The idea of going to therapy is scary for a lot of people. And there are some really awful characterizations of what a therapy session looks like.
Some of the most common questions and concerns I’ve heard over the years are:
- What am I supposed to say?
- How qualified is my therapist to help me?
- Will the therapist think I’m crazy?
- Can therapy really help me? What exactly happens in a therapy session?
- What if I don’t know what to talk about?
- Will my loved ones have to come in with me? Or alternatively, can my loved ones come in with me?
- What if I can’t stop crying?
- What if I don’t think the Therapist and I are a good fit?
These are just a few of the concerns that keep people from trying psychotherapy, even if they think it could be beneficial to talk to a professional about the problems in their life. So let me take a few minutes to talk a bit about what you can expect from a positive experience in therapy, as well as some red flags to look out for. Hopefully, if you’ve been considering trying psychotherapy, this will help you feel a bit for informed and at ease about the process.
Before your first therapy appointment
There are different levels of designation that allow people to provide “counselling” services, and they can all be useful in their own way. My own personal recommendation would be to ensure your Therapist is at least a registered Social Worker, Psychotherapist or Psychologist. This means the Therapist is bound by a certain code of ethics regarding their services and have a level of education that gives them the know-how regarding the best clinical service to provide. This also helps when it comes to payment, as a lot of benefits plans will cover at least a portion of services provided by these professionals. This is absolutely not to say that these are the only professional services that you might find helpful, but if you feel like the issues you need to work through are primarily mental/emotional health based (such as anxiety disorders, depression, trauma, PTSD, etc.) a clinical Therapist is probably a good idea to look into. You might also find services being provided by a Psychiatrist, but if you are looking for a place to talk with someone and work through your psychological and emotional struggles a Psychiatrist may not be as able to provide this. The focus of the Psychiatrist is more around medication. I have worked with many clients who were both seeing myself for counselling and a Psychiatrist for monitoring of their medications. As well, I know clients that have used a Naturopath or Herbalist instead of a Psychiatrist. What I’m really saying here is that it is important for you to make the decision around what route is best for you and what is best for your mind and body.
At your first therapy session
A good number of people come to their first session with an idea about what the problem is, but struggle with what their goals for counselling are. For a lot of people the problems have been ongoing for so long that they don’t even know what their life would look like if the problem didn’t exist.
It is the job of the Therapist to help you figure this out. So if you don’t know exactly what you hope to accomplish by going to therapy, it’s okay! Getting a functional understanding of the problem (meaning how the issues are affecting the different areas of your life) and setting goals for therapy can take several sessions. And it’s important that your Therapist takes the time to work through this with you, versus telling you. The Therapist might offer some suggestions as to goals that might be helpful to work on but you should always feel like you are in control of your sessions and your therapy.
Will my Therapist want to talk to my loved ones?
Only if you want them to. This is your therapy and you get to decide what is shared, and with whom. Therapists are bound by rules of confidentiality, meaning that without your permission he/she cannot share anything you’ve discussed. There may be exceptions to this, such as when children are in therapy, safety concerns, etc. so be sure to ask about your Therapist’s confidentiality policy. In fact, this is something that should be discussed with you at your first session.
The relationship with your Therapist – A key to successful therapy
The relationship you have with your Therapist is referred to as the therapeutic alliance/rapport, and has been shown by researchers to be a key factor in successful outcomes in therapy. And it makes sense. Therapy is about feeling safe, about being able to open up and be vulnerable with someone you trust is not going to judge you, and who is going to support you to move through whatever struggle you may be experiencing. It is a really powerful relationship and good Therapists are constantly attending to their rapport building skills with clients. I mentioned the word “safe”, and this is something you should be feeling at all times when seeing your Therapist. If something doesn’t feel right or you just don’t seem to be connecting with your Therapist, I urge you to say something. Any good Therapist will actually be grateful that you bring issues like this up, so a conversation can be had about options to either repair the relationship or to help you find someone that may be a better fit.
Will the Therapist think I’m crazy?
I am mentioning this specifically because I have been asked this question so many times over the year; 1) No, you are NOT crazy. You may be going through a really tough time, or have experienced an incredible amount of hurt or trauma that is impacting how you think, feel , act and so on, but let me say this again, you are not crazy. There is a reason why you are doing what you are doing, and kudos to you for having the guts to try and figure it out. 2) You are not alone. You are not the only person who has ever experienced what you are going through, or has felt what you are feeling. You are just being super courageous by opening up about it.
What does a typical therapy session look like?
This is hard to say, really, because there is such a wide range of therapies out there. And your Therapist might have certain specializations that they can offer to you. If you have researched a certain type of therapy that you think might be helpful to your specific issue, ask your Therapist if they are able to provide the service, and if not you can always see what they can offer or get a referral to another person who is qualified.
Generally though, you are likely to feel emotional in your sessions. And again, this is why ensuring you feel comfortable and safe with your Therapist is key. I was once told something that I have shared with many of my clients who would apologize for crying or using my last tissue; if you walk into a therapy office and they don’t have back up tissues for the back up tissues, then you turn around and walk right back out. Therapists are used to witnessing all kinds of emotions; this is a big part of their job. Your Therapist should not appear uncomfortable with your emotions and in fact it is important for Therapists to validate clients when they are able to release something they have been holding on to for a really long time. It is a HUGE step towards healing. On the other hand, an individual session or your therapy overall is not a failure if you don’t cry or have an emotional breakthrough. Everyone’s process is different, and so the most important thing is to simply be honest and open.
*I must mention that while emotional expression and release can be really important to productive therapy, if you express to your Therapist (or he/she has other reasons to believe) that you are at risk of harming yourself or someone else, or you are in a state of crisis, he/she is bound by their code of ethics to break confidentiality and get you help in some way. This is a way to ensure people are kept safe.
What do I talk about?
You may have something particular that you want to talk about in your session, and if so make sure you let your Therapist know as your time together begins. It can be helpful to create a session agenda together, that way you know what you are going to get out the session and that you both agree on what is important to be working on that day.
On the other hand, if you have no idea what to talk about during your session, it’s also okay to let your therapist know this. They will likely have a few suggestions of possible topics that could be helpful to focus on. I will say, however, that if you find yourself coming to session over and over again with nothing to talk about, you might want to consider the fact that it might be time to bring your counselling to a close.
Making the decision to go to Therapy and to talk to someone about the problems in your life can be nerve-wracking. My best advice is to do your research, find someone who feels like a good fit and have a positive mindset about what the two of you can accomplish together. Psychotherapy can be a really useful tool to include in your holistic health plan as it aids in repairing the mental and emotional issues that hold us back from being our full selves.
Faith is taking the first step even when you don't see the whole staircase. - Dr. Martin Luther King Jr. Click To Tweet