• The therapist's empathic understanding of the client's situation - i.e. his or her ability to join you, the client, in understanding your individual experience. Empathic understanding stands in contrast to a stance that imposes the therapist's framework on the client's experience, an orientation that may, for example, place you in a diagnostic category that only loosely matches your experience. To the extent that the therapist connects with your internal life, s/he joins you in that experience. This shared understanding bridges the isolation that accompanies psychological conflict, promotes the trust that is a prerequisite to self-disclosure, and positions the therapist to understand both the influences that have brought you to your current situation and the elements that block change.

• The establishment of a collaborative relationship is another factor that profoundly influences the course of therapy. The therapist's manner should convey that s/he sees the client as an agent whose personal commitment to engage the process will make all the difference in outcome. This position stands in contrast to a hierarchical "doctor" - "patient" relationship, a relationship that promotes reliance on the therapist's authority and in the process inadvertently discourages thorough self-examination and disclosure - an effect that disables full engagement. In contrast to the hierarchical relationship, a collaborative relationship is a shared synergistic process of working together in a way that enables self-responsibility and promotes full commitment.

• A third element is the assumption of a non-judgmental attitude toward the client and his or her expressed concerns. While most therapists agree with this concept in principle, subtle and insidious judgments can persist. Even the attribution of a "disorder" suggests a value judgment. To acknowledge that a person is anxious is not judgmental per se; to say that s/he has an "anxiety disorder" is to assign a deficit. An individual's natural response to such perceived judgment is to establish distance- from the therapist as well as from the unwanted self-concept. This mindset discourages the kind of self-reflection that facilitates change. In contrast, a non-judgmental stance encourages self-observation, allows one to confront unsettling feelings and behaviors, and promotes the assumption of full responsibility for one's choices. This level of full engagement sets the stage for change.

• Throughout this process, it is important that the therapist actively supports attitudes and behaviors that are alternatives to counterproductive patterns. The recognition of positive strivings promotes a broader self-understanding and encourages the development of new ways of meeting one's needs in the world.