What is seen as helpful in therapy. Could it be helpful to you, now?

talk can be action

This web site has matured over the years and it is now possible to see threads that connect the small, safe experiments. Other pages have started to identify those threads.

On this page, I broaden my collection of safe experiments by using some research findings. To do this, I owe a debt to a particular research paper:

What Clients Find Helpful in Psychotherapy: Developing Principles for Facilitating Moment-to-Moment Change

by Heidi Levitt, Mike Butler, and Travis Hill from The University of Memphis in the USA.

The source for their paper is: Journal of Counseling Psychology 2006, Vol. 53, No. 3, 314–324

A research view

Some conclusions from this article are:

  • that a caring relationship promotes preferred outcomes, e.g. an improved ability to reflect and be curious.
  • improved self-compassion is a high priority for clients. Is this your view?
  • such changes in self-care do not depend on any one strategy. They emerge from the mists of the relationship.
  • at a deep level, clients are sensitive to the therapist unable to maintain their own self-care or self compassion.

All this may not be so profound, you might say;  we know that humans, as social animals, are sensitive to non-genuine behaviour. Also, we know that a focus on symptoms and problem-solving techniques have definite limitations. I trust that I make some of these limitations quite clear in, for example, when ‘doing’ isn’t enough.

Is this so new or surprising?

Further research also highlights how ‘personalised therapy‘ is not so new or radical. Facing the fact that different types of psychotherapy often reveal similar results in the therapeutic alliance (how you and I work together – the quality of our relationship) was identified by Luborsky (1) as early as 1976.

This understanding of the ‘alliance’ gave an impetus to what is termed ‘process-oriented’ research (‘process’ roughly means HOW we work together).  Luborsky suggested variations in the different phases of therapy arise from the dynamic nature of the alliance (that is, the back-and-forth of conversations and connectedness in the consulting room).

Some of Luborsky’s view

He distinguished two types of alliance:

  • the first, found in the early phases of therapy, was based on the patient’s perception of the therapist as supportive.
  • a second, more typical of later phases in the therapy, represented the collaborative relationship of client and therapist – where they share of responsibility in working to achieve the goals of the therapy through a sense of collaborative responsibility.

It is to enhance this collaboration that I most often use email between sessions.

Research and safe experimenting

So in what way does this research help us with small, safe experiments?  This ‘process’ related research identifies some specific qualities and actions as ‘helpful’.   It is clear that clients rarely attribute their important changes to any one intervention. 

Too often the ‘qualities’ in the therapist, and the relationship that they build with their client, are highlighted. I would add that pre-preparation by the ‘client’, before entering into therapy, can make a difference.  This page on my website may be of help to you; to double check on your readiness to use therapy

This is in line with the theories about models of change. Changes do not happen for the asking; most often they have to be worked on.

The research by Heidi Levitt and others identifies six detailed ‘clusters’ to advance effective change.  On this page, I identify these clusters and show how they might help in the design of your safe experiments. I have amended the researchers’ labels to integrate them with the ‘safe experiment’ perspective. 

I seek to make the research relevant by offering hyperlinks to other pages on this website. There you should find one or more relevant experiment you might want to develop.

So here are the clusters from Levitt and others

Cluster 1: Commitment to therapy: an honest negotiation is more likely to bring success

For instance, in the research, one client described how her therapist “showed me—that she was invested in my therapy, so—that let me know that I could be invested in my therapy. [ I said,] “So I need to know that you . . . are not going to hurt me, because it’s happened too many times”.

What are some of the implications from this for designing small, safe experiments?

  • Frank discussion may be needed with therapists, spouses and other important people in your life.
  • Feelings need to be expressed openly, even though this is risky. That cannot happen unless I have safe place to express myself as I move along the ‘scenic route’ of change.
  • Relationships, and not just ‘professional’ ones,  need to be mutually examined.

Cluster 2: The environment we operate in reflects on the care on offer

This cluster attends to the impact of the environment in sustaining or impeding change. What are some of the implications for designing small, safe experiments?

  • the ‘feel’ of the consulting room might be significant, as will your home and work environment. Are all ‘safe places’? See my illustrations relating to the Window of Tolerance (WOT) to check out what is, or is not, safe. If not, what needs to be changed?
  • an experience of safety, comfort, and relaxation is not optional if there is to be change; it’s not just the physical surrounding of home, work and therapy room that make a difference. We are sensitive to changing levels of comfort and tension. Who brings what to the level of comfort?
  • the therapy room, and our living rooms, are reflections of our personality. Consider, for example, the ‘familiar environment’ for any-one experiencing domestic abuse. Creating a sense of being cared for is not easy to attain when surrounded by tension or a fear of ‘walking on eggshells’.

Cluster 3: Out-of-Session processing: making change happen between the world of therapy, and my real world.

  • I ask my visitors to see therapy as a 24/7 process. If I attend one hour of therapy of week, I still have 6 days and 23 hours in which to things happen. So what needs to be done, and who needs to do what during that long period of time? You do not have to do anything, but please consider the impact of that decision on the pace of progress.
  • I use emails as encouragers and to ‘check-in’ on events. I like folk to reply – to give information on any ‘results’ from small, safe experiments – but I do not require it. True, without an interchange, the small victories are easily lost and the small defeats can become more powerful. The scenic route may become longer, but that can be important for many people.  I would prefer determine the pace of your progress. I do not want you to follow my ‘rule’ or expectation, just because …..
  • defeats needs to be talked about it in order to identify the ‘something a little bit different that can be done next time around’. How often do you ask yourself that important question?
  • safe experiments between formal therapy meetings can improve self-reflection. OK, all this has to be reconciled with the demands of our everyday lives;  to assist here I suggest we identify the smallest and shortest safe experiment that might be done, even if quite often.
  • part of the therapy hour is spent considering what’s been going on; more importantly, in my view, is the question: in what way do we move between the world of therapy and our “real life”?
  • leaving therapy sessions can bring its own demands. Some people I know design safe experiments to help the transition before and after sessions, e.g. using the car journey to see me in a thought-out way.  Reading my web-site leads and other self-help books can assist to build a bridge between the therapy room and home. It may encourage conversation with others or form some creative responses to day-to-day events, e.g. how can I be assertive at this very brief moment, now?
  • being able to make a note of those ordinary events – as well as any other insights that arrive through the week – can aid progress.

Cluster 4: The Therapeutic Relationship: self-exploration needs sustained trust even in the Face of Threat

Most clients do see trust in the relationship as central to change so this is a big cluster!

  • others around us – family, friends, colleagues and neighbours – can help or hinder change. It is not simply about what happens in the consulting room. Knowing who I can trust and what they might do for you can be a practical step to make.
  • The therapist does not have to be a ‘friend’.  The research showed that the qualities most sought in a therapist were abilities to understand, to remain impartial and to demonstrate reliability. It seemed that these qualities  are sometimes missing in the wider world. The safe experiment of ‘stepping back’ demonstrates how we can help develop those qualities in ourselves.
  • What emerged about ‘dependency’ in this research was interesting. This tendency to ‘depend’ on a therapist, or any care-giver, is well known. As a temporary feature it can be helpful and nurturing. As an unresolved experience, it can make endings tricky.  Depending on a therapist may increase trust in the first instance,  and then it needs to decrease during therapy, as the client became more self-reliant. This process may require a balance between emotional closeness to others and a growing confidence in our sense of self.
  • In the world of therapy, the technical term for this process of separation is individuation; safe experiments need to build up our ability to separate from others at a safe pace.
  • a caring response, here, includes others’ having faith in our ability to ‘individuate‘, how to go about it and to set a pace that ‘works’. One research client reported: “I had a first session with him, he was completely open with me about everything. . . . And I told him a lot of things about me. . . things that I had done that. . . I regretted and he never blinked an eye, I never heard him say anything under his breath. . .. He always listened to me, you know, he always encouraged me to express my feelings, he always encouraged me”
  • in short, then, trust is developed after scrutinizing therapists, and others, for an ability to care, especially when vulnerable issues are raised. However, conveying respect for our feelings and experiences needs to be extended beyond the consulting room. That might involve safe experiments in the art of ‘asking for things’ from others.
  • Cluster 5: Holding the tension between caring for yourself in just the ‘right’ amount and still provide firm direction when you can see it is needed

Here is a personal challenge

What can we do on our own, and where do other people become important?

Paying for professional support helps you to recruit an ally in managing the tension, as given. The therapist can be some-one able to demonstrate the balance between care and direction; between emotional closeness and just enough ‘distance’ to see the wood for the trees.

What about doing this for ourselves?! A trickier task, I think. The research identifies some helpful steps:

  • Flexible: small safe experiments need to be flexible. There can be an unpredictability in outcomes that can be puzzling but these do not need to be designed out of the system. In a text on  Dialectical Behaviour Therapy (DBT) I once read a line that discouraged problem-solving “through haphazard, trial-and-error approaches that are not grounded in values“. 
  • …. but not too tight? I could just as well say to DBT trainers that “highly organised, structured experiments – using closely-managed protocols – unable to entertain the possibility that values can be changed” might well miss opportunities – valued by you!
  • able to foster greater intimacy through self-acceptance and ‘genuineness’, that is, being yourself and liking what you see. 
  • Sustaining self-care without defensiveness,
  • challenging of ourselves and others with confrontation that disrupts trust and compromise.
  • emotionally aware without drowning in our experience.

See, here, how the approaches to therapy most often tell us more about the therapist – whether DBT’ers or Robin Trewartha’s – not your own needs!

The point, here, is that you are the common factor. You may find discovery through trial-and-error will work sometimes. On other occasions, you may well need the security of a tightly defined objective.

The research identifies some unhelpful steps as

  • being over-controlling, that is, being pushy and expecting too much of yourself, too soon.
  • self-pitying in the face of adversity.
  • jealous of others and their relationships or achievements; this is not difficult to do and it promotes a judgemental attitude towards yourself and other people in your world.
  • extreme responses such as catastrophising. These can be promoted by our attitudes but these extreme responses make it difficult to stop and step back; to explore our experiences in a way that promotes change.

Possibly, ‘helpful’ and ‘unhelpful’ are obstructive or extreme words in their own right! As I emphasise many times, we can learn from small defeats and small victories.

It is also possible that I will be deterred and distracted by too many small defeats. Equally, I could become too smug in the face of too many small victories!  Both responses may encourage a reluctance to entertain change.

In short, look for the balance that promotes your own recovery, in your own way.

Cluster 6: structuring a focus with a small experiment that encourages thoughtfulness and self-discovery

The research went on the list how to bring about that focus; through:

  • challenging ourselves to seek out new perspectives.
  • looking for and recognising patterns in our behaviour.
  • just noticing what we are doing; remember the thinking-about-breathing experiment – your first starter for ten!
  • watching ourselves, e.g. through the body scan.
  • engaging with others to seek out new perspectives.
  • allowing our emotional experiences to be – as well as other self-expression,
  • questioning the meaning of our thoughts and beliefs.
  • recording, creating and expressing self through action and movement

A mixture of the creative and the structured might help.  I doubt any one approach will help on its own. Whatever happens, I’d want for you is heightened self-awareness and a increasing confidence in your ability to reformulate or accept problems. Therapy, itself, can provide a basis for safe exploration. Use the professional service to guide you more deeply into challenging emotions in order to understand and accept their place in your life. There are limits to what you want to do on your own;  emotional experiences can threatening and support to recognize them and learn to tolerate or change them may not be straightforward.

It is not easy to let our defences go in a safe place and may be helped with strong alliance with some-one else.

Help on the Internet

In between working on ourselves and employing professional therapy services, there are guided tasks you can undertake using internet resources. A good therapist may be able to direct you towards more reliable resources.

Also, there are a number of organised local services in activities such as Yoga, Pilates and mindfulness that seem to work for some, if not all.

In short, can you gain a deeper understanding of your own experiences as they occur moment-to-moment?

What do you need to help this happen?

What can you do on your own and/or with others in your life?

Can you watch out for external events and internal experiences that will inform – even improve – your decision making?

Do the Clusters, listed here, help you work out what is do-able – on your own or with others?

Since I wrote this, I have seen a Paper in Psychotherapy Research by:

Timothy Anderson and others from 2015. Called  “Therapist facilitative interpersonal skills and training status: A randomized clinical trial on alliance and outcome

…  and their conclusions that therapy can be effective ‘so long as both relational and technical factors are both interacting in harmony‘. I read this to mean that the knowledge and the skills of a therapist do make a difference to therapy.  They authors continue by saying, and I summarise, that relationship factors are a central core of the therapeutic alliance and,  in addition, factors relating to the model of psychotherapy used in treatment are (no less?) important.

In particular, they emphasis that the therapeutic alliance, and its relational base, are strongly linked to skillful use of techniques and treatment systems.

OK, this does rather state the obvious – that outcomes arise from the shared experience of ‘client’ and therapist. Even so, I still assert it is how you, a ‘receiver’ of therapy, including the information on this website, translate that shared experience that can make a substantial difference to outcome.

Take the mystery out of therapy and the change processes

I think this point about you, as a potential user of therapy, is worth emphasising as it can go some way to moderating from the mystique that surrounds some therapy – especially the more esoteric and protocol-driven systems.

Throughout this website, I have cautioned against the self-interests within therapy (and, by the way, that includes my own self-interests).

By being cautious about the self-interests of others, it is possible to notice the impact of the self-interests you possess!

Further information to consider

Designing safe experiments

Actions in safe experiments

Limitations to safe experiments

When Action is not enough

or you can start over, at:


(1) Luborsky, L. (1976). Helping alliance in psychotherapy. In J. L. Cleghorn (Ed.), Successful psychotherapy (pp. 92-116). New York: Brunner/Mazel.