Resilience as a Goal in Psychotherapy

Our collective tolerance for distress seems to be declining since the pandemic. The number of Americans who currently have or are being treated for depression has increased to 17.8%, a seven-percentage point increase since 2015 and the highest percentage recorded by Gallup (Witters, 2023). An alarming 43% of adults say they feel anxious, an increase from 32% in 2022 (American Psychiatric Association, 2024). The increased level of distress, while caused by many factors, may point to weakened abilities to tolerate distress or unreplenished resilience. The connection between resilience and mental health isn’t well substantiated, making it difficult to establish a direct correlation or create targeted interventions for prevention. Clinicians may be the best-positioned group to understand and consider the importance of resilience as a prerequisite for mental health, spawning new areas of inquiry and improving psychotherapy outcomes.

This article intends to generate conversation around how we might fortify therapy with resilience, integrating prevention and intervention. While prevention isn’t typically thought of as the primary purpose of therapy, we have a growing responsibility to provide sustainable personal growth that outlasts the duration of our sessions.       

Resilience Defined

Simplifying the complex concept of resilience may be a helpful start by using a simple but familiar analogy: immunity is to our physiological health as resilience is to our psychological health. Both systems represent the less visible processes that protect us from threats while determining our efficiency in recovery from more serious disease.

Resilience theory suggests it is not the nature of adversity that is most important, but how we deal with it (Zimmerman, 2013). In the wake of post-pandemic life, we may want to be more expansive in our thinking regarding adversity. The combined impact of acute and chronic stress by living through a prolonged crisis, perennial conditions (e.g., political climates) that amplify stress, an erosion of skills that mitigate stress, and a lack of resources for support, all serve as important considerations when conceptualizing adverse experiences.

Unique factors of resilience can be difficult to measure, however, they are likely significant considerations when strengthening this trait. These factors may include the influence of technology on how we delay gratification, experience extrinsic reward, and process information. If you provide psychotherapy services in an under-resourced community with insufficient support services, mitigating factors (e.g., challenges of unmet basic needs) provide evidence that therapeutic success is dependent upon resilience. If you work with children in any community, the ability to delay gratification, navigate differences, and control impulses seems like an eroding foundation that traditional therapy is struggling to buttress.

Resilience likely involves an ability to adapt to the unfamiliar or unexpected, tolerate acute and chronic distress, overcome adversity, and rebound from misfortune using skills that range from attitudinal to action-oriented. Resilience, from the lens of this author, protects against mental health impairment and may aid in the recovery from hardship while serving as an inoculation against chronic stress. Higher resilience levels may help us take important risks, such as apologizing for an embarrassing error or engaging in a complex conflict, that are driven by vulnerability as opposed to fear. Our determination to persevere in the face of obstacles, be brave when facing challenges, and maintain an unwavering belief in oneself may all contribute to our resilience.

With an eroding capacity for distress, we may find it increasingly difficult to negotiate differences, increasing our instinct for self-protection. When we view contrasting beliefs, attitudes, and/or perspectives as threats to be dispatched, we rob ourselves of the opportunity for growth. As a result, our remedies for challenges become overly simplified, myopic, and unsustainable. Inter- and intrapersonal conflicts can result from this challenge, leaving us overwhelmed by turmoil. Resilience can serve as a buffer to protect against burnout from distress and may create an opportunity for growth instead of erosion.

Resilience is an invisible force that ebbs and flows over the course of our lives, similar to motivation. With highs and lows taking place over the course of months, days, and even hours, we are spending and generating resilience regularly. We may grow a reserve for times of greater duress or, like a bank account, get into the red when our resilience is depleted. We may not be aware of this balancing act until we require a larger withdrawal from our reserves and by that time, it may be too late.

Resilience Under Attack

According to a global study, daily screen time across various devices (e.g., computers, laptops, tablets, mobile phones, televisions, game consoles) increased from nine hours in 2012 to 11 hours in 2019, with time spent on mobile phones increasing by roughly two-hours (Harvey, 2022). Data deluge is an insidious threat to our mental health and cognitive capacity, introducing the concept of brain rot. The constant battle of notifications, alerts, and application usage is stimulating our minds without rest, straining our bandwidth to process sensory information, synthesize new data, and make time for meditative thought, creativity, and problem-solving.

Resilience rust is a casualty of our fixation on devices, increasing visual stimulation and keeping us in a state of hyper-alertness, while diverting attention away from other senses responsible for peace and intimacy. Constant exposure to data and alerts can overwhelm cognitive functioning, leading to impaired memory, increased stress, and overall cognitive fatigue (Storoni, 2024).

The problem may only worsen as we move from a bombardment of data from artificial intelligence to quantum computing. If estimates of our “digital universe doubling in size every two years is accurate, with 2.5 quintillion bytes of data created every day” (Parikh, 2025, para. 13), how will our brains manage all of this information without compromising emotional integrity?

Therapy Implications

Experienced clinicians may translate the initial client requests as the most visible and disquieting effect of a more complex condition. While tempting, the focus on alleviating suffering or treating symptoms may not produce sustainable gains that help clients recognize patterns, themes, or contextual inputs that may reemerge in new circumstances. We are positioned to help people appreciate our growing reliance, dependence, and even addiction to the technology driving our brain rot and resilience rust. Widening our focus to helping clients understand the myriad of factors likely contributing to their dis-ease can better position them to take greater ownership for the interventions in therapy and the prevention work fortifying them against future issues.

While the efficiency of telehealth, the allure of targeted interventions, and the promise of symptom reduction are increasing in popularity with providers, we may be inadvertently risking a seismic shift in problem ownership. As author Jonathan Safran Foer contends, we don’t take action until issues become a crisis and even then we look for solutions without considering the etiology of the issues themselves. Foer (2019) elaborates on this in his book, We are the Weather:

We are killing ourselves because choosing death is more convenient than choosing life. Because the people committing suicide are not the first to die from it. Because we believe that someday, somewhere, some genius is bound to invent a miracle technology that will change our world so that we don’t have to change our lives. Because short-term pleasure is more seductive than long-term survival. Because no one wants to exercise their capacity for intentional behavior until someone else does. (p. 64)

Placing our trust in experts or solutions leaves one susceptible to an erosion of self-confidence. If one isn’t proactive about building a stable foundation, there is only so much that can be piled on before cracks begin to form. As clinicians, we can address this harmful pattern by embracing the importance of fortification as a ubiquitous goal for all our clients. This paradigm shift has importance well beyond the healing of malaise, as identified by Claxton (1997):

If the need for certainty become intemperate, undermining the ability to tolerate confusion, then one may develop a vulnerability to demagoguery and dogma, liable to cling to opinions and beliefs that may not fit the bill, but which to assuage the anxiety. (p. 6)

Tolerating ambiguity and unpleasantness may be the most underrated psycho-social-emotional skill for people of all ages. Without the ability to endure discomfort and be curious about what we don’t understand, we will rush to solutions, especially ones that are convenient and immediate. As clinicians, this information is critical to guiding our work and influencing our role with clients. If we can manage expectations and resist the natural urge to be helpful, we can teach people how to be their own therapists.

An early guiding edict that shaped the practice of medicine was to naturally aid the body in its own healing process. Similar to physiological illness, we have strayed away from this early belief that treatment to provide symptomatic relief is the only purpose of therapy. Perhaps overwhelmed by the volume of referrals, the influence of managed care, or the urgency of clients for immediacy, we seem to be moving toward a quick-fix model of treatment. Also, similar to medical treatment, there are risks in addressing what is most visible. When physicians prescribe antibiotics for viral infections, antibiotic resistance occurs (Cedars-Sinai, n.d.). When clinicians focus exclusively on symptom relief for anxiety or depression, neglecting to explore etiology, we reinforce an external locus of control.   

The paradoxical theory of change has been a guiding force in Gestalt Therapy since coined by Dr. Arnold Beisser in 1970. Fundamental in this belief is the idea that we need to understand something before we can hope to change it (Beisser, 1970). Resilience requires constant examination because it’s in a perpetual state of flux. Therapy represents an opportunity for the client to immerse themselves in this ongoing self-examination with a trusted objective partner, who explores the perspective and the lens through which they are making meaning of the data.

A resilience tool promoting autonomy in a person’s health and healing journey also has the potential to make therapy more sustainable. While symptom relief is a desired outcome for those who are suffering, we can extend well-being beyond relief from tension. Resilience is universal to all people engaged in personal growth work, whether healing from past hurts or navigating current challenges. If each client is helped to identify where they are susceptible to further unrest with a plan to continuously fortify themselves against duress, we can provide a gift much greater than immediate relief.

Whether a client is coming to therapy for symptom relief, healing from trauma, optimizing relationships, or any form of betterment, resilience can provide a fortifying framework for meeting their needs more effectively.

Next Steps for Resilience in Psychotherapy

Emerging technologies are reshaping our mental health delivery system. Beginning with telehealth during the pandemic, our collective priorities for efficiency, convenience, and immediacy are influencing the medium but also the nature of professional services. While this may seem like a threat to our industry, we can learn to leverage these technologies to amplify our scope of practice.     

As artificial intelligence gains in popularity as a treatment methodology, we can utilize this tool to integrate prevention and intervention. In doing so, we may increase client autonomy and volition by providing a self-help tool that motivates, rewards, and stimulates experimentation. New technologies allow for improvements in tracking therapeutic intervention outcomes and can allow clients to shift their focus to another goal or to refining their skills for continued growth.

Using a dynamic assessment tool (as this author experimented with), end users were able to track their results, contrast their scores at different points in time, and benefit from immediate recommendations to shape their efforts.

Goal planning can also be accomplished in conjunction with the self-assessment tool. Early adopters of a quasi-experiment were able to see the percentages of their five FACET’s (Fluidity, Amity, Capacity, Elasticity, Tenacity) of resilience and the corresponding five critical tools/skills for each FACET. Appreciating their scores allowed them to create specific, concrete, and measurable action plans as part of their goals (Scherz, 2025). While there was no examination for efficacy of correlating goals with RQ, it is an area for future study.

Clinicians would likely find this component of client responsibility as adding value to their therapeutic approach. As clients experience greater ownership of their work and the ability to both measure and see success with immediacy, their enthusiasm for personal growth will improve. This author has been using a newly created tool to observe resilience of educators in several school districts, using this information to track and amend personal growth work. Early indications point to increased client volition and greater efficiency on the part of the intervener.

Another potential application for this work are psychology graduate students who may feel better prepared for practice using a resilience measurement and tracking tool. If graduate students can first use this tool to modulate their own stress, they may gain a greater appreciation for how to apply the work of resilience with others. Application and research continuously intersect, with the growing opportunity for each of us to be engaged in this work simultaneously.

There will likely be other more creative applications of this concept if the premise of integrating prevention and intervention resonates with providers. As we explore the value of stimulating resilience as a critical component of therapy, we can take advantage of new technologies that advance our efficiency and productivity as clinicians.