For Adults: What to Expect from Therapy? People often wonder about what to expect from therapy. They are not sure what to expect of the therapist, themselves, or if the therapist has any expectations of them. We know that therapy works: research shows that people who receive therapy are better off than people who don’t. Here is a short overview to help you get the most out of your time in therapy.

People have different beliefs about therapy. Let me explain how I do it. First, if you are ever in a crisis, we deal with it immediately and until you are safe. Second, your confidentiality is important, and I am bound by law and the ethics of my profession to protect it. I will give you more information on these two subjects at our first appointment.  These are the only rules written in stone about how I do therapy. Everything else depends on your uniqueness as an individual.

Let’s start with you. In some ways, I am similar to a designer you have hired to improve a room in your home. You have ideas about what bothers you about one of the rooms in your home (or one of the parts of your life). You may also have ideas about what your ideal room would include. You may have a vision of how life would be nicer once that room is re-modeled. I will help you envision your future “room” in detail and to plan the steps that you can take to change the “room.”
  • Together we will create your goals.
  • You will work on those goals between sessions, as much as you can.
  • You have a great deal of expertise about your life that will be used in our work.
  • The thoughts, feelings, and memories that you bring to therapy are the most important part.
Some basic parts of my approach: 
  • I will help you reach your goals with out violating your basic beliefs.
  • Many clients see some improvement in the first few sessions.
  • Under the right circumstances, most individuals are able to change.
  • Our work will build on your strengths and whatever past changes you have already made.
  • Research has demonstrated that the client-therapist relationship is very important to change.
  • I will ask you to fill out some short questionnaires to better understand you and your situation.

Let me describe each of them to you and why I think they’ll help you.

The Outcomes Rating Scale (ORS), filled out at each session, will help me understand how well you are doing during the course of our work, from your viewpoint. If you feel the same or worse, we will discuss the changes that can be made to meet your needs. 

Good research has demonstrated that when clients feel satisfied with their therapy sessions, positive results are more likely. This is also just good common sense. A very brief Session Rating Scale (SRS) will help me to understand how you feel about each session -- so that we can make the necessary adjustments. I’ll have you fill it out at the end of the session, and we’ll discuss it as needed.  It is important that you provide honest feedback even if it is not positive. It might help to keep this in mind: Many clients say that giving their therapist some "negative feedback" greatly improved their work together. 

So, here are the basics:

At our first appointment, we’ll decide how we’re going to address your concerns.
  • Aside from questionnaires, I will ask you to test out ideas for solving your problems that we come up with together, by seeing if they work or not in your ‘real life’. As we work together, it is important that we both pay attention to two things: (1) how you are feeling about the therapy sessions themselves and (2) whether or not you feel you are progressing.
  • These scales will help us not lose focus. Research has shown that you should expect to have a good idea whether your therapy with me is going to be helpful by the 3rd session and not beyond the 6th session.
  • We’ll make adjustments as needed.  If things are still not progressing, we will talk about trying something or someone different. Changes like this never mean that you failed at therapy; just that this particular therapy was not the fit you needed.  If you like, I'll stay with you until you are settled with a new therapist.
Generally speaking, you have reason to be optimistic that therapy can help in a variety of ways, depending on your wishes: help with practical life problems, finding the underlying source of those problems, making your strengths more clear and more usable, or thinking about the people and events that have shaped your life.


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