What to Expect in Therapy
Information about psychotherapy is readily available nowadays, yet the expectations around the therapy process remain somewhat unknown. Exiting mental health stigma and inaccurate beliefs, as well as media and pop-culture references have likely contributed to the spread of misinformation. Below, we discuss some of these beliefs in more detail- next month we’ll follow this post with frequently asked questions (FAQs) to address issues that come up in therapy.
What is psychotherapy or counseling?
Psychotherapy or counseling, often used interchangeably and termed “therapy,” are focused on addressing emotional concerns, depression, anxiety, relationship issues, stressors, or a myriad of other difficulties. Sessions, can take the form of individual, family, couple, or group. Various treatment approaches, including cognitive behavioral therapy (CBT), psychodynamic therapy, or interpersonal therapy (IPT) set the framework for the meetings. In attending therapy to deal with difficulties and obtaining treatment or support, one spends time learning about the issue(s) that contribute to the problem, and eventually some sort of action is taken. The therapy space allows for trust and empathy to occur between an individual and a counselor or psychotherapist. During and after treatment, individuals usually begin to feel better and healthier. Psychotherapy and counseling require an investment of time, energy, and effort towards feeling better and making changes in one’s life. Whether referred to as therapy, psychotherapy, or counseling, they are collaborative processes between the client and therapist.
What does the first session look like?
Because individuals come in looking for help, support, or change, a lot of conflicting emotions might emerge about the first meeting. At once one might feel relieved, excited and anxious. Often times clients are surprised that they aren’t asked to lay down on a couch, which interestingly enough, some therapy offices don’t even have. The conversation style takes a little bit of getting used to, as most of us aren’t accustomed to talking about ourselves for a prolonged period of time. In addition, providing in-depth personal information can also be a challenge. We generally find that approaching the first session as an assessment and history gathering (not a therapy session) helps ease some fears, as it gives a clear roadmap for the conversation. During the first appointment, we address the client forms that were completed and go through the consent process. We’ll also discuss your reason(s) for coming in, your history, expectations, and jointly set some goals. This meeting can be a little longer than follow-up appointments (anywhere from 60-90 minutes), because there may be a lot of information to go over, while simultaneously starting to develop the therapy relationship.
The relationship is the most important part of therapy. While there is a lot of information about how evidence based therapy approaches are critical aspects of successful treatment, significant research also indicates that your perception of competency and the real bond (the relationship) that you develop with your therapist, is the MOST important component in helping you create lasting change. Once you start to get the hang of therapy, you’ll guide the conversation.
What about ongoing sessions?
After the first meeting the tenor of therapy changes: The therapist might move away from planning the sessions, and you decide what to talk about, thus guiding the conversation. The style of therapy (e.g., cognitive behavioral therapy (CBT), psychodynamic therapy) may have an impact on how much or how little structure is imposed by the therapist. Subsequent sessions (45-55 minutes) are therefore aimed at addressing set goals and helping clients gain a better understanding of the issues at hand. Given that therapy is an emotional process, it is important to note that discomfort may sometimes arise, and it might feel challenging. It's helpful to address these concerns openly with your therapist and to process ongoing difficulties in order for the therapeutic trust to build.