All approaches also consider the relationship between the therapist and the person receiving therapy (the therapeutic relationship) to be an important factor – another part of the ‘what’ of therapy – that drives changes. Better outcomes are associated with: a strong bond; having a shared understanding of the problem; and working on a clear goal. Within therapy, one person experiences care and empathy from another. The person receiving therapy comes with positive expectations (or such expectations are shaped in therapy), so that during the therapy they become hopeful. Although what a person may ‘do’ in a session may vary, the activity of therapy provides them with the means with which to cope with their distress.
Most therapeutic approaches also aim to find ways to encourage people to face the internal experiences or situations that they have been avoiding because they find them uncomfortable or upsetting. This may occur at each point of a person’s engagement with therapy, including: at the point of making the appointment; when sitting with the therapist; talking to them about feelings; exploring the past and/or current difficulties in detail; and in making changes in day-to-day life. Through this process, the person is assisted and encouraged to learn to tolerate discomfort (or it may reduce over time), and the individual comes to think about their experiences differently. The individual learns something new, adapts their responses, implements changes, re-evaluates and so on… Reducing avoidance brings about change.
https://psyche.co/ideas/psychotherapy-under-the-microscope-how-exactly-does-it-work
