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A Human-Centred Approach to Healing
Cognizance, when thoughtfully integrated into therapeutic practice, refers to the conscious awareness of one’s thoughts, emotions, behaviours, and relational patterns. This awareness is not merely intellectual—it is a lived, felt, and unfolding journey that encourages clients to explore their past, reflect on their present, and reimagine their future. Through this process, clients are empowered to recognise where change might be needed and where their inherent strengths lie dormant, waiting to be nurtured.
An increase in self-awareness can support clients in developing stronger emotional regulation, deeper and healthier relationships, and a more settled sense of personal identity and well-being. Therapeutic techniques such as mindfulness, cognitive-behavioural approaches, and psychodynamic exploration often provide helpful frameworks through which this cognizance is cultivated. However, at the heart of it all lies the therapeutic relationship itself.
The Foundation: Understanding the Therapist-Client Relationship
A strong therapeutic alliance is not simply beneficial—it is vital. The quality of the relationship between therapist and client often determines the success of therapy more than any particular technique or modality. It’s not only about what is said or done, but how it’s shared between two human beings.
In its essence, therapy is a relationship built on trust, safety, and respect. It must be a space free from judgement, where clients can explore their inner lives honestly. For this to occur, the therapist must serve not as a superior figure or distant expert, but as a fellow human being who listens with empathy, supports without controlling, and values the client’s autonomy at every stage.
The Cognizance Therapeutic Principle
Over years of practice—primarily through online therapy—I have developed what I now call The Cognizance Therapeutic Principle. This approach is rooted in equality, empathy, and mutual respect. While the roles of therapist and client carry natural differences, particularly in responsibility and expertise, I believe it is possible—and necessary—to redress the power imbalance in several key ways.
This principle is designed as an addition to the traditional and universally expected boundaries of ethical therapy. It does not replace the core frameworks of confidentiality, safety, professionalism, and duty of care that all therapists are expected to uphold. Instead, it offers a layer of human-centred flexibility and client empowerment that complements those foundations. In some cases, the Cognizance Principle intentionally overrides standard practices—for example, in choosing not to charge for missed sessions—when doing so better reflects the values of mutual respect, autonomy, and equality that are central to this approach.
A Mindful and Respectful Way of Working
The Cognizance approach recognises that, regardless of background, belief, or identity, every person is of equal value. It calls on therapists to be continually aware of the significance of the client—not just as someone seeking help, but as a person in their own right, capable of insight, strength, and growth.
This principle is not abstract. It must be seen, felt, and enacted from the very first session, shaping both the relationship and the practical structures of therapy. It is an approach that honours the client’s autonomy and fosters a working relationship where the client is not only respected, but central.
Applying Cognizance: Building a Stronger Therapeutic Alliance
1. Therapist Self-Awareness
Therapists must be mindful of their own internal responses—thoughts, feelings, assumptions, and even their limitations. By acknowledging these honestly, we can ensure that they do not interfere with the therapeutic process or diminish the client’s experience.
2. Empathy and Active Listening
Genuine empathy is more than understanding—it is about feeling with the client. Active listening, with full presence and without judgement, helps the client feel truly heard and validated. This fosters trust and opens the door for deep emotional work.
3. Valuing the Client’s Autonomy
Clients must be free to make choices about their own therapy. This includes the freedom to assess the value of the relationship, to express discomfort or dissatisfaction, and to decide their own pace of change. Respect for autonomy is the heartbeat of the Cognizance principle.
Working Practices That Reflect Cognizance
To reflect these values in a tangible way, I have adopted several working practices that place the client’s dignity, independence, and agency at the forefront. These may, at times, differ from conventional therapy norms—not out of disregard, but out of deliberate respect for the client’s position in the therapeutic relationship.
1. Free Initial Consultation
The first session is always free. Just as the therapist must assess suitability, so too must the client feel confident that this relationship could be helpful. There should be no financial pressure influencing such a fundamental and personal decision.
2. No Charges for Missed Sessions
Life is complex, and clients are human. Missing a session should not result in punishment or shame. To charge for a missed session without compassion reinforces the imbalance of power and suggests the client’s circumstances or humanity are secondary to policy. This is a conscious divergence from standard therapy norms, chosen to uphold respect and equality.
3. Post-Session Invoicing
Invoices are sent after the session, never before. This allows the client the space to reflect on the experience and decide freely whether they wish to continue. It subtly shifts the power dynamic in favour of client autonomy and reinforces that the client is not beholden to the therapist.
4. No Advance Payments or Deposits
Asking for payment in advance can suggest a lack of trust in the client and may subtly shift the therapeutic focus to financial transaction rather than relational growth. Trust is foundational—so the therapist must demonstrate it first.
Exceptions: Protecting the Therapeutic Framework
Of course, there must be some reasonable boundaries to protect the integrity of the process:
- Client-Initiated Reimbursement: If a client insists on paying for a missed session, respecting their wishes maintains their sense of agency and acknowledges their ethical framework.
- Repeated Missed Sessions: Chronic absence may indicate a need for the therapist to reassess the working agreement. In such cases, reasonable boundaries—such as requiring advance payment for future sessions—can be introduced transparently and respectfully.
The core principle remains: both therapist and client carry shared responsibility for maintaining the integrity of the therapeutic relationship.
Bringing It Together: A Partnership Built on Respect
Cognizance in therapy is not a technique—it is a way of being. It calls the therapist to continual awareness: of self, of the client, and of the precious space held between them. It asks us to lead without control, to support without superiority, and to honour the client’s inner wisdom as much as our own training.
In a world where therapy can sometimes become clinical, commercial, or impersonal, the Cognizance Therapeutic Principle is a quiet but firm return to what matters most: two human beings, sitting together, working honestly and respectfully towards healing and growth.
