How Does Therapy Work?



Whether you’ve decided to take the first step and seek help, or you are still contemplating if therapy is for you, one place to start is understanding how exactly therapy works.  Psychotherapy involves communication between patients and therapists that is intended to help people, whether it is through talk therapy or activity based therapy such as sand tray, art therapy, etc.  It helps you identify and change troubling emotions, thoughts, and behaviors.  Much in the same way you may start antibiotic therapy to treat a bacterial infection, you start mental health therapy as a method of healing and improving your emotional and psychological well-being.

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What does therapy consist of?

Unlike a yearly physical or one-time appointment with a medical doctor for prescriptions, psychotherapy requires consistency and commitment.  It is not a one-time, fix-all appointment.   It is often used in conjunction with medication and other treatment options.  For example, someone may be prescribed anxiety pills but also attend therapy to help them learn to process the anxious feelings and work through them.  Therapy can include helping a person become aware of how they think and understand those thoughts, identifying ways and tools to help cope with triggering situations or thoughts, examining communication skills with others, and applying techniques that help develop problem-solving strategies.  Depending on your age and needs, there are many types of therapy including play, sand tray, CBT (Cognitive Behavior Therapy), EMDR (Eye Movement Desensitization and Reprocessing).

Therapy typically starts weekly, especially with adolescents and teens since it may take longer for them to open up and feel comfortable.  Once you have had four to five sessions of building rapport, you can start to transition to every other week or less often.  The number of sessions can vary from age to mental health needs, starting with about 6-8 sessions.  With adolescents and teens, it can take longer to build rapport with their therapists to feel comfortable enough to start sharing.  If you have had extensive trauma in the past, therapy can be ongoing.

Before your first session

First, so there are no surprises, do your research!  Read your therapist’s bio to see if you feel like they will be a good match.  Are you looking for certain characteristics in your therapists such as a certain gender, age, or race?  Make sure your therapist accepts your insurance or has a copay you can manage weekly.  You don’t want any surprises or additional stress.

What about deciding if you want to do virtual or in-person?  While many therapists do both, some are only on an online platform and some prefer in-person.   If your therapist does both, it provides great flexibility on those weeks you can’t attend in person but still want to attend a session.

What to expect in your first session

This is the first opportunity for the therapist to get a better understanding of your concerns and client goals with counseling.  The therapist and client are working together to determine that this is the best match for both and that the therapist specializes in the client’s needs.  Before your first session, most practices will send you intake forms that you can complete giving a brief history of major concerns.  You will go more into depth on issues you feel like you are having or symptoms you are not able to work through.  You want to bring up any important information you feel your therapist should know, such as a history of suicidal ideation, psychosis, self-harm, or any type of chemical or substance abuse.

This is your opportunity as a client to ask questions and set boundaries.  What is the therapist’s approach to therapy?    Is there something about the therapist you are NOT comfortable with?  For example, you have trauma or issues with older males and your therapist is an older male.  Or you were hoping for an older “experienced” therapist and a younger therapist walks in.  Share your concerns in the beginning so that you are comfortable speaking up anytime you are being triggered.  Permit yourself to let them know at any point in the future that if you don’t agree or are feeling conflicted with a discussion, you can speak up.  Therapy isn’t always about agreeing with everything being said, but learning to verbally disagree and talk through the emotions you are feeling and why.  Work through the barrier.  You should know by the end of the first session if you feel like you made any connection.  It may not be a breakthrough since this was a “get to know you” session, but it mentally sets you up for the next few sessions on how the therapist conducts a session.

Doing Couples Therapy?

Much like individual counseling, a couple’s first therapy session is a “get to know you” session, incorporating boundaries, asking questions, and learning the therapist’s approach.  Both partners will be required to complete intake paperwork, as each individual’s perspective can be different in the beginning.  Both partners must consent to being seen and both must be willing to work together.   Couples counseling cannot be one-sided with the commitment.  It takes both partners willing and ready to reflect, change, and work hard.

Co-Parenting therapy is another type of therapy involving two or more parties.   The goal is to learn to work together as a team for the benefit of the children.  Co-Parenting typically refers to parents who are not currently living together due to divorce, separation, or no longer committed to each other.  This is NOT couples therapy.  Step-parents can play a role in sessions as well.  As with couples or family sessions, all parties must consent before starting and be willing and ready to commit.

What about minors?

Adolescents and minors can take longer to build rapport.  The first session can be split between a parent and a teen, half the time with a parent and half with the teen.  This is to make sure everyone is on the same page with counseling.  Parents are also given a minor intake form to complete before the first session to share any concerns from the parent’s perspective.  Trust in any therapist/client relationship is very important, but even more so with teens.  Explaining confidentiality between the client (adolescent/teen) and the therapist should be discussed both with the teen and parent.  Parents should be given feedback on what to expect as far as what can and can’t be shared with them.  The family can request a parent session at any time but generally will meet every 4 to 5 sessions to review progress.

Completed your homework and ready to start?  Give us a call today to get started!  Still on the fence?  Let us help and walk you through each step.  You’ve got this!

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