How Does Therapy Really Work???

When most people start the counseling process, what they want to know is "how is this really going to work?" In the counseling world, we call this “creating change.” There are a million counseling theories and models for creating change. For instance, some therapists use CBT, DBT, Person Centered, etc. When searching for a therapist, it can be a bit overwhelming deciding the best fit. However, the good news is that research after research has shown that it is the therapeutic relationship that is the biggest factor in creating change and not the theory that a therapist uses. Wow, that’s powerful information.

Because it is the therapeutic relationship that matters the most, my number one goal in the counseling room is to unconditionally accept my client and show empathy and understanding. My goal is that they know I am journeying with them in a judgement free environment. For me, this means being a real and genuine person.

When I meet a child for the first session, my goal is that we get to know each other. We typically spend the time doing rapport building activities in order to build trust and therapeutic rapport. While the child might feel that we played games the whole time, in reality we built trust, understanding of the therapeutic process, and an introduction to understanding feelings and emotions.

Teenagers are occasionally resistant to the counseling process because it is often not their idea. Through activities, such as Table Topic Conversation Starters, and getting to know and understand their interests and passions, I strive to truly connect with the adolescent. It wouldn’t be uncommon for me to follow a YouTube star or band that a client is passionate about in order to truly understand their interests.

For adults, is there anything scarier than to open up to a complete stranger? I try to recognize the bravery and vulnerability that is needed to truly open up in a counseling session. The first session can typically involve getting to know the client outside “the problem” and truly understanding how they click. Going forward, I love to use a combination of theories to create that change clients are seeking. We might try to look at a problem through a different lens, challenge cognitive distortions, or try new behaviors, but whatever we do in the counseling room, it is always judgement free.

If you want to understand my counseling style or any counseling theory or model more, feel free to email me at I’d love to talk more!

Written by Amy Rollo

Amy Rollo is a Licensed Professional Counselor Supervisor and owner of Heights Family Counseling. Amy has been practicing for fifteen years. She has doctoral level training in the areas of child and adolescent counseling, marriage and family therapy, and adult counseling. Amy Rollo provides counseling and evaluation services in the Houston Heights and surrounding areas. Amy’s goal in counseling is to journey with her clients in order to foster positive changes and growth in their lives. Read more about Amy's counseling style by visiting