During the “structure”, clients have the opportunity to access, express, and address their innermost feelings and needs in a safe environment. Structures are generally conducted in a group, but each structure is tailored to the individual needs of one person at a time, while the other group members offer support by playing roles or otherwise contributing to the structure.

Other techniques learned in Pesso Boyden therapy include ‘accommodation’, a role-playing skill that is used to satisfy requests of the person in treatment, and polarisation, a technique that helps people work to clarify ambivalent feelings. Most forms of psychotherapy involve a therapist who takes charge of the session, but Pesso Boyden therapy differs in that therapists are directed by the people in their care. This allows the client to maintain a sense of control as they receive the help they need and explore new or previously unconsidered aspects of the self. The therapist typically asks the person in treatment to speak about the issues being experienced experiencing, gradually using respectful questioning to help uncover the underlying causes of these concerns.

As the structure progresses, the therapist works with the individual to keep track of body sensations, emotions, verbal expressions, internalised commands, and core beliefs. Once the individual recalls an emotionally charged memory of a time when a basic childhood need was not satisfied, the therapist asks for permission to recreate an external scene of that memory. Group members may offer or be asked to play the role of the affected individual’s parents, former caregivers, or any other important “characters” in the past memory.”