“The lack of self-esteem and self-belief is at the core of many, if not most psychological issues.” The biggest exception is probably narcissism, where the self-ego is so inflated that it is out of touch with reality and self-centered to the detriment of others around. But, many social structures actually work more against developing a healthy self-esteem. We are seeing every day that there is a worryingly increasing gap between the “elite” and the “invisible”, where 99% of the people have a growing feeling of being exploited, with many becoming poorer in real terms every year. These are difficult circumstances to cultivate a healthy self-esteem and positive outlook. In addition, a therapist also has to be culturally sensitive, as in many cultures an outwardly individualistic and self-confident attitude and behavior is frowned on and discouraged. By many it is seen as decadence and a loss of traditional values. So, a therapist can work with a client to improve their self-value, but of course it has to be done with sensitivity of his/her cultural values and personal context.
Another issue is the danger that the client will view his/her therapist as an expert, which has an impact on their professional relationship by changing the power balance, which has the potential to cause difficult situations and harm. This used to be the basis in older therapy methods, such as psychoanalytic therapy, but the modern approaches changed it to a collaborative process where the therapist and client work together towards a solution. The client is treated as the expert of his/her own life and experiences, which is a more realistic and viable setup.