It can sometimes be difficult when choosing a therapist to find a clear and concrete explanation of the theories and ideas that shape their practice. As psychologists and therapists we all too often hide behind jargon and labels which don’t really tell you that much about how each practitioner understands mental processes or how their treatment might lead to a greater sense of well-being.

For this reason, I’ve sketched out below FIVE FACTORS which I have explored, researched and worked on with hundreds of clients and patients from all walks of life over many thousands of clinical hours. I’ve also made sure that all of these apply to and work for me! I would never expect my clients to do anything that I wouldn’t be willing to do myself. 

What I’ve tried to give you below is an overview of how we would start to process and help you with whatever issue you might bring to our sessions.  I believe that engaging with these five factors are the key ingredients to any effective course of therapy, although as in any good recipe, the amount of each ingredient, as well as how we use them is also crucial.

Although I focus on five factors, this really isn’t a one-size-fits-all model. I do think though that it’s good for us to have some guiding principles right from the start that we can both agree on.


My understanding is that we are usually willing to look at, and pay for, therapy because we are stuck or struggling with a situation or issue (or even a bunch of things) that we can’t completely get our heads around.

Our brains are incredibly good at solving problems. But not all problems are alike. Being-human is not the same kind of problem as “How do I travel from point A to B in the fastest possible time?” Or: “What do I do if I get a puncture en-route?” 

You may even have noticed that your brain is so good at problem-solving that it wants to help you out by doing this for your being-human “problems” 24/7! This can sometimes become a problem in itself.

Here are a few questions to get you thinking about your “stuck” or “struggling” stuff.

  1. Think of three areas in your life where you are stuck or struggling in some way. These can be general (self-esteem issues, anxiety, depression, addiction or other eating/drinking issues) or specific: e.g. I really struggle to get out of bed in the morning. Or: I get very angry and frustrated when I talk to my mother on the phone. Or: I want a partner, but can’t face the idea of dating.
  2. How long have you been struggling with this issue?
  3. In what way do these issues get in the way of you living your life to the fullest? You could even complete the following sentence: If [THIS ISSUE] weren’t such a problem for me”, I would …;OR “If I didn’t have [THIS ISSUE] I would be more…


Often we can be critical and blaming towards ourselves, or others, or even our own poor problem-solving brains for not coping or helping us out sufficiently with the challenges of being-human.

Perhaps this is because these coping strategies often include anxious or compulsive ways of thinking, depressive symptoms, self-control issues (addictions), self-harming behaviours, or problems with anger or other anti-social emotions.

Coping strategies are often learned or cobbled together in our times of greatest need but no longer work that effectively for us in our adult lives. Or maybe they continue to work relatively well at times but may just require a little bit of tweaking to get the best out of them.

Here are some questions to get you thinking about the ways in which you have been coping with life up to now, and whether this has been working well for you or not.

  1. Go back to the three areas where you feel you are still struggling.
  2. Now get your problem-solving mind to list all the things it has done (or thinks you should do in the future!) in order to “solve” that problem. Also give each “solution” or “coping strategy” a score out of ten for how well it is working for you at present.
  3. What do you notice?


Sometime we can be struggling with issues that have their roots in traumatic or difficult situations we’ve experienced in our lives. Fortunately we all belong to an extremely resilient species. Since time immemorial we have rebounded from relentless wars, countless disasters (both natural and man-made), as well as violence and betrayal in our own lives.

Sometimes though we can get “stuck” in past traumas, just like we can get stuck in present-day struggles. For this reason, we might need to do some work using EMDR or other forms of trauma-focused therapy to help you come to terms with some of your traumatic life experiences.

Here are some questions to see if trauma might be having an impact on your life.

  1. Have a brief look at this questionnaire which lists some of the traumas we experience as human beings.
  2. Note how many you have experienced in some way in your life. Even more importantly than the amount of traumatic experiences you have had: notice how you feel inside your body and mind when you recognise some of your trauma. Do you feel cut off and detached from it? Or alternatively very emotional and upset? Or do you feel an emotion (either positive or negative) but at a level which you are comfortable with?


Talking things through in therapy can bring release and relief, as well as new insights and perspectives on our suffering. This however might not have much of an impact on our habitual ways of being and functioning in the world (see Factor Two: Our Current Coping Strategies). We are all creatures of habit and this is as much the case in the way we function emotionally as anything else.

With this in mind, we might want to dedicate some time (or even a good amount of time) in therapy to creating or developing new or different coping practices as well as building our life-skills muscles. As with any fitness programme, the muscles we need to target will depend a great deal on the coping practices we already have in place (which often start to protest when we try and shift them), as well as the outcome we’re wanting to see for our lives.

Here are some questions to explore if you might be willing to try out some new strategies and practices when working with your stuck and struggling issues.

  1. To what extent do painful experiences (thoughts, emotions, urges, memories, physical sensations) make it difficult for you to live a valued life at the moment?
  2. To what extent would you be willing to try out some new strategies that could help you engage more flexibly with those things you struggle with?
  3. Would you be willing to try these out even if initially they might feel a little unfamiliar and uncomfortable to you?


Trying out new coping practices and life skills in therapy can be a little bit uncomfortable at times and does require a certain level of focus and commitment. So why do it? Hopefully because by increasing our psychological flexibility and range, we are more able to live the kind of lives we all aspire to.

In order to discover what that this kind of life might look like for you, it would be helpful for us to do some work assessing and working on your core values.

What it it that really makes you “tick”, what’s your “thread”? Once you are in touch with these core values, we can then start thinking about small ways of  turning those values into meaningful activities that you can then dedicate time and energy towards.

Here are a couple of questions to get you thinking about your core values, your thread:

  1. Think of 5 things that you really like about yourself as a human being (i.e. your “Character Strengths”). Here’s a list if you’re not sure what to put down:
  2. Now, think of five things that you really value doing with your time. Of those five things, in what ways do they “feed your soul”?
  3. How often are you doing these things at the moment?

These five factors might seem a little bit overwhelming to begin with, especially when we just want to get some clarity on our lives and start feeling better. For this reason, it’s important to make sure we use these different ingredients in ways that are most useful for you, both in the short and long term.

As with any recipe, one can make a very simple and delicious dish in 50 minutes, but we can also cook up something together that is sustaining and beneficial for you beyond whatever number of sessions you choose to have.


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