Golden Thread of Therapy: Presenting Problem

The golden thread of therapy is the client's presenting problem: what brought them to treatment and what they hope to get out of treatment. 

Many therapists are "raised" in a specific theoretical orientation. This is the silver thread of therapeutic weaving. It is what the therapists anchors themselves to as they navigate the complexities of someone's life. 

Examples of theoretical orientation: if a therapist is cognitive behavioral they may first start with understanding how thoughts are helpful or harmful the person's mood or functioning. If a therapist is dialectical behavioral, they may start with holding two truths to true at the same time while radically accepting reality. If a therapist is based is attachment, they will seek to understand how early experiences shape relationships, mood, and functioning. If a therapist is psychodynamic,  they may seek to explore how the past influences current experiences. While there is overlap, each therapy has specific strategies to help clients meet their goals. 

Praxis is an active and evolving process in which a person learns a concept or skill, puts it into practice, then reflect on the implementation in order to reconceptualize the skill and repeat the process.  

Therapeutic weaving is a practice of intentionally implementing specific strategies from many theoretical orientations to create a bespoke form of therapy for each client.