If you are new to therapy, you may be wondering how do therapists really work and what should I expect? You may also begin to wonder, “How will I know that therapy is working for me?”, “Will I just begin to feel better or will others notice a change in me?”, “Will the change be obvious or will I simply sense that something is different or that my feelings have shifted over time?”
Treatment often varies, therapist to therapist, and person to person. And treatment often depends on the issue or concern that one has. It may also depend on the approach or theoretical orientation of the therapist. In other words, this is not a situation where one size fits all.
All the same, we do expect that therapy has a focus and a direction, and that there will be a time when therapy is no longer needed. One way that therapists have of determining the direction of therapy is by asking clients, “How would you know that you were better? What would signal your problems had been resolved?” Your answers to these questions can help you and your therapist begin to identify what success might look like and set goals to achieve that success.
Sometimes therapists will use objective measures to determine whether a client is making progress. For example, if a client presents with depression, the therapist may administer an instrument such as the Patient Health Questionnaire (PHQ-9) or the Beck Depression Scale to establish a baseline or current level of depression. Your self-report of your feelings and mood are important reference points against which to evaluate change. As treatment progresses, the therapist may re-administer the assessment at certain intervals to gauge progress.
Therapists also usually track patterns and frequencies of behavior, such as clients’ willingness to engage with others, expand their support system, or re-engage in activities that they had dropped out of.
Your therapist may well caution you against immediately interpreting feeling worse as a sign that therapy is not working. Change is often difficult and sometimes the issues we are talking about in therapy are painful. There may be topics that you have never allowed yourself to discuss before. You may have to deal with distress when finally taking on feelings and experiences that have been long buried.
Also, don’t expect change to happen overnight once you initiate therapy. It may take time to see the benefits of therapy depending. According to the American Psychological Association (APA), at least 50% of individuals seeking treatment will need approximately 15-20 sessions before they begin to report feeling better. Some conditions, such as personality disorders or co-occurring conditions (e.g., addiction and depression) may require longer treatment.
Remember – the goal of therapy is not to completely eliminate stress or feel happy all of the time – that is unrealistic. Life experiences are complex and sometimes traumatic – therapy is not going to magically make you feel complete happy and stress free. But you can look to therapy to equip you with important insights regarding your feelings and behaviors and give you tools to navigate difficult experiences and times.
If therapy seems to be stagnating or you are not making as much progress as you hoped, consider talking to your therapist about the process and what you are feeling. There may be many reasons why therapy has begun to stagnate and slow down. For example:
• Are you really focusing on what you need to address? Sometimes we come into therapy for one reason, such as a break-up or substance abuse, but there are deeper, more important issues to be addressed.
• Are you in need of a different therapist? Perhaps someone with a different perspective or approach can help you tackle the next step.
• Do you need to take a break from therapy? Sometimes taking a break from therapy allows you the time to absorb what you have learned and begin to apply it. You can always return at a later date.
If you believe that your situation or condition is not improving, then talk to your therapist. The main thing is to be able to ask questions or adjust focus if things don’t seem to be working well. Sometimes there is not a good fit between the client and the therapist. And because the therapeutic relationship is so important to progress and healing, you need a good fit.
If you find that you need to look for a new therapist, a recent article from National Public Radio offers some suggestions for finding a good match with a therapist:
Try to be clear about what you need help with and what it is that you want to resolve
Do some research so that you understanding training and credentials. Also, don’t be afraid to ask for a recommendation from a friend or primary care provider.
• Know your budget and what is covered by your healthcare provider.
• Ask questions to determine if they are a good fit for you in terms of personality, approach, culture, etc..
• Allow at least 3-5 sessions to really gauge the level of fit.
If you believe that you are ready to take that first step to finding a therapist (or think that you need something different) we are ready to assist you. If you want to schedule an appointment or simply ask questions, please feel free to reach out to one of our therapists at Family & Child Development.