Therapy 101: How does therapy work?
We often see therapy portrayed in TV and movies or hear jokes about therapy. Maybe we know a friend or family member who sees a therapist or maybe we even follow some therapists on social media. But what is therapy actually like? What do we do? What are we supposed to say? Let’s break it down.
The Consultation
Before your first session, you’ll get a chance to talk with your potential future therapist on the phone. Let’s think of that consultation like the lead-up to a first date. The conversation is brief, but it’s the chance for you to get a feel for what spending an hour with this person might be like - does it get a little easier as the conversation goes on? Are there any immediate turn-offs? What’s the general feel that you get from the other person? One way to help you feel this out is to think ahead of some questions to ask to get at what’s important to you. For example:
What’s your approach to therapy?
What’s your experience in working with people who share my same identity or have had similar experiences as me?
What’s your office like?
How do you keep your records?
Do you diagnose all of your clients?
If the fit feels good enough from this initial conversation, then maybe it’s worth going for that first session (date). Are we still following this analogy? K, good.
The First Session
The goal for this first session is to start getting to know each other and collaborating around what you want therapy to look like for you. This first session or two may feel a little more question heavy than future sessions, plus we’re also going to talk about things like confidentiality, privacy, and the potential risks and benefits of therapy. And remember that date analogy? Same rules apply: at the end of the session, you get to decide whether you want to meet again or not. If so, you’ll get to decide when the next session is. It’s typical to start out by meeting weekly, but advocate for what works best for you, whether that’s weekly, twice per week, every other week, etc. If the fit isn’t feeling right and you don’t want to schedule another session, that’s ok too. Let your therapist know and they’ll provide you with a few referrals to other therapists that may be a better fit. No hard feelings, we promise.
What happens next
Moving forward, sessions will depend on what you need that day. Some days you may come in with a clear idea of what you want to talk about or work on, whereas other days you may look to your therapist for ideas. During the 50 minutes, we may practice skills or explore patterns of thoughts, feelings, and needs. We may breathe together, sit together, draw or create together, or try out a combination of all of the above. Some days as therapists, our job is really just to listen. Regardless of the specifics, the structure stays the same: the space is yours. You get to decide what to share, how much to share, and when. If your therapist brings up something you don’t want to talk about - it’s ok, even encouraged, for you to say your version of “I don’t want to go there right now.”
Along the way, we’ll also make space to talk about our relationship - how therapy is going, if you’re getting out of it what you were hoping to, are there things we could be doing differently, etc. We mean it when we say that feedback is welcome!
Is this working?
The goal of therapy can’t be to feel good or happy all the time. We’d be setting each other up to fail if it was. What we believe instead is that growth happens gradually, over time, in a mostly non-linear fashion. However, depending on what your specific goals are, that growth or change may not always be easy to recognize. Here are some sneaky clues that show us that therapy may be working:
Increased awareness of our thoughts, feelings, urges, desires, needs, and patterns
Increased ability to identify and actually feel our feelings
Increased intention in our decision making and responses to things
Practicing skills outside of session that we’ve learned in session
Setting and maintaining boundaries in our relationships
Increased sense of control over our lives
Speaking more kindly to ourselves
Part of the process in therapy will also be working with your therapist to identify and recognize where the growth is happening, or not happening, for you. Growth is a process that without a doubt takes time and work - but we sure think it’s worth it.
Saying goodbye
How long someone stays in therapy is a personal decision influenced by many different factors. Some people are in therapy to reach specific goals and once those goals are reached, therapy naturally concludes. Some people consider therapy to be part of their ongoing routine of self-care and continue without the desire to have specific, measured goals. Some may reach a point with their therapist where they have done the work with them that they feel they can do and are ready to try therapy with someone else. Some people realize they aren’t actually ready for therapy or need a break from it. The scenarios are many, but the common thread is that you get to decide. Your therapist won’t be mad or take it personally when you are ready to end. We’ll talk about it and come up with a plan to make the transition feel as safe as possible, with you leading the way based on what you need.
I should also note that life happens and sometimes those goodbyes are less planned, like you make an unexpected move, or are out of your control, like your therapist has to take an unexpected leave (yup, we’re human too). Even in those less planned scenarios, we will still be there to support the transition as best we can alongside you.
Coming back
Therapy is not usually a one and done type of deal. Coming back to therapy after previously meeting goals is not a sign of failure and does not erase previous progress made. Rather, as our lives and our needs change, we’re likely to have different seasons where therapy could be helpful. How do we know when that is? Maybe you catch yourself falling back into some old patterns or habits that aren’t feeling great. Maybe there has been a new stressor or life event that you’d like to process with someone neutral. You may decide to return to your previous therapist, or you may decide to try someone new, perhaps someone with a different approach or specialty. The choice is yours!
While progress is being made in decreasing the stigma and awkwardness about talking about therapy, a lot of murkiness remains around what actually happens in the therapy room. We’ve been on both sides of this process, as both therapists and clients, and we hope this information demystifies the process for y’all, even just a little.
Have questions or requests for future topics? Get in touch! Interested in scheduling a free consultation with us? Head here to fill out our quick and easy consultation request form. We can’t wait to hear from you!
Warmly,
Sammy & Miriam
