My layman theory is that therapy is only useful for second-order emotional suffering.
Many people are miserable because they live miserable lives, identifying the emotions involved and the needs that aren't being met is good but the emotions are there and the needs aren't being met for very practical reasons, and reframing isn't going to do jack to solve it. That's first-order emotional suffering.
Then there are the emotional pathologies that develop on top of that, the second-order emotional suffering, and that can be treated by therapy. For example, if you're miserable because you're poor, therapy won't help solve the anguish and stress of making rent, but it can solve second-order emotions like feelings of shame and self-hatred. Or if you have a life altering accident, it won't solve the baseline misery dealt by the terrible life consequences, but it can help with the residual panic attacks from the trauma of the accident.
Many people are miserable because they live miserable lives, identifying the emotions involved and the needs that aren't being met is good but the emotions are there and the needs aren't being met for very practical reasons, and reframing isn't going to do jack to solve it. That's first-order emotional suffering.
Then there are the emotional pathologies that develop on top of that, the second-order emotional suffering, and that can be treated by therapy. For example, if you're miserable because you're poor, therapy won't help solve the anguish and stress of making rent, but it can solve second-order emotions like feelings of shame and self-hatred. Or if you have a life altering accident, it won't solve the baseline misery dealt by the terrible life consequences, but it can help with the residual panic attacks from the trauma of the accident.