What helps
outside therapy?
My choir did more for me than any therapist.
Friends, peers, creativity, faith, practical know-how and pleasure, and how therapy can help someone use them without claiming the credit.
What this is: a guide to the resources people draw on outside therapy.
Why it matters: most of what helps people happens outside the therapy room.
The sharpest reframe: a peer group can bring recognition, or feel excluding.
One thing to take away: ask what helps, and what it costs.
The short version
Therapy is one of many things that can help. Friends, family, disabled peers, music, faith, humour, practical know-how, advocacy and pleasure all matter too, sometimes more and sometimes less, depending on the person. Pluralistic writers include these “cultural resources” in their thinking about what helps. For disabled people, resources outside therapy can be especially important, and sometimes complicated: a peer group can bring recognition or feel excluding, and family can provide essential care and also conflict. Therapy can help someone notice and use these resources, without claiming the credit.
You might recognise this
Illustrative statementsDrawn together from common experiences. They are not quotes from individual people.
Cultural resources in pluralistic thinking
Established theoryJohn McLeod’s account of pluralistic therapy includes attention to the cultural resources people already draw on: activities, relationships, communities and practices that help them, outside formal therapy. The idea is that therapy can help people recognise and make use of these, rather than locating all helpful change inside the therapy room.
Resources disabled people may draw on
Our frameworkDisabled peers and communities
Recognition, shared knowledge, humour and politics. Not having to explain.
Friendship and chosen family
People who know you beyond disability.
Creative and expressive activity
Music, art, writing, performance, making things.
Faith or spiritual practice
Where the person wants it, on their own terms.
Practical knowledge
Equipment, access hacks, benefits know-how, getting around.
Advocacy and services
Organisations that can act where therapy can’t.
Pleasure and meaning
Sexuality, food, nature, sport, rest, anything that makes life feel like one’s own.
Sadhbh is 35 and lost most of her sight over the past three years. In therapy, she talked mostly about loss. When her therapist asked what still brought her pleasure, she mentioned singing in a choir she had joined before her sight changed. She had stopped going because she couldn’t read the music.
They talked about whether she wanted to go back. She did. She asked the choir leader for audio recordings of her part, and learned by ear. She also tried a local group for people with sight loss. She went once and didn’t return: the group was mostly about adjusting to daily life, and she wanted to be making music with people who shared that passion. A few months later, she found an online community of blind musicians, which she loved.
Sadhbh is a fictional teaching example, not a real person.
Resources can be complicated
Our framework- A peer group can offer recognition. It can also feel excluding, for example if someone feels “not disabled enough”, or not like the others.
- Family can provide essential care and also be a source of conflict or control.
- Faith communities can bring belonging, or messages about disability that hurt.
- Activities may need adapting, and the adapting itself can be tiring or grief-laden.
So the question isn’t just “what resources do you have?” but “what does this resource mean to you, and what does it cost?”
What therapy can do
Our frameworkAsk about them
What helps, what used to help, what you enjoy.
Notice what’s been lost
Resources that stopped when access changed may be recoverable.
Support access
Help the person ask for what they need to take part.
Respect choices
Including the choice not to join disabled communities.
Not take the credit
Change that happens through a choir or a friend is still real change.
What needs attention here?
The person has lost an activity they loved
Possible focus: exploring whether it can be adapted
Watch for: assuming it’s gone for good
A peer group didn’t feel right
Possible focus: respecting that, and looking for others
Watch for: pushing them to try again
Therapy becomes the only support
Possible focus: widening what helps
Watch for: becoming the centre of the person’s life
Possible starting points, agreed with the person, not rules.
How you’d know it helped
Two different questions: whether the work is going well, and whether it is actually helping.
Is the work collaborative and accessible?
- Therapy asked about life beyond the room.
- The person’s choices about communities were respected.
Is it helping with what matters?
- More sources of support and pleasure, on their terms.
- Therapy is one part of their life, not the whole of it.
Words you can use
For clientsQuestions worth carrying, as a therapist
Therapist Reflection- Do I ask what helps outside therapy?
- Do I assume disabled peer groups are always good?
- Am I comfortable with change I didn’t cause?
Evidence & sources
Sources checked in October 2026, using targeted searches rather than a systematic review. “We have not located” means our searches did not find it.
McLeod, J. (2018), Pluralistic Therapy: Distinctive Features. Routledge. Includes a chapter on cultural resources.
Cooper, M. & McLeod, J. (2011), Pluralistic Counselling and Psychotherapy. London: Sage.
The list of resources, the complications and the role of therapy are this site’s synthesis.
Sadhbh is constructed for learning. She is not a real person.
Our targeted searches did not find studies, designed around disability, of how disabled people use cultural resources alongside pluralistic therapy.
Last reviewed: October 2026.
How to cite this page: Donaghey, C. (2026). What Helps Outside Therapy?. Disability in Psychotherapy. Available at: https://disabilityinpsychotherapy.online/what-is-psychotherapy/pluralistic-psychotherapy/what-helps-outside-therapy/ (Accessed: [date]).