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What to Expect from Therapy

Have you been considering starting therapy but unsure of how to get started? Which therapist should you choose? What should you talk about? How often should you go? What should you expect?

These are all normal questions to ask when you are deciding to start therapy. First of all, let's talk about the reasons people decide to go to therapy. For some people, life has become unmanageable. There may be an issue that you have been trying to handle on your own, but it is overwhelming and you aren't having much success. For example, if you are dealing with an addiction of some sort and have been "white knuckling" it, it might be time to seek professional help. Or, if you have been struggling with anxiety, and no matter what you search on Pinterest or what podcast you listen to, you just cannot seem to get a handle on the anxiety. Or, you may have experienced trauma that keeps resurfacing in your life and you need help to process the trauma. For other people seeking counseling, there may be a big life transition that has happened. A divorce, loss of a job, a death of a spouse, a new role as a caregiver or even parenting teenagers are some big life transitions that require outside help. Some people may seek counseling to improve their marriage. Your marriage may not be in crisis, but you would like to improve communication or talk through some things in counseling. Or, alternatively, your marriage may be in crisis and before filing for divorce, you may want to work with a counselor first to see if the marriage can be saved. For other people, they may not be dealing with a big life event, a trauma or something unmanageable; they may seek counseling as a way to stay mentally healthy (like a check-up with your doctor). And, others have a less concrete idea of why they want to begin counseling. Perhaps they need a safe place or an unbiased person to listen to their hurts or circumstances. There is no "perfect" reason to begin counseling; it is specific to the individual seeking help.

Once you decide to start counseling, what is the next step? Finding the right counselor may take some time, but don't give up! The Psychology Today website is a great site to search for a counselor. You will read about the counselor, their fees and whether or not they take insurance, the types of clients they work with (individuals, minors, couples, etc) and the areas they specialize in. Another great option is to ask family or friends who have seen counselors for recommendations. Once you find a counselor you would like to work with, see if you can schedule a 15 minute consultation. You will have a free phone call with them where you can ask questions and see if it feels like a good fit. If you decide to schedule an appointment, and after the first session you don't feel comfortable with them, please keep looking until you find the right counselor. You should feel safe, seen and heard in the counseling space. The therapeutic relationship is one of the most important aspects of counseling.

Each counselor utilizes different counseling modalities. Some types of therapeutic modalities include: Cognitive Behavioral Therapy (CBT), EMDR (a type of trauma therapy), Solution Focused, Psychodynamic, DBT, ACT, IFS, Humanistic, Family Systems and Gottman to name a few. The type of therapy is not as important as the therapeutic relationship, but it is helpful to have an understanding of the type of therapy your counselor utilizes. If you are needing help resolving a traumatic memory, you might search for an EMDR therapist. If you are wanting to work on your marriage, you may want to find a counselor who is trained in Gottman. Each counseling modality works towards helping you heal; they may just view the issue and healing differently.

Once you have chosen your counselor, what should you expect? You will fill out some paperwork before your first appointment which helps your counselor learn about you before you meet. During your first session, your counselor will ask you about why you are seeking counseling and help you establish some goals for counseling. Your counselor will also do some history taking to learn more about you, your family and the frequency and intensity of symptoms (if you are seeking counseling for an specific issue such as anxiety, depression or panic disorder). Based on your needs, you and your counselor will decide on the frequency of appointments. If you are experiencing very frequent and intense symptoms, your counselor will likely suggest starting out with weekly appointments. However, over time your appointments should become less frequent. Eventually you may stop counseling altogether (termination) or come in on a monthly or every other month frequency for a "check-in".

The following is from our website, but it is a good summary of what to expect from your counselor:

Your counselor will:

  • Offer compassion, support and confidentiality

  • Listen to your needs

  • Encourage you to grow

  • Challenge some of your assumptions

  • Move you towards independence

  • Respect your value system

  • Abide by ethical standards

  • Make referrals when appropriate

Your counselor will not:

  • Tell you what to do

  • Fix your problem

  • Take sides in a dispute

  • Act as a disciplinarian to your child/teenager

  • Give legal or medical advice

  • Impose the counselor's beliefs on you

  • Work harder than you do

Lastly, if you start counseling and over time feel as though you are not working towards your goals, please communicate this to your counselor. Often, a person starts counseling wanting to work on a certain goal and then life happens, and the conversation changes to the more pressing issues at hand. Your counselor wants to help you and would love feedback on what your needs are and what you want to be working towards.

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