People ask just how it is that therapy or counseling works.
The short answer is that there are many ways, not just one way in which therapy may work to help someone. Professionals all have their own preferred theory of therapy which is the basis of their practice. What they do is highly influenced by the theory they use, though the truth be told most of us borrow from other theories if we see a procedure that might help a client.
The way counseling might help also varies with the problem the client brings to the office. In the early days, there was one profession that largely dealt with problems of the mind, psychiatrists. Today there are many specialties that work to help people with their problems of living. A caveat here, I have my preferred way of trying to be helpful. This is my opinion so I won’t pretend to fully explain all the procedures.
Therapists are empathetic, nonjudgmental listeners.
There are some things people don’t feel comfortable talking to their families and friends about. One school of therapists, Rogerians, believe that most of us have the answers to life’s problems we just need to talk them out. Being able to talk through urges and fantasies helps people to understand themselves and may lead to an improved ability to control their behavior. Clients sometimes say their therapist just sat there, listened and didn’t tell them anything. If you want or need more than listening, discuss that with your counselor.
Therapy can be a corrective emotional experience.
Many clients tell me they have trust issues. Often this is because there has been no one in their lives they could trust or because they were not trustworthy themselves. If their family was never very affirming, a positive therapist can help them to learn to affirm themselves. Group therapy is especially good at teaching people how to deal with interpersonal problems by allowing them to experiment with new behaviors.
The counselor can provide reality testing.
Clients may come to therapy with incorrect perceptions. People think they are fat when they are normal or below in weight. They think of themselves as too old or too dumb when they are in fact at a normal developmental point in their life. People make plans that they do not have the skills or resources for, they have expectations of others that are not realistic. Having someone to “bounced ideas off” can help ground plans in the real world.
Counselors help people change life stories.
Many people have a “story” about themselves that started in early life and which they have been unable to alter. People with call themselves “a loser.” This personal story, saturated with problems, may keep them from trying new things because they expect to fail at any new effort.  Narrative therapists help people create a new story.  Cognitive therapists would call this a “thinking distortion” and use various methods to get the client to challenge this belief and create a new belief about themselves that was more adaptive. Instead of thinking of themselves as a “loser” the client may begin to see themselves as a “survivor” who has continued to try in spite of obstacles.
Counselors teach clients new skills.
A substance abuse counselor would teach a client refusal skills. A career counselor might teach his client how to use online career inventories, interviewing skills or resources to use to conduct a job search. Marriage counselors may teach couples communications skills. Family counselors may teach parenting skills. Skills-based approaches may involve recommendations for books to read and real-life homework to increase skills. School counselors primarily work on academic issues, what classes to take and how to succeed in school.
Counselors help clients get in touch with themselves.
Exploration of the self, personal growth and discovery are all legitimate reasons to see a counselor. Counselors don’t make decisions for clients, but they can teach clients decision-making skills and encourage clients to practice these skills. Therapy can help clarify values and assist clients in evaluating choices. People may come to counseling confused and in need help in gaining clarity.
Psychotherapy can assist in changing personality.

Psychotherapists often focus on basic personality characteristics. Psychologists can give and administer personality tests while psychotherapists can spend time working through personality characteristics the client may wish to change.  Changing an underlying personality characteristic takes more time and effort than the crisis-driven techniques but it can result in long-term changes in coping skills. Psychodynamic therapists work on the unconscious. More cognitive therapists would approach personality issues by trying to help the client gain a new worldview. “Getting a new pair of glasses” results in seeing the world and problems differently.