When I meet a new client, I can usually tell quite quickly who knows their way around a therapy room, so to speak, and who’s just walked into therapy for the first time. There’s a lot of uncertainty and confusion about what happens in the therapy room. In fact, I’m often pleasantly surprised that, despite the uncertainty and anxiety involved, there’s still an endless flow of people willing to take the risk of sharing their most private thoughts with a complete stranger. It tells me a lot about the determination of people to overcome painful circumstances and live a more satisfying life.
I do think it would be a lot easier, however, if there was more understanding of the process of therapy before people make the step of starting. It may lessen some uncertainties, encourage more people to seek help and avoid disappointment for those whose expectations are not in line with what therapy actually is. In an attempt to provide some clarity, I’ve answered some common questions potential clients often ask:
Is therapy only for weak people, or those with serious mental health issues?
Therapy is no walk in the park. It takes a lot of courage to admit you need help, reach out and then share your deepest thoughts and feelings with another person. I’m often deeply moved by the courage of my clients and learn a lot from their strength and perseverance. ‘Weak’ just doesn’t come into it.
Whilst therapists sometimes support clients with severe mental health issues, such as bipolar disorder or personality disorders, much of our work involves working with people on everyday issues which impact one’s health and well-being. This may involve supporting someone through separation, bereavement, stress or anxiety. It may also involve teaching clients how to manage their emotions better, manage a stressful work environment or cultivate stronger, more meaningful relationships.
Will I be prescribed medication?
The mental health field is made up of a range of different professionals. Only doctors and psychiatrists can prescribe medication. Whilst your therapist is there to help you explore the difficulties you’re facing in a range of different ways, she cannot prescribe medication.
How do I choose a therapist?
Most therapists have their own website or form part of a clinic which has a website that lists the therapist’s qualifications, experience and areas of expertise. It’s wise to look through this website to check if the therapist’s expertise matches the issues you wish to work through. Depending on the issues you wish to discuss, you may be more comfortable speaking with a woman than a man, or vice versa. Age could also be an important factor when choosing a therapist. Are you comfortable speaking to someone younger or the same age as you or would you prefer an older therapist? Contact the therapist or clinic and ask questions, if need be. Most therapists and clinics will devote the time necessary to ensure you have all the information you require before making a decision.
How often should I attend?
This varies from person to person and really depends on what you feel you need. The therapeutic relationship is a crucial aspect of successful therapy. Therefore, at the beginning of therapy, I usually encourage my clients to attend every week since the therapeutic relationship is in its early stages and regular meetings help strengthen it. Also, the sessions may bring up difficult or painful emotions, so having regular meetings will allow the therapist to support you until the process gets easier. Over time sessions can be set every 2 or 3 weeks, or monthly after some time. How much time you have and what you can afford will also need to be considered when deciding how often you can attend.
What actually happens during a session?
The first session is quite particular and different from subsequent sessions. I use first sessions to get to know my clients – how they’re feeling, what brought them to therapy, what symptoms they’re experiencing, family history, and so on. I’m also open to the client asking me any questions which will help them determine if I’m the best therapist for them. The first session is also the time to discuss therapeutic goals, frequency of sessions, client confidentiality and anything related to the therapy process itself.
As every therapist has their own unique style of working, it’s hard to generalise in terms of what will happen in each session. Generally, however, clients are invited to share their thoughts and feelings with the therapist, without being judged, criticised or pressured to be a certain way. This is a very unique relationship in that, unlike when speaking with friends or family, the focus will be on you and meeting your needs.
Will my privacy be respected?
An important part of therapy is knowing you can share your deepest fears, longings and vulnerabilities with your therapist and she won’t share them with anyone else. Therapist confidentiality is an essential part of the client-therapist relationship. However, you also need to know when confidentiality may be broken. Mental health professionals have an ethical responsibility to break confidentiality if the client is in danger (i.e. you are at risk of attempting suicide or at risk of being seriously hurt by another person) or if there’s a risk of harm coming to another person, such as if you reveal a child or other vulnerable person is or may be at risk of being abused, you plan to harm someone, etc. Saying that, incidents of breaking confidentiality are quite rare so this needn’t be a cause for concern. Ultimately, your safety and well-being are the therapist’s main priority and such laws aim to protect you and the wider community.
How long should therapy last?
This really depends on a number of factors and what your needs and wants are. Some people have a specific problem they wish to address, such as handling stress, and just a few sessions are enough. Someone else may be experiencing various symptoms, such as anxiety and low mood, and deeper exploration reveals childhood abuse, trauma or neglect. Such work would require long-term therapy lasting months or even years. Ultimately, it’s your choice how long you stay in therapy. It may be helpful to ask your therapist for guidance on this and come up with some therapeutic goals which you can work towards together.
Will my therapist give me advice?
I often meet clients who come to therapy with the notion that I’ll tell them what they need to do to solve their problem or make their pain go away instantly. This isn’t what happens in therapy. Apart from very particular circumstances where a client may be in danger, most therapists will not give advice. The role of the therapist is to explore, alongside the client, what’s causing them distress or difficulty. The therapist then guides and supports the client towards making their own decisions and making changes in their lives. In other words, the therapist empowers the client to make their own choices, knowing that when therapy is over, the client will feel more confident in trusting themselves to get through difficult periods or make important life decisions.
Will therapy hurt?
When I started attending therapy many years ago, there were many moments I wanted to run out of the room and never go back. Yes, it hurt. It hurt a lot. Over time, however, I realised that not dealing with my old, unresolved issues may have felt safer at the time but that didn’t mean these issues weren’t affecting me. In fact, these unacknowledged issues were hurting me every day and stopping me living the best life possible. A skilled therapist will help you work through any issues you have slowly, at a pace you can handle. And whilst it may be painful at times, therapy gets less painful and easier as time passes and as you gain strength and resilience.
How do I know if my therapist is good at what he/she does?
Becoming a therapist involves a great deal of training and deep, personal work, not just prior to practicing but constantly throughout one’s life. Because of that, I believe that the majority of therapists choose to be ethical, competent and professional, putting the best interests of the client first. We are all human, of course, and may say the wrong thing sometimes, disappoint you or have an off day. Like every other professional, we’re not perfect. However, if you’re baring your soul and investing the time and money to seek help, you want to know your therapist is doing a good job. As there’s so much uncertainty and lack of knowledge about what actually happens in therapy, I’m going to try to clarify for you what a good therapist looks like.
- She fosters independence – it’s natural in the beginning of therapy to feel quite dependent on your therapist. A good therapist can hold these dependency needs but will, at the right time, empower you to be able to support yourself and feel confident standing on your own two feet. If you’re worried about feeling too dependent, discuss this with your therapist.
- She has strong interpersonal skills – she listens, is sensitive to your emotional state and responds to you warmly and appropriately.
- She’s knowledgeable – Your therapist should be able to communicate concisely and clearly with you what may be causing your distress and pain. She should have the necessary knowledge and skills to be able to do this, whilst also being willing to inform you if she needs to consult with another professional about the work.
- She doesn’t over-share – Therapy is one of those unique relationships where the focus is on you. Whilst therapists will share information about themselves if they feel it will benefit the client, therapy shouldn’t involve discussing the therapist’s issues or life circumstances.
- She’s reliable – Ideally, your therapist attends sessions on time and doesn’t cancel last minute, unless there’s an emergency. These practical issues foster trust.
- She has good boundaries – Although therapists genuinely care for their clients and are invested in their growth and well-being, your therapist isn’t your friend and certainly not more than a friend. They don’t lend you money, do business with you, meet you outside therapy to socialise or do anything which could lead you to feel abused, betrayed or hurt.
- She makes you feel accepted for who you are – A therapist won’t criticise you or judge your life choices. She certainly won’t impose her religious or personal beliefs and values on you.
- She’s open to discussion about the therapeutic process – Good therapists are open to receiving feedback from you about how you feel therapy is progressing. If you feel stuck or that you’re not progressing fast enough, therapists need to be able to discuss this honestly without being defensive or angry.
I hope I’ve helped clear up any uncertainties you had about therapy and what it involves. If you’d like more information, please call or email the clinic and we would be more than happy to speak with you about any doubts or concerns you have.