger in the best possible light, what am I trying to accomplish?" Then ask the follow-up question, "What might be a more effective and less costly way to get that than getting mad?"

Depression results from giving up, that is, from folding rather than continuing to try to get what we want.

An anti-depressant technique: Do a 3P's visualization. Pinpoint the situation where you have given up. Pump up your internal sense of power by visualizing yourself as far larger, and then, from that larger stance, Problem-solve to find new solutions.

Anxiety arises when we see a potential danger ahead, and danger that is imperiling what we want such as safety, a treasured relationship, our health, or something else that we value.

One therapy technique for frozen or spinning thoughts that go with anxiety: write a list of all the concerns that come to mind. Then return to each item on the list, one at a time. Figure out what additional information you need to respond effectively to that concern, then devise a plan of action for how to get it and then what to do.

An additional technique: To understand in a deeper way the source of anxiety reactions that feel disproportionate to the situation, try the visualization that I call That Was Then, This Is Now.

With these techniques, negative emotions can point the way to feeling better.

Like traffic lights that help you get safely to where you want to go, emotions tell you vital information. They tell you to stop (like a red light) when you feel angry in order to figure out what you want and better ways to get it, to proceed (green light) instead of giving up when you feel down, and (yellow light) to proceed with caution when you feel anxious.

What are the signs that your therapy techniques are working?

Effective therapy techniques relieve your emotional distress—and especially anger, depression, and anxiety. They replace your distress with feelings of well-being. And they lead you to discover more satisfying solutions to your problems. How appealing is that?

To find a therapist, visit the Psychology Today Therapy Directory.

More from Susan Heitler Ph.D.
More from Psychology Today