Things you might not know about therapy. . .

1). Not every therapy is right for everyone.

While many therapies, such as CBT (Cognitive Behavioral Therapy) and Psychopharmacology ("psych meds" or "antidepressants, etc."), work for a great number of people reliably, there is no guarantee that any treatment or technique will work the same way, or as effectively (or "at all" for that matter!), for any given person or concern. This is true not only of psychotherapy, but also in other fields such as the general practice of medicine .

2.) You should feel good/better all the time if the therapy is "good."

This is a tough one and it is often misunderstood. Although therapy does typically help improve how you feel the majority of the time, it is not uncommon, particularly in the treatment of trauma, that a person could revisit symptoms, imagery, thoughts and other triggers that remind them of, or are associated with, unpleasant emotions and situations. "Good" therapy does not avoid this often necessary part of treatment, but rather provides a safe, supportive and healing relationship in which to explore, reprocess, desensitize and recover from current and past negative symptoms and experiences.

3.) Therapeutic growth and recovery is linear i.e. "always goes forward."

It is a truth about human growth and development that there are sometimes periods of "forward growth" followed by some sliding back before new growth continues again. In the recent past, some psychological scholars and practitioners identified and labeled this slipping backwards as "regression." Psychological growth is usually better understood as occurring in waves of growth followed by periods of temporary "regression" or "pulling back," which are then frequently followed by again by another push of forward growth. So, although at times in therapy, it may feel as though progress is "slow, "or that success is "fleeting," the overall direction of growth is typically a positive one with true psychological gains, growth and development being maintained over time and well into the future.

4.) A "good" psychologist should know exactly which therapy or technique I need

immediately.

This is another common misconception. Like most experiences in life psychotherapy often requires some "trial and revision" to adequately address an individual's unique and specific concerns. While psychologists are typically trained in a multitude of techniques and intervention strategies, as with other treatment options, such as prescription medications (e.g. antidepressants, anxiolytics, etc.), it is often wise to for a patient and psychologist to "try on" several different approaches and strategies, that are supported by the current research literature, in order to determine which approach provides the most symptom relief with the greatest ease, best fit and most acceptable level of comfort. It is my belief that although there are many general and broadly effective treatments that address certain types of problems and symptoms, such as CBT, DBT, or EMDR, each client's unique personality and situation deserve careful attention and care that tailors the components of an intervention, technique, or treatment approach to that individual's unique style, history, preferences, desires and needs. In good psychotherapy you can be sure that, one size" does not usually "fit all."

5.) How long do I need to be in psychotherapy in order to feel better?

The answer to this question depends on many factors. A psychologist's expertise, training and experience can certainly play a role, as can a client's readiness for, and motivation and engagement in, the process of psychotherapy. Some current research reports that a small percentage of folks will feel noticeably better after simply making their initial appointment with a psychologist! Most folks, however, tend to notice the first improvements in mood, and attitude after about 6-8 regular weekly sessions. Recent research also reports that, for a typical case of depression or anxiety, 28 sessions of CBT, IPT and some other forms of therapy, was the norm for approximately 85% of clients to feel, and report, that they had made adequate clinical progress and that therapy had been successful in resolving many of their symptoms. It is important to note that this number should be take only as a general trend and not a hard and fast "rule." Due to the complex nature and diversity of psychological symptoms and concerns, it is not unusual for some clients to engage in therapy for 6-12 months or more before they feel confident in reporting that they have made significant gains and recovery from their mental health symptoms and conditions. This is particularly true in cases that involve multiple diagnoses, significant trauma, recovery from multiple stressors simultaneously or recovery from certain types of past abuse or neglect. It is also important to note that some clients choose to work for a limited period of time, say several months, to resolve a particular problem, symptom or situation, and then leave therapy to return later for another "round" of sessions to address any remaining, or new, concerns. Psychotherapy can be emotionally demanding and stressful work and therefore it is often desirable, and advisable, to for one to take a break from therapy following a success and return at a later date to continue one's therapeutic journey. If you should find that you are not improving in psychotherapy as you had expected, or wanted, it is critical that you bring this to the attention of your therapist as soon as you are able so that the situation can be discussed, explored, and if possible, corrected so that you are able to experience the recovery and change that you desire.

6.) People only go to therapy to discuss their problems or because they have problems.

In truth, people attend therapy for many reasons. For many, getting treatment for a mental health condition or for reducing symptoms is a primary goal. However, clients frequently see a psychologist for relationship advice, assistance with grief, career counseling and development, personality exploration and assessment, and a whole lot more. Clients also may believe that they should only talk about things that are "not going well" as part of their psychotherapy sessions. This would be a huge missed opportunity. The positives aspects to one's life and one's strengths are important and significant parts of that individual's psychological and emotional life and as such deserve an equally important place in sessions as do one's problems. If we don't feel that we can celebrate life's joys and pleasures, as well as share our problems, with our therapist, then we may miss out on the experience of fully sharing the best and most cherished parts of our lives with a compassionate, supportive and committed listener who will rejoice with us as our growth shines in our lives.