Psychotherapy treatment is a mystical, magical healing journey.
Almost, but not quite.
Therapy looks different for different people.
A variety of therapy options
In today's rapidly changing society, there are a variety of therapy options. You can get psychotherapy treatment in an office. There can be a couch. Or ... we can talk through computers. Your clinician can join you at the hospital, simply by clicking a button. There are apps that have been developed specifically to address common mental health concerns and issues. Given how many ways therapy can look, and how many tools we have at our disposal, it is natural to wonder what to expect in a psychotherapy treatment relationship.
At its heart, therapy is a healing relationship. When it comes to the nuts and bolts of how it works, it is both an art and a science.
As the field of psychology has evolved, clinicians have been able to design different types of interventions, and to test them. What this looks like, in a nutshell: researchers write out a treatment protocol. Clinicians follow this protocol. Clients complete measures before and after trying out the elements of the protocol, and then we can see if their symptoms improve.
Practicing psychologists are typically trained in multiple different therapy options and protocols that are "evidence-based," i.e. research shows that doing the steps in the protocol in a certain order helps to alleviate distress. For example, I am trained in therapies such as Cognitive Behavioral Therapy or Acceptance and Commitment Therapy. This means that I can pull practices from these therapies to help you feel better, and do so with some confidence, because these interventions have helped other people feel better, too.
Which of all the therapy options is best for me?
First, let's soften that thinking a bit. Let's notice the good/bad, "all or nothing" thinking that may be operating, and take comfort in the alternative thought that we are living in an age where there are multiple solid options for your care. All we need is a place to start, and that first step is with you.
Placing trust in another person can be hard. What will make it easier for you? Would you like to meet face to face, or by video? And, are there particular techniques that you know work well for you, to help you feel better? Perhaps you need support while weaving those back into your life. Alternately, are there new skills that you are naturally curious to learn more about? Perhaps you are drawn to mindfulness, or you have heard that working on communication skills in therapy can be helpful.
You already have some wisdom about what is right for you, and you have every right to talk about this with your clinician as you begin therapy.
Second, there are some nitty gritty details that do help practicing clinicians choose a starting spot. For my part, in the first few sessions I listen closely for information about current stressors that are pulling focus in your life. As I hear more of your story, I scan my mental database of therapy interventions for specific skills that could be helpful for you to practice. I will "gut check" with you to see if you feel that the skills I'm thinking about would be helpful for you, too. Then we'll put together a potential plan and timeline for care. Of note, this timeline can change if you need it to, as can the focus of the therapy. You have a lot of power and choice. Your clinician's job is to act as a helpful guide, so that you know what your options are. Together, we will do the best we can with the information we've got, as we think through the pros and cons of any potential approach to treatment or change to a treatment plan. We make choices collaboratively.
Psychotherapy treatment is a partnership
The art of psychotherapy treatment lies within our collaboration, and this is why fit really matters in our work. It takes time and patience to figure out how to weave what we know works for other people into your individual life; as such, feeling safe communicating with your treatment provider is extremely important.
All along the way in psychotherapy treatment, the balance that I am working to strike is to honor your expertise and to bring you my own. You know best what is going on in your life and how the skills we are practicing are working; your voice and your lived experience matters. I have read (a lot of) books and talked to a lot of people. My hope is that together, with our shared knowledge and experience, we can create an environment where it feels possible to have an ongoing conversation about how things are going, and safe to heal.
Being able to have collaborative, empowered discussions about your care in a context that is safe, trusting, and respectful is part of how the therapy relationship is healing.
Action step: Now that you have some of this background information about how I approach the treatment planning process, take a look at this Treatment Plan tool. This tool is designed to help you begin to clarify your goals for your care. It won't substitute for a clinical conversation, but my hope is that it will help you feel organized, grounded and centered as you take steps towards something new.
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