What to Expect from Therapy

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In the technology age, there is a lot of information at our fingertips. When looking for a therapist people can experience this as both helpful and a bit overwhelming. First of all, there are so many of us! Depending on your location, there might be at least 30 of us within a one-mile radius. Then there are pictures, videos, mission statements, specialties, and work history to consider. By the time you have narrowed it down to a few providers you are going to call, you might have a better grasp on the questions you want to ask us, but not necessarily any idea of what your therapeutic experience will be.

The idea of sites like Psychology Today, Good Therapy, and Theravive is to supply you with information so that you will feel more comfortable making your decision. I would like to add to this by letting you know what you might experience during your time in therapy. Keep in mind that this is, by no means, exhaustive.

In the beginning (first few sessions) your therapist will usually gather a family history. This is a brief overview of relationships, experiences, and circumstances in your family. In some cases, it’s better for the therapist and client to first establish rapport before going into a family history. This approach is taken when it might be too traumatizing to discuss your past. When this happens, your therapist will strategize with you and provide coping skills to help resource you.

Next, there is the rapport-building phase. This is pretty continuous; it starts the first time you interact with your therapist whether this is over the phone, over email, or in person. The therapeutic relationship is constantly growing and changing, but rapport building is most important in the beginning. Positive rapport is our bedrock. This is when the two of you are getting to know one another and reaching a comfort level. Here, establishing trust is the main goal. This may take any length of time, but often there is a felt sense of trust and safety around the two-month mark. Safety and trust are imperative to the therapeutic process. If you can’t trust your therapist, it’s going to be difficult to explore the things with which you want help. (It won’t be impossible, just more challenging. If you are experiencing difficulty trusting your therapist, I encourage you to tell them. Some people come to therapy with difficulty trusting others in general; this is totally workable, and we see this all the time! It won’t scare us off or deter us from working with you.)

After a family history and rapport building comes the strategizing phase. During the strategizing phase, you and your therapist take an inventory of what brought you into therapy, troubleshooting the whys and hows of what has and hasn’t worked in the past. Here, you solidify your goals and come up with a plan that will help you reach them and measure your progress.

Once you and your therapist have come up with goals and a plan, you will begin the action phase. This is when you dive into what brought you to therapy. The action phase usually involves exploring your thoughts, feelings, and behavioral responses to certain stimuli. Your therapist asks questions about your experiences and makes suggestions. Many of us assign weekly homework to deepen insight and progress.

Next, is the refinement phase. During this part of therapy, you and your therapist measure your progress again and identify the areas for growth, fine-tune the strategies and skills you have learned, and begin to look at closure.

In the closure phase, you will usually find that you decrease your sessions, usually from once a week to every other week. Some people start this titration during the refinement phase. It depends on what the therapist and client decide is right for the client. Sometimes it’s at this point that the client, the therapist, or both realize that closure has been reached prematurely. If this is the case, then the number of sessions is increased. Otherwise, closure continues until the meetings have intentionally and planfully been stopped. Often the therapist periodically checks in with the client via email or phone to monitor progress, provide a bit of support, and assure the client that the therapist is still here to support the client.

It’s important to mention that these phases are fluid and quite seamlessly flow into one another. This might make the beginning and end of each phase less discernable. This means that you will most likely start the strategizing phase while you are still in the rapport-building phase, that you will begin the action phase when you are still in the strategizing phase, and so on. This is natural since these phases are interdependent on one another.

Each therapist might view or approach the phases a bit differently, but they are acknowledged as stated above. Therapeutic style, however, varies from provider to provider.

Some of us use varying degrees of self-disclosure as a tool, and some of us would never share even a shred of personal information. Some of us give advice when indicated and others will rely just on questions and interpretations to lead the client. There is no right or wrong; it depends on what you feel is right for you. I am not the best fit for each and every person seeking therapy. My client and I have to find out if it’s a good fit during our initial phone consult and our first few meetings.

If you have any other questions about what to expect in therapy, please call or email me! I would love to provide some insight as you begin your therapeutic experience.

Love and Be Loved,

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