Making the decision to enter into therapy is never an easy one. Whether you are getting individual therapy, couples therapy, or family therapy, it is not easy to make the first call and to ask someone else for help. Because this is a difficult decision, it is important that you are comfortable with the person who will be working with you. Remember, that just because you have had an initial visit with someone, this does not mean that you are committed to continue to work with the person. Chose someone with whom you can feel comfortable to discuss any issues that you might have.
Once you have chosen a therapist, there are several things to keep in mind. First, everything that you say is confidential. This means that your therapist can not tell anyone anything about anything that was discussed without your permission. This includes even letting someone know that you are in therapy. The only exceptions to this are if you are suicidal or you threaten to kill someone and the therapist has a reasonable belief that you will carry this out. If you are suicidal, the therapist will most likely ask you to sign into the hospital. If you don’t do so voluntarily, the therapist can insist you go into the hospital where you will be evaluated by a psychiatrist to determine if you are suicidal. If the psychiatrist believes that you are, you may end up staying in the hospital until you are no longer a danger to yourself. If you threaten to kill someone, the therapist has a duty to warn that person of this imminent danger. In addition, to the above, the therapist is a mandated reporter. This means that if you have or are causing harm to a child or an elderly person who cannot take care of themselves, the therapist must report you to the appropriate authorities. The only other exception to confidentiality is if you are in a court proceeding and the judge orders the therapist to reveal information about you.
Second, therapy is hard work. You will be discussing issues that may be very painful to you. This means that there will be times that you feel worse rather than better. Therapy is a process by which you begin to look at the issues you are facing as well as issues from your life that might be impacting these current issues. It is a process of discovery and growth. But in the growing there is often pain. This is normal and means that you are working on the issues that you need to be focusing on.
What to expect
The therapist will generally begin by talking about what brought you to the decision to seek help. In addition, the therapist will ask you about your current life as well as your family of origin. Often, the therapist will ask you how you “feel” or “think” about some issue. At the end of the initial session, the therapist will generally sum up what he or she has learned about you and then set goals with you regarding what you hope to accomplish during the therapy process. There is no strict guideline regarding how long therapy takes, although the therapist might give you some idea as to how long the process may take.
Subsequent sessions will focus more on understanding the underlying issues that are impacting you and keep you from having the type of life that you want.. Sometimes the therapist may ask you to keep a journal or to do some other type of homework between sessions. This will aid the therapy process.
If the therapist feels that medication should be considered, the therapist will discuss options with you. Generally you will be given the name of a psychiatrist that has worked with the therapist in the past. If you have a medical doctor already who will prescribe psychotropic medications, this can also be considered. Your therapist will want to discuss your case with the medical doctor so you will have to sign a release of information.
Therapy is hard work! There will be times that you will leave the session feeling worse than when you walked in. There will be times that you don’t want to go back to therapy because of the way you feel. These are the times that you need to be in therapy the most!
Being open and honest is important. You will be forming a strong relationship with your therapist. If you are upset about something that was said, speak up! If you are worried about talking about a topic, speak up. There isn’t much that your therapist hasn’t heard before. In addition, it is not the therapist’s job to be judgmental. The therapist is there to help you.