I view therapeutic techniques like a tree. The more evidence-based therapies such as Cognitive Behavioral Therapy (CBT) are the limbs and leaves of a tree -- the behaviors and thoughts we can see and trim and, without maintenance, can grow to be quite an overwhelming situation again. 

The underground roots of the tree are where the more impactful change can occur -- deeper work that is hard to capture in any given scientific study. It’s where the work can get rich and messy. If there is a shift at the roots, there is a more permanent shift in the whole system.