People who aren’t familiar with psychotherapy may feel anxious and not be sure what to expect, anticipating their first appointments with a new therapist. Questions like: so, we just sit & talk?; will I have to spend lots of time discussing my childhood?; is this even going to work? are common. Anxiety levels can increase as the appointment date draws nearer, and that anxiety can prevent some people from even making the appointment in the first place. This blog addresses some of the questions and misconceptions about psychotherapy sessions, and shares insight into what you can expect from your sessions, and how to make the most of them.
_________________________________________________________
COMMON FEATURES OF A PSYCHOTHERAPY SESSION
Therapists, clients and their therapeutic relationships are all unique, so there’s no single description that fits all therapy sessions, but basically, you should consider sessions to be your personal problem-solving workshops! After the first few appointments together (where you share info and get to know each other), therapy is a time for you and your therapist to unpack and address whatever issues are on your mind:
- After initial discussions about your situation and goals, your therapist will create an individualized plan for working together, which you’ll review together and have the opportunity to ask questions about.
- At the beginning of a session, your therapist will typically ask how you’ve been since the last time you met, and if there are specific topics you’d like to discuss.
- You’re invited to speak openly and honestly in therapy, and your therapist will listen without interruption, criticism or judgment.
- Over time, your therapist will guide discussions & interventions, and provide constructive feedback to help you address issues to improve your mental health.
- From time to time, your therapist may assign homework for the next session (e.g. completing worksheet exercises, journaling, engaging in activities that help you explore growth edges, creating personal goals and strategies, etc.)
- During subsequent sessions, you & your therapist share progress, address areas where you need forward momentum, and celebrate / build-on your successes.
- Some therapists take notes during sessions; others take notes after sessions.
- For ethical / professional reasons and to comply with regulatory privacy laws, your conversations are held in strict confidence.
Some therapists employ interventions such as music or art into their treatment. Others incorporate life-coaching, meditation, visualization, or role-playing exercises. But regardless of the approach your therapist uses, they should listen without judgment and engage with you to find solutions to the challenges you’re facing.
MISCONCEPTIONS / THINGS TO KNOW ABOUT PSYCHOTHERAPY SESSIONS
- There’s usually no couch (and if there is, you don’t have to lie down on it). This cliché lingers because during the heyday of Freudian psychoanalysis, it was believed that patients were more open to sharing when they lied down on a couch and didn’t look at their therapist. Today, therapists are more focused on creating a therapeutic relationship with their clients and typically have cozy chairs, sofas, pillows – even plushies – to help clients feel comfortable and open to sharing during sessions.
- Therapists do more than just sit & listen. The stereotype of a therapist barely engaging with their client or giving them the “blank stare” is another holdover from the early days of psychotherapy. Today, therapy is an interactive process and is more based on the relationship between the clinician and the client.
- Therapists don’t really ask, “how does that make you feel?”. This is a film / television stereotype. In reality, it’s a rather useless question that: (1) has little therapeutic or probative value, (2) can potentially be triggering for the client, and (3) fails to consider the context of what’s going on for the client and how it’s impacting them in their day-to-day.
- Therapy isn’t all about your childhood. Some people worry that their therapist will connect everything to subconscious “skeletons” from their childhood. While you might talk some about your childhood experiences if it’s relevant, today’s therapeutic approaches are more evidence-based and practical. The focus of your therapy will more than likely be your present-day life and the future you want to create.
- There are no “eureka!” moments in therapy. Unlike in TV shows & movies, there’s no big breakthrough in psychotherapy where you overcome all of your issues with a single big ugly-cry. Realistically, therapy is more like a series of small breakthroughs. While you may certainly come to major realizations, those moments don’t immediately resolve all of your reasons for coming to therapy.
- Your therapist won’t tell you what to do. Therapists will guide you to solutions they believe are best, but they typically don’t make direct suggestions about what to do – nor should they. It’s up to you to apply what you learn during sessions.
- Therapy does not “cure” you. Psychotherapy is not a medical treatment where the “illness” is eradicated by a cure and doesn’t return. Therapy helps clients uncover and develop strengths, and learn new skills that will allow them to deal with the challenges that arise in everyday life. A successful psychotherapy experience means you have developed the inner and outer resources to deal with those ups and downs. It is mainly a tool for people to cope with their issues.
- Therapy doesn’t have to be a “forever thing”. People who are new to therapy sometimes worry they’ll be “stuck” doing therapy for years. While there’s nothing wrong with continuing therapy long-term if it’s working for you, you don’t have to. During your initial sessions, you can talk with your therapist and get their thoughts on shorter-term approaches that could work for you. The goals for therapy that you and your therapist create can also including a plan for eventually transitioning to less-frequent sessions, and then for leaving therapy. Therapy is really about whatever you need, ranging from a one-time conversation or short-term source of support, to an ongoing experience that can optimize your long-term mental, emotional and physical health.
- Psychotherapists don’t prescribe medications. Only doctors and psychiatrists can legally prescribe mental health medications (such as antidepressants, mood stabilizers, etc.). Your psychotherapist might refer you to a psychiatrist if they believe your mental health symptoms warrant medication, but the treatment you receive during sessions with your therapist will involve psychotherapy only. (And FYI, psychotherapists don’t receive compensation for medical referrals to psychiatrists).
GETTING THE MOST FROM YOUR THERAPY SESSIONS
Now that you know more about what psychotherapy sessions are all about, here’s a few ways to help you get the most from sessions with your therapist:
- Work with a therapist who’s a good fit for you. It’s important to find a clinician who is a good match, personally. Feeling comfortable and being able to connect on a personal level with your therapist can increase the likelihood that you’ll reach your goals for therapy together. For more info, click here for points to consider when choosing a new therapist.
- Be willing to engage in the process. You get out of it what you put into it – and making progress isn’t always easy. You have to be willing to be vulnerable and honest, to be open to new ways of thinking, and to giving it time. It’s also important to consider your goals for therapy (e.g. healing from a trauma, practicing a more mindful life) and to share that info with your new therapist.
- After & in-between sessions matter, too! The most important aspects of therapy occur outside of your sessions. For example, feeling emotionally exhausted after a session is not only normal, it’s also a sign that you’re putting in the work, and that it’s working. Following through with between-session homework assigned by your therapist (e.g. worksheet exercises, journaling, practicing a skill discussed during therapy) is also important. The ultimate goal of psychotherapy is for you to take what you learn during your therapy sessions and apply those insights to your daily life in-between sessions.
Don’t let stereotypes or anxious feelings about therapy keep you from getting the support you need, or from engaging fully with your new therapist. Modern psychotherapy uses principles that are proven, practical, and more short-term than traditional psychoanalysis. It places value on the therapeutic relationship between client and therapist, and holds space for your involvement in creating the goals and strategies for therapy. Through the process of psychotherapy, you’ll discover new things about yourself and learn how to strive for the life and future you want. By sharing this information, we hope to give you the confidence to take that next step on your mental health journey.
_________________________________________________________
IntraSpectrum Counseling is Chicago’s leading psychotherapy practice dedicated to the LGBTQ+ community, and we strive to provide the highest quality mental health care for clients of all ages and across the spectrum of identities. For anyone looking for affirming and validating support or healing with any issue, please click here or email us at help@intraspectrum-chicago.com.
