Restoration Therapy: The 4 Steps of RT and How They Can Change Your Life

“Deliberate practice is a behavior, and flow is an experience.”
Grit: The Power of Passion and Perseverance by Angela Duckworth

When I was 21 years old and sitting alone in my college apartment, full of anxiety, but knowing my life needed to change, I had some inkling that they only way through the anxious feelings was to put myself in situations to practice working through it. I’ve shared the story in other posts about how I prayed to God to give me an opportunity to speak, and if I was given that opportunity, I would take it. Without knowing it, I was asking to be put into situations of practice.

I remember the first opportunity that I was given to speak after this prayer. I received a call from the campus pastor at Grand Canyon University, asking if I would like to give the sermon at the Easter morning sunrise service. My initial thought was absolutely….NO. And so I told him thank you and hung up the phone. But over the next few minutes my stomach wouldn’t stop with the feeling that I should have said yes instead. In many ways, not only was anxiety keeping me from speaking, but it was anxiety that propelled me to call him back up and say that I would speak. Hence the importance of learning to discern between healthy and unhealthy anxiety. Between an anxiety that keeps you from the life you want and need to leave, and an anxiety that propels you towards the life you want and need to live.

For the next few weeks I lived in anxious agony knowing that I would have to get up and speak in front of my peers, and that the possibility of me stuttering were about 100%. But I studied a text that I wanted to preach and I practiced over and over again until I felt like I was about as comfortable as I could be up front in front of about 150 peers. I didn’t sleep a wink the night before my sermon, and I set three alarms just to make sure I wouldn’t oversleep, even though I don’t think that was a possibility at all given the state of my anxiety. I wish I could tell you that I got up that Easter morning in 1996 and gave the most amazing sermon ever. I wish I could tell you that I didn’t stutter at all. But in all fair recollection I stuttered my way through most of it. It probably wasn’t as bad as I remember it, but it wasn’t as good as maybe some of my friends tell me today that it was. But I made it through. I survived. And that practice gave me the courage to keep saying yes to any opportunity to speak that comes my way. Because any opportunity to speak in front of others is an opportunity to face my anxiety and to practice my way through it. And with practice I have become better and better, and most of the time people are surprised when I share with them that I used to stutter and still struggle with it on occasion.

But over the course of the last 22 years I have been putting into practice what Angela Duckworth so eloquently states in her quote from Grit above. I have intentionally been practicing my way through my anxiety, and it’s through all of that practice that on occasion I feel like my speaking is in a flow state. But those moments of my speaking that feel easy, as if I’m in a zone, and in the flow, having fun, I know only happen because of all the countless hours of deliberate practice.

But how do we take something we need to practice, especially anxiety, and put it into practical steps that can be practiced?

What are the 4 Steps of Restoration Therapy

It’s hard for me to clearly identify exactly when I started formalizing the practice of my anxiety, though that Easter morning in 1996 was probably the beginning of it. I’m sure there were other attempts at practice before then, but that was the first I really remember intentionally choosing out of a desire to grown, rather than out of necessity.

For many of us when faced with anxiety, just being in conversation with someone, or leaving the house to go into public, or facing a difficult task, are all attempts to practice working through anxiety. But what if there was a more formal way to do this that could be practiced over and over and over again?

I first came across the 4 steps in the Restoration Therapy model when I was on staff at The Hideaway Experience in 2010. I first started as a curious observer of this model, sitting in on some marriage intensives, before I realized how powerful this work was and wanted to go on staff.

In the Restoration Therapy model there are 4 steps that go as follows:

  1. Say what you feel
  2. Say what you normally do
  3. Say your truth
  4. Say what you will do differently (and many of us add to the reminder… “and do it”.)


In Step 1 the person practicing the steps is to say out loud the underlying feeling they are experiencing in that moment. So I know more me that most often when I normally do anxiety — remember, anxiety is not a feeling, but is a response to an underlying feeling. That distinction is important) — I tend to feel alone, not good enough, inadequate, abandoned. Those are the core underlying feelings that I have identified in my Pain Cycle. So Step 1 is simply saying the underlying feeling out loud to someone in a conversation that you are having with them, or often out loud while you are alone. Many times I’m in a situation where I can’t say it out loud (i.e. a meeting perhaps — though there are times when saying it out loud in a meeting is a good option), so I simply say it out loud in my head.

In Step 2 the person practicing the steps is to say out loud what the coping behavior they normally engage in is, based on the underlying feelings they just said out loud in step 1. Since we are talking about anxiety in these posts, the prevailing coping behavior is anxiety, though there are nuances to anxiety that can help one understand their anxiety even more. For example, when I move into anxiety I tend to perform (i.e. achieve and get good grades, reports, results, etc.), and it can also cause me to withdraw. Anxiety is my primary behavior, but it comes with other attached behaviors as well. So Step 2 is simply saying what you normally do out loud. What I have been taught and read and experienced first hand is that when we say something out loud, it simply fires (how is that for a scientific word) in our brain differently, and a person who says out loud their behavior that they normally do, is actually less likely to do it. Why? Because I have now moved my coping behavior from this automatic unconscious response that I have been doing most of my life, to a conscious thought that I am choosing to work on. Most of my years with anxiety were just on autopilot, and it wasn’t until I started to practice my anxiety and say things out loud did I start seeing significant changes to my anxiety.

In Step 3 the person practicing the steps is to say out loud their truth. Their truth is the belief they have about themselves, or that they have heard others say about them, or that they believe that a higher power or spiritual source thinks about them. For example, in the Christian tradition, one might say that they know they are loved based on what they read in the bible and what they discern in prayer. They also might know the truth about themselves in the community they worship in as people may communicate those truths to them over time. But perhaps the most powerful truth is one’s ability to anchor themselves in a deep truth about themselves, because God or a friend can communicate truth all day long, but if one doesn’t believe it themselves, it often doesn’t take root. So for me, the truth that I have been working on all these years is that I am good enough, that I am adequate, and that I am not alone and haven’t been abandoned. I tell myself often that “I can do this”, or that “I am capable”. Step 3 is tricky for many because they don’t always full believe what they are saying, but part of that is the practice. I may not fully believe something at first, but overtime I am learning to rewire my neural network and belief system.

The apostle Paul in Romans 12:2 writes the following: “Do not conform to the pattern of this world, but be transformed by the renewing of your mind. Then you will be able to test and approve what God’s will is—his good, pleasing and perfect will.”

That is, we are transformed by the renewing of our mind, by beginning to think the truthful thoughts, and to allow those thoughts to shape who we are and who we become. And it can take time for those thoughts, for those truths, to make the journey from our heads to our hearts. But you can even see that in this text there is the sense that practice is required as Paul asks the readers to test and approve.

In Step 4 the person practicing these steps is to say out loud what they will do differently (and then to do it). That is, they are to identify what action they want to take instead of anxiety in this case. For me it has been a constant practice of saying out loud to myself that I will be non-anxious, and that when I’m non-anxious I will work towards not needing to perform or achieve, and I will work towards staying engaged and present with others, rather than withdrawing and shutting down.

Putting the 4 Steps Into Concrete Practice

Often when I am working with people and we have identified their four steps I work on helping make it concrete for them. That is, when they leave my office, how can they literally, and practically, practice these 4 steps. What I have found to be super helpful is to not overcomplicate the process by adding more and more tools, but simply to encourage them to move through their days saying out loud the 4 steps as they are triggered.

I typically have handouts that I give clients where they can not only identify their 4 steps, but I have a handout where they can graph out their 4 steps with the steps listed next to the graphs. And on these handouts is instructions to simply notice themselves as they move through their lives and to be able to pause and walk through the 4 steps when they are in conflict, or triggered by some emotion that comes up that they notice. I also encourage them to practice the 4 steps when things are good, almost like one would practice a fire drill so they know what to do if and when there is a real fire.

But probably the most powerful thing that I do in my practice to help clients make the steps concrete so they can practice them and begin to see the transformation, is a technique that I learned when I was on staff at The Hideaway Experience. I keep the large Post-It notes in my office hanging on the wall. And by large, I mean the big 25×30 inches. And as a person identifies their feelings, coping behaviors, truths and new actions, I simply graph it in a circular pattern up on the board for them, with the 4 steps listed in sequential order next to the corresponding words. I then ask this individual or couple or family to take home the chart or charts and hang them somewhere where they will see it each day. Often for people this is the back door in their closet, but sometimes it ends up on a person’s fridge. But seeing the 4 steps everyday is a great reminder to practice, practice, practice. And it’s only through practice that transformation occurs.

Insight + Practice = Transformation

I have this belief in my work that insight alone is often not enough to create transformation. Sometimes it can, but it rarely does all by itself. But when a person takes that insight and combines it with practice, then we can move towards transformation.

I remember when I had been working at The Hideaway Experience for several months, but hadn’t really put my insight into practice. I had all kinds of new insight, but it lacked practice. I mean, I practiced all the time in my head which was great, but I hadn’t said it out loud to anyone before. Until one day I was coming back from working at The Hideaway Experience one weekend doing an intensive. I was on cloud 9 and my wife came to pick me up at the airport. We sat down to breakfast on the way home and during our conversation she said something that triggered some underlying feeling and I noticed myself shutting down. She noticed me shutting down also. She asked what was wrong, but like usual, I kept saying nothing was wrong. And then I thought to myself, why don’t I put into practice what I preach and walk through the 4 steps.

As I was sitting across from her that Monday morning at Breadwinners Cafe in Plano, TX I walked through my 4 steps out loud. It was awkward and weird and clumsy to put into words what I had always kept to myself, but the very process helped me and her emotionally regulate ourselves, and we stayed engaged in that conversation. And an argument, or tense conversation that what normally would have lingered for hours, if not days, we were able to stay connected and resolve in a matter of minutes. That’s when I knew things had changed in my life. And I knew I needed to practice again. And when you are looking to practice it’s amazing how many opportunities will rear their head.

Shortly after that I found myself getting ready to speak at a young adult retreat for Bel Air Presbyterian Church, a church I had been on staff of for many years. And though I was full of anxiety it was just another step along the journey of practice. I remember on the first night before my talk, standing in the men’s bathroom, pacing back and forth and just walking through 4 steps over and over again. I did that each time before my talk, and most of the day throughout the weekend. That weekend ended up being one of the best weekends for me ever as a speaker, and it gave me more and more confidence that practice along with the insight I was gaining, was the pathway to work through and transform my anxiety.

Look for Opportunities to Practice

I remember getting another opportunity to speak in front of others when I was offered the job to be the college pastor at Bel Air Presbyterian Church in 2002. I remember sitting in a chair in the intern office and just saying to God, “If I take this job, you are going to have to show up, because I can’t do this on my own.”

And I believe that will always hold true. I can do all the work I want to know myself better. And I can look for opportunities to speak (and often they will find you). But at the end of the day I am stepping out in faith and trusting that God will meet me in my anxiety, and in that encounter God will transform it for good.

I believe the same is also true for you.

I want to leave you with this quote from Terry Hargrave and Franz Pfitzer about the need for practice. They talk about skills which is about practice. And what they say is what I am echoing here. We need insight about our anxiety, but we also need to practice it. It’s when we combine these two things that we grow as people.

“From a Restoration Model perspective, insight into issues of identity, safety, and self-reactivity help the patient or client get the cognitive connection and leverage needed to understand not only where his or her vulnerabilities and reactions take place in an automatic manner. Skills, on the other hand, help the client or patient have a clear behavioral and mental map of what needs to be accomplished to make the changes that are clear to to insight. Further, skills provide the client or patient with the ability to practice change so it becomes habituated. Both skills and insight clearly have advantages in therapy, but the wisest and most beneficial therapy will make use of both to maximize effectiveness and change.”
Restoration Therapy: Understanding and Guiding Healing in Marriage and Family Therapy by Terry Hargrave and Franz Pfitzer.

Rhett Smith is a Licensed Marriage and Family Therapist in private practice in Plano, TX. He specializes in helping people struggling with anxiety find new opportunities for growth, as well as spending a majority of his week with couples as they navigate relational issues. He is the author of The Anxious Christian: Can God Use Your Anxiety for Good? and What It Means to Be a Man: God’s Design for Us in a World Full of Extremes. Rhett lives in McKinney, TX with his wife Heather and their two children. You can discover more about Rhett’s work through his writing and podcast at

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