20/04/2026
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PART 4: Building Skills
Starting to get into the nitty-gritty now, good and effective therapists help their clients develop the skills needed to progress towards the life they aspire towards.
There's no one way to 'cut this cake' of different skills in therapy. You could define these any number of ways. My favourite, again inspired the great Donald Meichenbaum, is to divide skills broadly into 3 categories -
* Internal or intrapersonal skills, which tend towards being around working with, or shifting our emotions/feelings and cognitions/thoughts (such as judgements, predictions, dwelling on the past, memories, images, rules we make or have about ourselves, life and the world, and many others). These skills can take a huge array of forms and approaches but in my practice will often include aspects such as emotional regulation, relaxation training, attentional control, distress tolerance, self-monitoring and awareness, urge surfing, emotional authenticity/freedom, mindfulness, self-efficacy (self belief), bolstering positive emotions (such as gratitude and awe) & motivation, and helpful self-talk, as well as self-hypnosis.
* External or interpersonal skills, which tend towards how we interact with the world and other people. These might for example include skilful and effective communication, conflict management, assertiveness & problem solving.
* 'Wrap-around' skills - which may include helping a client live a more complete or full life and helping to guide them towards skills that I can't always directly help them with. Examples might be for example how to access business, legal or financial advice, or working on a CV, or finding ways and places to socialise.
You might notice that some skills cross these categories. Problem solving for example cwould probably be considered both an interpersonal and intrapersonal skill.
Often when clients get sufficiently skilful, they naturally start coaching others in the same skills. Don Meichenbaum refers to this as being in 'consultative mode' and tends to show the skills are really starting to bed in.
The development of these skills helps the client to develop a pathway or stepping stones towards achieving the goals and aspirations we will likely already have articulated and agreed upon in our work together. A central idea throughout will be on understanding, normalising and preparing the client for future 'wobbles' or relapse. Understanding that almost all of us will indeed wobble, and if/when we do, we will be ready.
Next up in this series...Personal experiments
