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As the pioneers of brain science continue to push advanced behavioral health to new levels, more tools become available for those who support people toward overcoming mental health struggles.Perhaps one of the most powerful of these tools is engagement. The deep intrinsic need humans have for engagement is so great that when it occurs the “feel good” chemical oxytocin is released in the brain.  Just Google “the effect of oxytocin” to discover the effects it has in evoking positive thoughts and emotions.

In 1902, Charles Horton Cooley developed the concept of “The LookingGlass Theory,” which refers to a person’s self-worth grows out of how the people in their front row perceive them. Therapists incorporate this into therapy by initiating small steps of engagement with the client. During the process, the therapist begins to form an authentic belief that the client has the capacity to succeed at achieving mental well-being. This belief, in turn, eventually evokes the client into believing as well in their capacity to succeed. Once the belief is formed new more positive behaviors can begin creating healthier psychological functions. The old adage holds true: “Tell kids they can fly and they begin to grow wings.”


An engaging relationship between a therapist and client goes even further:

  • The empathy extended from the therapist helps the client feel understood: “Finally someone understands my pain and what it’s” Feeling understood without being judged is one of the great core human needs.
  • The TQ (Trust Quotient) between the therapist and client increase to a point where a high trust quotient is established which allows for influence. The therapist can begin modeling how healthier thoughts, emotions, and desires can be established – “a sermon watched is always more powerful than one heard.”
  • The therapist begins validating the client. Validation, when done authentically, is a powerful self-worth booster that builds hope and self-confidence.

Engagement brings each of these key interpersonal dynamics into play in helping a person regain mental health well-being.


Many reasons exist as to why engagement is not practiced in therapy/counseling. Perhaps the greatest reason is that it’s a relatively new discovery in behavioral health and many people are unaware of its effectiveness as of yet.

A Danish study discovered that there was no evidence that one method of therapy was more effective than another. The study went on to show, however, one factor that makes the therapeutic process more effective is the therapeutic alliance, which is the relationship between the client and the professional. It went on to further state that a professional’s credentials or even experience had little bearing on the effect size of therapy, but the level of engagement that existed was the only factor that proved to be effective. This is why our clinical team ranks engagement as an advanced behavioral science. As we embrace these and other advanced tools of the 21st century, more people can be supported towards overcoming a mental health struggle.


Initiating engagement by the professionals requires more than IQ or the knowledge of how to do it. If requires a high EQ (Emotional Quotient) that enable a person to demonstrate deep levels of vulnerability, compassion, and empathy. Not all people do this well and unfortunately many schools don’t teach it.

A person struggling with a mental health issue may not have been in an engaging relationship for some time and may find it difficult to enter into one. This requires the professional to initiate and lead the process. Some of the client’s barriers that need to be overcome are:

  • The client may have been hurt by someone they trusted, which makes it difficult for them to regain trust and be vulnerable again.
  • The belief that the vulnerability required in engagement is too scary or awkward, so it’s best to avoid it altogether.
  • The therapist’s pace of establishing engagement is moving faster than the client comfort level.

Awareness of these challenges allows the therapist to initiate engagement and set the appropriate pace in the process.

Tune into the next blog as we dive deeper into the anatomy of engagement. We will discuss the intricate dynamics involved while in engagement is underway –and like surgeons; we ought to use the most advanced methods in working to overcome a mental health struggle.