As a counselor I've been on the interview side of the therapy process. When I say "interview" I don't mean checking to see if a particular person merits a scholarship or certain job. I mean the information gathering process where I learn about the person's family, symptoms, medical history, and a myriad of other topics that I would often forget to ask about.
My default whenever I am talking to someone is to look for points of intersect between our lives that I can use as part of a grid for understanding a person or to use conversation to explore their symptoms. For example, if a man walks into the counseling room who is consumed by guilt whenever he does not get an A on a test, or if someone else spends the session crying because of the guilt she experiences every time she takes a drink even when she thinks it's her only choice, I am able to get a look into both of their worlds, and they are surprisingly similar. Each is driven by a desire to live up to some standard imposed on them.
Now, there are a lot of directions we can go with this and a lot more questions we can ask. We would want to understand more about Person A's desire to achieve (Is it imposed by his parents or by himself? What happened in the past when he didn't get the grade? What will happen if he's able to get all the grades? Does the fear of failure transfer to other areas?). We'd also want to know more about Person B's drinking (Is there a history of drinking in the family? Does she experience depression? Does her community add guilt for her choices? Do they encourage her to drink more? Does she have friends who do both?). All of these are good things to know, and each of these points should be explored in therapy or conversation.
However, I think there is a more important first step. Relationship. A relationship (or change in relationship) is necessary to change, and these relationships tend to function in two ways. On the one hand relationship provides the context for change. By this I mean, just as certain environments allow certain plants to flourish more (palm trees in the tropics), relationship is the environment that best allows change to take places. Context is an indirect method of relational change
The other way that relationship leads to change is through contact. Consider, for example, the effect of water or wind on rocks--erosion. It is their interaction. In relationship this would look like confronting the person about their situation, brainstorming ideas for change, and then working with the person to stick to it. Contact is a direct method of relational change.
Without context the implementation of change can be rough and abrasive. This might leave some people to abandon efforts because they do not feel understood or loved. Without contact the implementation of change can stagnate. This might leave some people to abandon efforts because they see no impact.
We need to create an environment for change that also allows us the ability to confront the changes needed.