Tips For Getting the Best Results from Therapy
Welcome to the world of therapy. It can seem mysterious at first - ‘What do you talk about? How do you know if you are getting better? Do you have to lie on a couch? How long will it take? What do all the initials after the therapists’ names mean? Do therapists prescribe medications?’ All good questions and you will get slightly different answers from different types of therapists.
Within our office alone, there are LMFTs (Licensed Marriage and Family Therapists), an LCSW (Licensed Clinical Social Worker), LPCs (Licensed Professional Counselors), and additionally an RPT (Registered Play Therapist). People might have one or more ‘primary’ licenses and, in addition: specialized certifications.
What’s the difference between a psychologist/psychiatrist? Psychologists provide a wide array of services based on their specializations and, in addition, do formal testing evaluations. Psychiatrists are medical doctors who have specialized in psychopharmacology and prescribe medicine for mental health conditions like depression, bipolar disorders, and anxiety. Some general practitioners also prescribe mood management medications depending on how long they’ve known you and what their specialties are. Therapists and psychiatrists often work together for collaborative treatment.
Who should I go to? First and foremost, the therapist you choose should feel like a good fit personally. Read their biographies on their website, call and talk to them for a few minutes, and then give it a try. Due to confidentiality, it’s less typical to find an online review. Ask friends or trusted professionals for recommendations.
If it doesn’t feel right after the first session, you may need to try one or two other therapists to find what you are looking for. The healing comes from a combination of the relationship with the therapist and the techniques the therapist has specialized in using. This can vary widely. Examples are:
CBT -Cognitive Behavioral Therapy- focused on challenging common thought distortions
ACT -Acceptance and Commitment Therapy- which shifts your thinking towards being more ‘mindful’ (in the here and now) and developing awareness about what your mind ‘fuses’ with or gives energy to. We have approximately 6-7,000 thoughts a day; which thoughts do you choose to pay attention to? Are you responding with your reactive mind or your wise mind?
DBT -Dialectical Behavior Therapy- teaches mindfulness and self-soothing, helps us to challenge our thought distortions, and adds learning to think about others’ points of view, which makes others’ actions seem less personally directed. DBT is great for impulsiveness, highly emotional people, and teenagers.
EMDR -Eye Movement Desensitization and Reprocessing- trauma treatment (more complicated to explain but very effective and research-supported). It evolved from working with veterans who have PTSD.
And of course, other therapists specialize in marital therapy, family therapy, and play therapy.
When starting the therapy process, here are some helpful tips to keep in mind:
1. Identify what you hope to get out of therapy. Your therapist will help guide you towards what they think is the best match between your personality and your treatment goals. It is important that you know this is a collaborative process. Express your needs, ask questions, read books, and do your homework assignments. Go to your first appointment with an open mind and understand the therapist will ask questions to help you define your goals. This may stir up some feelings, and many people shed tears from relief in the first session. Share any curiosity about specific approaches you’ve read about in your session. Ask questions about confidentiality, the projected length of treatment, etc.
2. Schedule sessions at a good time. Most therapists do 45-50 minute sessions once a week. Try and work with the therapist to find a routine time you can count on, which will help you remember your sessions, and to give your experience some predictability. Most therapists ask for a commitment and charge for missed appointments. Understand this is because they are holding a ‘spot,’ and they do a lot of behind-the-scenes preparation for your appointment- research, treatment planning, and documentation. Additionally, therapists know that after the first 2 to 3 appointments, you’ll start feeling some relief and an increase in hopefulness. It is common for clients to lose momentum for the work once they get some initial relief. But don’t stop! This is when the ‘real’ work happens. It is human nature to resist change. It’s uncomfortable to do things a new way, and doing things differently is hard and takes work. The cancellation policy encourages you to stick with things and commit to a course of treatment. Try and find a time you can give the session your full attention. Know that you might need some time to decompress emotionally after your sessions.
3. Be honest about your symptoms. Some issues seem embarrassing, and it can be hard to fully acknowledge the depth of your struggles. Therapists hear people’s private struggles for a living. It is highly unlikely that you will bring in information that they have not previously heard or addressed. There are strict rules protecting the confidentiality of the information shared in the therapy room. Therapists are very aware of common ways people numb their pain, including using drugs and alcohol. Therapists understand those suicidal feelings can be different than suicidal plans, and they will assess all factors before recommending bigger interventions. Most of the time, hospitalization is a last resort. Cheated on your partner? Again, a symptom of distress. Obsessional thoughts? Eating disorder issues? All of these point towards specific patterns we need to address. Marriage with no intimacy? Again, symptomatic of specific and general issues. When you take the steps to finally address your struggles head-on, be honest with yourself and your therapist so that your work can authentically begin.
4. Talk about the therapy relationship. Therapy can be both a lecture and a laboratory. When the issues you have outside of therapy show up inside of therapy, it is a wonderful place to have them compassionately addressed and explored. You can then learn healthy ways to express those needs. Afraid of seeming ‘needy’? Afraid of asking for too much? Worried about what your therapist thinks of you? All of that is information that helps the process. It’s a huge personal step in therapy to be able to talk about it.
5. Set expectations or markers to define successful changes. Establishing measurable markers or behaviors to watch for that indicate successful treatment will help you feel more motivated. Think about physical therapy - you are looking for better movement and less pain... In psychotherapy, you may be looking for calmer/ less frequent fights in your relationship, using assertiveness tools, fewer episodes or shorter periods of anxiety or depression, practicing self-compassion - you get the idea!
6. Do the work outside of sessions. Are you supposed to practice something? Read something? Keep a journal? Go to 12-step meetings? You get out of it what you put into it. If you strongly dislike something that was suggested, give the therapist that information. We are very adaptable. It’s our job.
7. Set boundaries around therapy. You get to decide who you would like to talk to about your therapy experience. If you decide to discuss, choose people who will encourage and support you and hold you accountable for your commitment to do this work.
A few other dos and don’ts:
Don’t obsess over being polite.
Don’t keep things to yourself.
Be your most authentic self.
Let your emotions show.
Try not to focus solely on symptom relief.
Don’t worry about the clock.
Establish a process for check-ins. (Know how to reach your therapist if there is a crisis)
Expect to drag your feet sometimes.
Don’t expect your therapist to tell you what to do. Therapy is less about advice and more about helping you make good decisions for yourself.
Be Patient.
(above ten tips from Kelton Wright, ‘Tips for Getting the Most Out of Therapy”, March 2, 2021)
Once you get the therapy process started, it is almost always more comfortable and natural than you imagine it to be before you make the first appointment. Finding the courage to make the first appointment is the hardest part. It can feel so empowering to finally take the step to tackle some of the patterns, behaviors, relationships, or emotions that stand in the way of living the life you want. You do not have to be an expert in the therapy process to start. Reach out to a therapist, and they can guide you from there. You are worth it.
