If you have never been in professional therapy before it can seem like a mystery. You may ask yourself these questions.
Getting the most out of therapy requires an alternation of spontaneity and focused reflection. It’s important to let your feelings and thoughts flow freely, but it’s also important to slow down, step back, and reflect on what those thoughts and feelings tell you.
ALL YOU NEED TO KNOW ABOUT STARTING AND ATTENDING THERAPY
CHOOSING A THERAPIST
It’s important to be able to distinguish between the therapy credentials held by professionals in therapy.
DOCTORS
DO YOUR RESEARCH
INITIAL ASSESSMENT OF YOUR CHOICE
TAKING CARE OF BUSINESS
THERAPY IS A COLLABORATION
Therapy is All About You
Set goals for change
Say anything you want in therapy
Talk about therapy in therapy
Ask What do I Want? How do I Feel?
Ask any question you have
Challenge therapy jargon if you don’t understand
Go deeper with thoughts
Save the deep issues and honest thoughts and feelings for therapy
Don’t expect or pressure the therapist to fix you or tell you what to do
Do the work outside your sessions.
Set boundaries around therapy
- Can I really be honest?
- Will I be judged or scolded or talked down to?
- How do you know if I am getting better?
- I am ashamed or embarrassed to talk about it. How do I tell the therapist the real story?
- Is therapy really confidential?
- What if I don’t like it?
Getting the most out of therapy requires an alternation of spontaneity and focused reflection. It’s important to let your feelings and thoughts flow freely, but it’s also important to slow down, step back, and reflect on what those thoughts and feelings tell you.
ALL YOU NEED TO KNOW ABOUT STARTING AND ATTENDING THERAPY
CHOOSING A THERAPIST
It’s important to be able to distinguish between the therapy credentials held by professionals in therapy.
DOCTORS
- PSYCHOLOGIST
- A psychologist will have a “PhD” or “PsyD” after their name.
- Psychologists have the highest level of training in psychology and providing therapy.
- They hold a doctorate in psychology, and typically have between 6-8 years of graduate study.
- Psychologists must be licensed by the state in which they practice, and licensing guidelines are typically very strict.
- PSYCHIATRISTS
- A psychiatrist will have an “MD” after their name.
- Psychiatrists are medical doctors that complete their general medical training, and then go on to specialize in psychiatry.
- Most psychiatrists focus on prescribing and managing psychotropic medications.
- Although psychiatrists sometimes provide therapy, they typically focus on medication management, and often work in collaboration with a psychologist who provides the therapy.
- LICENSED PROFESSIONAL COUNSELOR (LPC or LCPC):
- Licensed Professional Counselors are required to complete a two-year master’s degree in counseling or clinical psychology (M.A. or M.S.), two years of supervised post-degree experience, and to pass a written professional counselor’s examination to be licensed.
- LICENSED CLINICAL SOCIAL WORKER (LCSW):
- Licensed Clinical Social Workers must complete a two-year master’s degree in social work (M.S.W.), two years of supervised post-degree experience, and pass a written social work examination to be licensed.
DO YOUR RESEARCH
- Choose a therapist carefully.
- Know the kind of therapy that works best for PTSD and make sure the therapist you choose specializes in it.
- Research different types of therapists and approaches and select several clinicians who offer what you seek.
- Decide on the type of therapist you will feel most comfortable with (male or female, young or seasoned, progressive or traditional) and the credential type (Psychotherapist, Psychologist, Counselor, Social Worker etc).
INITIAL ASSESSMENT OF YOUR CHOICE
- If after one or more sessions with your initial choice you find yourself uncomfortable or unsafe with the therapist then you out have the option to switch to a new one.
- Do not feel bad about this. It is vitally important that you feel like you can say everything you want and need to in your appointments and if you hold back then you are going to hurt your potential success.
- It is recommended to attend at least three sessions to determine if it is a fit unless it is very clear after the first or second session that the therapist is not a fit.
TAKING CARE OF BUSINESS
- It is recommended by many therapists to handle “business first,” which includes payment, scheduling, insurance and any other logistics. This is much easier than trying to rush through it on your way out the door or after having a big emotional breakthrough.
- Schedule sessions at a good time.
- This means scheduling your appointments when you can give them full attention.
- For example, avoid scheduling a session in the middle of a work day when you have time restrictions or distractions.
- Give yourself time and space to process and reflect after the therapy hour so schedule it for when you don’t have to rush back to work.
- Always talk about any issues you have about your therapist with them. This is vital because problems you have with her may have an impact on any other work you want to do. For example, maybe your therapist angered you last week. Maybe you’d like to end therapy. Maybe you have a question about what you talked about last session. Raise these concerns in the beginning of your session, so you have plenty of time to process them. Oftentimes confronting the issues with your therapist can strengthen the therapeutic collaboration and improve therapy success.
- Forget the clock. Never show up late but rather aim to show up at least 10 minutes early. Therapy hours are 50 minutes. Don’t be a clock watcher. Let the therapist be in charge of ending the session on time. You've got enough to think about during the session, the therapist can be responsible for ensuring you receive every minute of the session.
- Check on your status any time during your therapy. This is a two-way discussion with both of you sharing your thoughts.
- How are the two of you working together?
- How well do you understand each other?
- Is therapy helping or hurting at this point?
- Tell the therapist if there is a problem with therapy The biggest mistake you can make is not to talk to the therapist when there are things you find uncomfortable about the interaction. You may be afraid to challenge or threaten your therapist, but they are professionals, and will be able to handle a negative reaction. If the therapist doesn’t handle it well that is a sign that you should talk to others or seek another consultation. Your therapist should be open to owning his or her part of whatever happened, as well as helping you understand your part.
- Speak up if you are thinking about ending therapy. If you are going to end your therapy for reasons like not making the progress you wanted, are having financial challenges or if there are personality clashes. If the therapy isn’t going well and you feel stuck, or not heard or judged or dismissed speak up about it. Even if something in therapy confused or hurt you, it’s good to practice being open about it. If the therapist isn’t a good match, this gives him or her an opportunity to offer other options.
- Be very honest about your relationship with your therapist. No therapist is perfect but question what it is that your therapist doing that works and doesn’t work? Is he or she leaving things out that you had hoped would be part of your work together? Do you find him or her cold? Intrusive? Not challenging enough? Too challenging? Do you worry that you like the therapist too much or that you depend on him or her too much? This sort of direct communication not only helps your therapist help you it also helps you get comfortable with parts of yourself that you usually hide.
THERAPY IS A COLLABORATION
Therapy is All About You
- Therapy is like taking a course where you are the only topic. There are no agenda items that don’t pertain to you and your needs. The therapist is there solely for you.
- You may find this uncomfortable if you are used to putting the needs of others before your own. If you let go of that you will have a more positive result.
Set goals for change
- Establish baseline goals with your therapist for positive change and then so track your progress to stay motivated. These goals include anything behavioral, emotional or situational. Goals are like signposts, positive or negative, telling you what direction you’re moving toward.
Say anything you want in therapy
- Some people censor themselves in therapy for fear of judgment or appearing impolite. You need to be able to say everything you need to say because that collaboration is what leads to progress.
- For example, a client discloses that they didn’t want to come to therapy that day. This opens the door to honestly discussing how they feel about therapy, making adjustments that’ll help or clarifying what makes that day feel so difficult.
- Being a ‘good client’ doesn’t mean being on your very best behavior, it means being the most authentic, unfiltered version of yourself.
Talk about therapy in therapy
- The issues you have outside of therapy often show up in session, he said. This is helpful since it gives you an opportunity to practice healthy coping and relational skills in a safe environment with your clinician.
- For example, if you’re passive you can practice being assertive. If you’re afraid of seeming “too needy” or you feel like you need to be strong for others, you can freely discuss it and receive guidance and support on the specific issue.
- Bring all of your emotions into your sessions. Your tears, your anger, your fear, your shame, and disgust. Positive or negative, good or bad, significant or not - bring them all.
- Notice which ones you try to avoid and work on understanding why.
- Be brave and honest, be willing to step back, contain them, and be curious without letting your emotions get out of control.
Ask What do I Want? How do I Feel?
- These are two questions can launch a session if you feel shy or don’t know what to say. If you find yourself lost and don't know what to talk about, revisit these questions and you will get the most you can out of the session.
Ask any question you have
- Clients sometimes censor their questions because they believe asking is against the rules.
- You're allowed to ask whatever you want.
- Want to know a personal detail, professional opinion or an explanation for something she said or did? You won’t know if you don’t ask. You may not get a straight answer, but you should get a reason why not, and you might learn something about yourself in the process.
- Ask why when you need to know. If you need to know why you behave or think or feel the way you do then ask that.
Challenge therapy jargon if you don’t understand
- Some therapists have been doing this work so long they assume everyone knows what they're talking about. If the therapist says some gibberish you don't understand then ask them to define the words for you or to explain it in layperson terms.
- Don’t be embarrassed if you don’t know because if you don’t ask then you will be confused and that will not help you progress.
Go deeper with thoughts
- If you find yourself running through mundane topics that don’t pertain to your real issues or you experience or there are awkward silences then question if there's a deeper issue you're avoiding.
- Ask yourself honestly what it is you're not talking about and talk about it.
- Discuss what you're discovering about yourself.
- Take the time to explore how you really feel, what you are afraid of, and what you can’t seem to find the right words to explain.
- Push beyond it is what it is and ask deeper questions. Try: "I wonder why I ...” or "deep down I really feel...” or “I’m afraid or uncomfortable to admit this but...”
Save the deep issues and honest thoughts and feelings for therapy
- These thoughts or questions are best discussed first with the therapist and not people outside your session. You don’t have to keep anything from your trusted loved ones but to really get help bring it to therapy first.
Don’t expect or pressure the therapist to fix you or tell you what to do
- In a crisis we often want relief as soon as possible and feel like we’ve run out of options. When a person feels really uncomfortable, they might put pressure on a professional to “fix” them.
- Therapy is not about them fixing you. Pressuring the therapist to fix you will leave you feeling more hopeless and frustrated. And getting the wrong kind of advice can rob you of the opportunity to find your own solutions and develop more confidence when faced with challenges.
- Instead of pressuring the therapist, own your issues and your progress. It’s a guided journey of self exploration not a plan designed by the therapist that outlines what he or she expects you to do.
- Collaborate with the therapist rather than expecting him or her to solve it for you.
Do the work outside your sessions.
- A therapy session typically lasts 50 minutes; however, in order to get the most out of it, it’s important to think of therapy as 24/7.
- Therapists recommend keeping a journal to reflect on your last session, prepare for your next one, and generally pay attention to your thoughts and feelings throughout the week. Bring it to your session so you have your talking points.
Set boundaries around therapy
- Create boundaries around who you talk to about your therapy. This might mean not sharing details of your sessions with people who would not be supportive or who would judge you or put you down for seeking professional help. You also don’t want to open to someone who gives unsolicited advice.
- When setting boundaries, the key is avoid creating pressure on you that undermines your own self-trust, hurts your feelings or confuses you.