In Therapy: Working through self-esteem issues (part 3)

In Therapy- Working Through...

Welcome to part 3 of the Self Esteem posts

In this final part, I would like to give some insight as to what might take place in a therapy session when working through self-esteem issues.

The way I’ve decide to do it is to pick a few therapy modalities and tell you a bit about what they might focus on, what they might consider a goal for their client, as well as what methods – the words, activities, challenges – they might use.

If you are interested in reading more about the vast variety of therapies that exist at present, please visit this post from GoodTherapy.Org.

So, without further ado, let’s see what therapy looks like when working through self-esteem issues…



  • This therapy draws on the importance of play in the child’s development in all areas (social, emotional, cognitive, physical).
  • Therapy with children might be different than that with adults, as children are still developing their emotional language, and possibly their language skills in general, depending on their age.
  • It might therefore be easier for a young person to communicate their feelings and thoughts through the medium of play.


  • To help the child express themselves.
  • Through play, the child will make sense of what they might be going through or struggling with.
  • To develop the child’s trust in the therapist so that effective work can take place.
  • The specific goals when working on self-esteem issues might relate to
    • reducing anxiety about their abilities, being rejected, being good enough or being sociable
    • improve confidence in their abilities and their personality and individual choices.
    • To sum up, a decrease in the consequences mentioned in part 2 and an increase in the kind of things mentioned as part of the tips throughout these posts.


      • turn taking games;
      • teaching autonomy by allowing the child choose what they want to do during the session;
        drawing or colouring;
      • visualisation;
      • reading stories or telling stories related to the child’s presenting issue.
      • For example, in the case of self-esteem, they might read a book about a child, like this one on the right.



  • Unconscious processes – these happen outside of consciousness, so we might not be aware of them. We might have put them in the back of our minds as they are too overwhelming to even think about.
  • Psychodynamic therapy will focus in the origins of low self-esteem.
  • Depending on the client’s age, it will delve further back in life or delve to the more recent past.
  • In the case of children, it might be working through issues that the young person is going through at present. These were mentioned in the causes of low self-esteem in part 2.


  • The aim is to develop a trusting and positive relationship with the counsellor in order to replay, in the sessions, those experiences that left them feeling negatively about themselves and struggling with their relationships, careers, and with themselves.
  • The side effects of low self-esteem (depression, loss of hope, anxiety), might need to be worked through as a means to the end of increasing their self-esteem.
  • With children, the process might be similar but I might include play therapy in order to understand my young client, and therefore help them understand what they are going through and help them work through it.
  • Learning to rely on the therapist will allow them to develop a sense of trust in others in their world.


  • To give the client the skills they might be lacking due to neglect, bullying or other life issues that might have impacted on their development.
  • Play therapy might be one of the methods used, especially when working with children.
  • Teaching the child to be assertive by working through examples that the therapist might give or from a book.
  • If the child is able to talk about their issues verbally, then use the child’s own stories as they can work through how they can tackle this situation or similar situations in the future.



  • This approach focuses on the here-and-now.
  • The therapist is warm, genuine and empathic.
  • The therapist trusts its client’s ability to work through the issues they bring, and to bring about the strengths that might have been quietened or neglected due to their life issues.
  • This is facilitated by the therapeutic relationship.


  • The therapist’s trust in the capabilities and strengths that already exist within the client, and the belief that they just need to be brought back to action; They might have been neglected or put away due to low self-esteem, and by working through this, the client’s strengths become stronger and their self esteem therefore increases.


  • To match self-concept with reality;
  • the therapist is there to encourage and listen, and facilitate the client’s search for their truth.
  • To increase the person’ss self-worth, and help the client become a more fully functioning person.
  • All of this is achieved through the therapist being congruent with the client, being unconditionally accepting of the client and being empathic toward their client.



  • It focuses on behavioural and thought patterns that might keep the child or adult stuck.


  • To restructure and change those thoughts that keep the client feeling not good enough, unlovable, and acting or feeling defeated.
  • If the client learns to act more confidently, they will be come more confident.
  • CBT uses homework and charts to challenge the behaviours and thoughts and to come up with new, more helpful and positive ones.


  • cognitive restructuring is used to identify unhelpful patterns of thinking and learning new more helpful ways;
  • for self-esteem issues the target might be changing the negative assumptions the child has of himself;
  • I would challenge and ask for proof that they are unlovable or whatever their negative pattern of thinking might be – usually there is little or no proof, and more evidence that they are indeed loved by lots of people!
  • I also use problem solving with my young and older clients, in order to empower them to successfully work through their problems, and stop feeling like the victim in life.


  • I also use techniques from Transactional Analysis (Ego States; scripts; strokes) and Gestalt therapies (chair work, role play), as a complement to the three mentioned above. These two therapies are grounded on elements from psychodynamic, cognitive and person-centred.

  • The chosen modalities are some of the ones I draw on to work with my clients. They make sense to me and my style of working, and they have proven effective when I’ve been in the client seat, as well as when using them with my clients.

  • This list is by no means exhaustive. Do have a look at the link mentioned at the beginning for a more exhaustive link.

New topic for this series coming up next monday! See you then!

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2 responses

  1. Pingback: Introducing: Mayra – Sworn Translator « Insights…from the desk of Karin Brauner

  2. Pingback: In Therapy: Working through anxiety (part 3) « Insights…from the desk of Karin Brauner

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