Psychotherapy is one of the most commonly used tools in the treatment of mental illnesses like depression, anxiety, and post-traumatic stress disorder (PTSD). Unfortunately, in spite of mental health awareness campaigns in recent decades, there is still a lot of stigma surrounding psychotherapy. Many people delay seeking help because they don’t want it to be known that they go to therapy sessions. This increases the risk of harm from destructive behaviours like self-injury, addiction, and disordered eating.
There are several ways for us as a community to ensure that people who need the help are getting it. One is to break down the stigmas surrounding mental illness itself, by promoting the message that there is no shame in experiencing depression and anxiety. Another is to remind people that psychotherapy is not only for people with diagnosed mental illnesses: many people seek out psychotherapists to overcome temporary bumps in the road, or to help them achieve specific goals. And finally, we can demystify the process of psychotherapy and talk about what actually happens when you are behind closed doors with your therapist.
What You Should Know Before Your First Session
If you have never been to a psychotherapy session before, being aware of a few things before your first appointment may set your mind at ease.
You Don’t Have To Spill Secrets Right Away
Many people avoid therapy because they are hesitant to talk to a complete stranger about the most painful, intimate details of their lives. It is important to understand that you are not expected to discuss anything before you are ready. Like any relationship, the client-therapist relationship should be built on trust, and this can take time to establish. As you become more comfortable with your therapist, you will find it easier to share more about yourself.
Confidentiality Is Key
What happens in your therapist’s office stays in your therapist’s office. The idea of telling your deepest secrets to someone you don’t know may seem frightening, but mental health practitioners are bound by a strict code of confidentiality. There is an extremely limited set of circumstances under which your therapist can divulge anything about you (for example, if you reveal information about ongoing child abuse, your therapist has a duty to report this). Outside of these exceptions, what you tell your therapist will never be revealed to anyone else.
You Can Break Up With Your Therapist
Sometimes, relationships don’t work out, and that’s all right. It’s not anybody’s fault. You may have a competent therapist and you may be committed to the therapeutic process, but you may simply find that you and the therapist don’t “click”. If this is the case, talk to your therapist about it. They will understand, and they will probably give you a recommendation for a therapist who would be a better fit.
Your First Psychotherapy Session
Your first session with a psychotherapist may be the most difficult, simply because it’s your first extended interaction. However, you may be able to reduce your anxiety about it by remembering that the first session is aimed at allowing you and the therapist to get to know each other. Your therapist will start by asking you some basic questions to break the ice: your age, what you do for a living, what your family composition is, what you like to do in your free time.
Next, they will try to establish what you are hoping to gain from your therapy. To this end, they may ask questions such as the following:
- Have you ever been to a therapist before? If so, what was the experience like?
- What mental health symptoms are you experiencing?
- Do you have a history of self-harm or suicidal ideation?
- What is your home life like?
- Is there a history of mental illness in your family?
- What would you like to accomplish in therapy?
The initial session also provides an opportunity for you to ask questions of your own. For example:
- Under what circumstances are you obligated to break client confidentiality?
- How long have you been a therapist?
- Have you ever treated anyone with similar issues to mine?
- Have you ever used the services of a therapist yourself?
- If we are unable to form a connection, will you help me find a therapist who’s a better fit?
- How will you ensure that the notes from our sessions are protected and kept private?
A Typical Psychotherapy Session
Once you and your psychotherapist have gotten past the introductory “getting to know each other” phase, you will settle into a routine when it comes to your sessions. This routine will be unique to your relationship with your therapist. It may be adjusted periodically as you go through your therapeutic journey.
Here is an example of a what might happen during a session:
- On arrival, you may check in with a receptionist or office manager, who will let your therapist know you are there. Many psychotherapists protect client privacy by asking outgoing clients to leave through a separate exit, thereby reducing the chances of interactions between clients in the waiting room.
- When your session begins, your therapist will ensure that you are comfortable. Are you seated comfortably? Is the chair positioned in a way that sets you at ease (some people, for instance, do not want their backs to a door)? Is the lighting and temperature comfortable? Some therapists will spend a couple of minutes ensuring that you are not going to be distracted by physical discomfort.
- Next, your therapist may ask for follow-ups on anything that was left outstanding from the previous session. For example, you may have been given “homework”, like writing in a journal or practising a form of self-care like meditation. If you had difficulty with a task, or if you did not do it, your therapist will help you overcome that obstacle. In some cases, that may mean adjusting your treatment to better fulfil your needs.
- Your therapist may ask what is on your mind, or what you would like to discuss. You will have the opportunity to talk freely about anything that is weighing on you. Your therapist will listen without judgement, and without interruption, except to ask clarifying questions where needed. Once you have said what you want to say, your therapist may ask you more questions about it. These questions are designed to either help the therapist understand the concerns or circumstances you are describing, or to help you gain some clarity into the things that are troubling you.
- Through a guided conversation, your therapist will help you understand the role of your thoughts, words and actions in the things that are happening in your life. You will gain insights into how you can use this information to your benefit, for example, by replacing negative thoughts with more productive ones.
- You may be given “homework”, such as journaling or going for a nature walk. You will leave your session with a clear understanding of the purpose behind these tasks and how it might benefit you.
- At the end of the session, you and your therapist will agree on the date and time for your next appointment.
- From time to time, you and your therapist may revise your therapy goals and assess your progress.
How You Can Make The Most Of The Therapy Process
There are some things you can do to derive maximum benefit from your psychotherapy sessions.
- Be open to sharing details about your life openly and honestly. It may take a few sessions for you to develop the comfort level to make this possible. Taking your time is okay. But ultimately, the more you are willing to share, the more successful your therapy will be.
- At the same time, don’t feel pressured into talking about something you are not ready to discuss. A good therapist will never press you to talk about something against your will.
- Remember that your therapist is not there to give specific advice about the situations in your life. They are there to listen, and to guide you through the process of understanding your issues and the best ways of dealing with them. The therapist’s goal is to help you help yourself.
- Avoid skipping psychotherapy sessions unless there are unavoidable circumstances such as illness or an emergency. Therapy takes time, and you may feel discouraged and tempted to skip sessions if you do not immediately see results.
- If your therapist gives you “homework”, do your best to do it. If you struggle with it, talk to your therapist, who will help you overcome the obstacle or adjust the task.
- If you have been to several sessions and you feel that you are not making progress, talk to your therapist. They will work with you to overcome this. In some cases, this may mean a recommendation to try a new therapist who is a better fit.
Therapy As Part Of Addiction Treatment
Addiction rarely happens in a vacuum: it usually has some underlying cause such as stress, trauma, or troubled relationships. One of the primary goals of addiction treatment is to explore these underlying causes and work toward resolving them. At Addiction Rehab Toronto, one of the tools we offer for this is psychotherapy. We have a team of therapists who use a variety of therapeutic methods to suit a wide range of needs. You will be paired with a therapist who is the best possible fit for you, and they will help you overcome the problems that led to you becoming addicted. Contact us for more information.