What is therapy?
The chance to meet regularly in a private and confidential setting with me to talk about areas of life related to:
- communication and relationships
- managing feelings and behaviors
- understanding and coping with painful experiences
- psychiatric diagnoses, such as depression, PTSD, anxiety
- decision making and problem solving
- self care
- changes in life—loss, marriage, divorce, a new baby, retirement
- parenting
- understanding yourself and others better
What might be reasons that you would seek therapy?
- You may feel a lack of satisfying connection to others, or feel you are too often in conflict with people around you
- Families may want help figuring out how to get along better and “fight fair”
- You may behave in ways you are unhappy with, or do things that have a negative impact on yourself or others
- You may be struggling to cope with mental health issues
- You may be overwhelmed by big feelings or disturbing experiences
- You may have an important decision that you have been unable to make despite working hard at it
- You may have been perfectly happy with your life until something changed, like a death, a layoff, or the illness of a family member, and you find you need help sorting through new expectations
- As a parent, you may need guidance at a particular stage in your child’s life, deciding how to respond in helpful ways to your child’s unique needs.
- You may feel a lack of purpose or meaning in life, and need time and reflection to help discover ways to make your life more rewarding.
- You may decide you want to set aside time to work on understanding yourself better, your choices, reactions, life story, what makes you “tick.”
Many clients also report that when they are in therapy they feel less alone in their struggles; less overwhelmed by, and better able to cope with, stress; more hopeful about the future; and confident that they have a designated place and person with whom they can talk about very personal subjects if they choose.
People use the words therapy and counseling to mean about the same thing, so you will see them used interchangeably in the information here. Therapy can happen with just one person and a therapist (individual counseling), with a group of people (group therapy), with a family or married couple (family or marital counseling), or with several families together in a group (multi-family group).
How does therapy work?
Like all relationships, counseling relationships go through phases. Each client moves at a different pace, there is no “right” or “wrong” way to be in therapy.
In the first session, you will meet with your therapist so that the two of you can see if you will be a good “fit” for each other. You will find out if you can trust and respect your counselor. Do you think you can be comfortable talking about yourself, your thoughts, experiences, feelings? You and your therapist will begin to set goals for therapy, and you may begin talking about things that worry you. It is generally advisable to see your therapist weekly, particularly in the early stages of work together. It is always OK to talk with your therapist about an appointment schedule that you think would work best for you.
If the therapeutic relationship is strong and trusting, you will become more comfortable with the counseling process. You may look forward to the regular meetings, but counseling is hardly ever all easy; there will probably be days that you have negative feelings either toward yourself or your therapist. There may be days that you don’t feel like going to sessions. Talking about these thoughts and feelings with your counselor is crucial to the therapy; it will make your experience richer and more helpful. It is the goal of therapy that you are able to talk honestly about these feelings and tolerate the idea that most relationships have easy and hard times, good and bad days.
You may slowly begin to develop more self-awareness and understand more about the connections between your thoughts, feelings, experiences, and behaviors. You may find traits or feelings in yourself of which you had been unaware. You may also discover communication and relationship patterns that you want to change, and begin practicing new ways of relating and behaving, ways that make you feel more “true” to yourself.
At some point, you and your therapist may decide that your goals are being reached, and that it is a good time to discuss meeting less frequently. Clients often reduce the number of sessions monthly as a way to taper off, before ending sessions completely. Maybe you have become more confident in managing relationships or stressors that were bothering you before. You may feel better about the choices you are making, or be more satisfied with your life than before you started counseling. And it is OK to return to therapy later if you think it would be helpful again.
What can I expect from a therapist?
Every counselor develops a unique professional style or way of working with clients. Some or more talkative or less talkative, more or less directive; some mostly focus on thoughts, while others focus on feelings, or behaviors. Some therapists have very specific training in certain ways of interacting with clients and certain areas of focus, while others will use a variety of strategies.
A good fit between a therapist and client means that the therapist’s style and focus helps you meet your goals, and feels safe, respectful. All therapists should be able to explain to you how they work, and why they work that way.
There are several promises that I will make to you, ensuring skilled, respectful, and professional care. I will:
- Tell you about my professional qualifications and training
- Explain how I work with clients and why I work that way
- Come to sessions sober, rested, and focused on you
- Provide a quiet and clean place to meet, without interruptions
- Work with you to set goals that you think are best, and make a plan (when and how often to meet, what you work on and how, etc.) that you like for achieving those goals
- Talk with you at least every 3 months or so about whether you think you are making progress toward goals, or if the goals or plan need to change
- Return your telephone calls in a timely fashion. Make a plan with you about who to call, or how to get in touch with you, in case of emergency
- Call you as soon as possible to cancel or reschedule sessions. Last minute changes should happen rarely and only for things like illness or emergency
- Plan 2-3 weeks ahead for vacation, other personal obligations, or regular schedule changes
- Keep our sessions confidential. The law protects the relationship between a client and a psychotherapist, and information cannot be disclosed to anyone without written permission. Exceptions include:
- Suspected child abuse or dependent adult or elder abuse, which I am required by law to report to appropriate authorities immediately.
- If a client is threatening serious and imminent bodily harm to another person/s, I may be compelled to notify the police and inform the intended victim/s.
- If a client intends to harm himself or herself, I will make every effort to enlist cooperation and ensure safety. If s/he does not cooperate, I may take further measures (without permission) that are provided to me by law in order to ensure safety.
- Talk with you ahead of time about what I usually do when it is necessary to break confidentiality
- Seek supervision and consult with colleagues in order to provide optimal care. I may tell other therapists certain facts related to your circumstances and treatment (without revealing your name) in order to receive helpful feedback and suggestions. These therapists are also bound by law to maintain your privacy and confidentiality.
- Communicate honestly and respectfully with you
- Take all of your feelings and reactions to events outside, and within the therapy session, seriously
- Keep the relationship a professional one
- Refer you to a different therapist if you and I don’t feel the therapy is helping you
- Give you several weeks notice if I have to stop seeing you, and help you find another counselor so that there is no break in sessions
- Understand that you have the right to refuse services
- Listen carefully to any complaints, concerns, questions you have regarding your treatment here
There are several things you can do to get the most benefit from the time you spend in counseling.
- Show up sober, rested, and focused on using the time to work toward your goals
- Think about our work between sessions. Experiment in life with the ideas we have in session. Make a point of noticing your reactions to people and experiences, and be sure to bring these up in sessions
- Be honest with me about experiences, reactions, thoughts, feelings, behaviors, in sessions and outside of them. It is OK to express negative feelings toward me. Honesty will help me know you better and work more effectively with you.
- Come to scheduled appointments consistently. This helps the therapeutic relationship and trust develop, and gives me the chance to see you in hard times and easier times, and in different moods.
- Call as soon as possible to cancel or reschedule appointments. Last minute changes should happen rarely and only for things like illness, job related or personal emergencies.
- Be prepared to talk with me about frequent appointment changes, cancellations or “no shows” (when you don’t call to cancel, and don’t come to your appointment). These interfere with progress toward goals, and often signal that something about the sessions is not feeling right to you. I will want to understand if there’s something the two of us can do differently to make it easier for you to come to therapy regularly. “No shows” can be a sign that either you are in serious distress, the therapeutic relationship is in jeopardy, or you are unsure about wanting to continue in counseling. These are all very important things to discuss. Because they hinder therapeutic progress, I may set a limit on the number of cancellations or “no shows” I will accept before offering you a different time slot or ending your sessions. I will work hard to help you find a different therapist if you think that would be better.
- Plan ahead 1 or 2 weeks for schedule changes, vacations, or work related obligations