TIPS FOR ENHANCING YOUR THERAPY EXPERIENCE
1. It's OK to be nervous. Clients come to therapy in a vulnerable state. Good therapists understand this and will try to do everything they can to make the experience worthwhile. It's a difficult prospect to tell your most intimate thoughts and feelings to a total stranger. Don't be hard on yourself for being nervous. It's natural and expected.
2. Be honest and forthright. While it can be difficult to share everything with your therapist, holding back information will only serve to compromise your therapy and inhibit your recovery. Psychologists operate from a conceptual framework, taking every piece of information into consideration when formulating that framework. We then use this as a basis for diagnosis and treatment. When we do not have important pieces of information, it is impossible for us to form an accurate conceptual framework, which inhibits diagnosis and ultimately treatment. As hard as it is, be honest about everything. Psychologists are bound by strict rules of confidentiality and therapy is a safe place to discuss even the most difficult topics. Please note that there are exceptions to the rule of confidentiality. Your psychologist should discuss these exceptions with you before therapy begins.
3. Therapy is a collaborative process. Treat it as such. Therapy requires teamwork. A good psychologist will not simply advise, but help you understand your situation and come to your own conclusions about the best course of action. When prescribing treatment, it is up to the client to follow through. Psychologists make recommendations in conjunction with the client's input, but ultimately the client has to do the work. Typically, you will be in therapy for 45-50 minutes per week, but therapy cannot end in session. The work must be carried through outside the session and that is the client's responsibility.
4. Keep a therapy notebook. One of the best things you can do when you start therapy is buy a simple notebook and bring it to every session. This can be used to take notes for future reference, store materials your psychologist gives you, or as a journal to record your thoughts, feelings, and insights. You will discuss a lot of important things in the course of a session and remembering all of it can be difficult, especially if it is an emotionally charged session. Also, many psychologists give "homework" assignments, worksheets, or other reading materials. Keeping all of this organized will facilitate the therapy process.
5. Be prepared to do the work. Therapy requires a major investment of time, emotions, intellectual energy and money. There is virtually nothing about it that's easy. If you are not at a point in your life where you are motivated to do this work, your psychologist will have to spend considerable time and effort helping you find that motivation. This is often a necessary part of the process, but being motivated and ready for change will greatly reduce the amount of time you need to spend in treatment.
6. Find a psychologist with whom you are comfortable. You may be working with the greatest psychologist on the planet and you may be the most motivated person who ever stepped foot in therapy, but if you are not comfortable with the person sitting across from you, it will be hard to get any really good work done. Personality conflicts happen and good psychologists will recognize them when they happen and address them in session. You should feel free to do the same. If your psychologist becomes defensive, ignores or dismisses your discomfort, or does not engage you in the problem solving process, you may want to seek treatment elsewhere. Even you both do all the right things, it still may not work out, and that's OK. It's not necessarily a reflection on the psychologist or you, just recognition of the limits of the circumstances. If you decide to part ways, you should ask for help in finding another competent treatment provider.
7. Shop around. Finding a good psychologist is hard. There are many mental health treatment providers, not all of whom are clinical psychologists. Psychiatrists, social workers, clinical nurse practitioners, and a host of other professions can be licensed to do therapy. All have varying degrees of education and experience. Some are very good at what they do, but many are not. It may take several meetings with several providers to find someone who is well suited to meet your needs. Ask your primary care doctor, your psychiatrist, your friends, your family, your insurance provider, or just call around and ask questions to see who you get a good feeling about. Don't be discouraged, you will eventually find the person who is right for you.
8. Look for the signs of a good practitioner. What indicators are present to let you know if the person you are talking to is a good clinician? Here are some things to look for:
- What are their credentials? Doctoral degree? Master's degree? Medical degree? What field, what profession?
- How long has the person been in practice? Don't jump to conclusions on this, but if someone has been successfully doing this work for a long time, this is generally a good sign. There are very good people who are just starting out, as well as some not so good ones who may have survived over time, so be cautious with this guideline.
- Where does the person get most of their referrals? Good referrals sources include word of mouth, other mental health practitioners, medical doctors, school systems, etc. Practitioners who rely heavily on advertisement, solicitations, or frequently changing referrals sources may not be as reputable.
- Does the practitioner allow you to ask professional questions about them? Their credentials, background, areas of expertise, theoretical framework? Do they give you specific answers? Are they defensive or vague? Do they openly admit their limitations or indicate specific disorders or populations with whom they will not work? Good clinicians know what they are good at and recognize those limitations.
- How available is the clinician? Good, reputable providers who take insurance are generally full with waiting lists. You may want to be cautious of clinicians who take insurance and are "very available."
- Does the clinician operate from a specific theoretical framework? There are many different “schools” of psychotherapy. While there are certainly good, broadly trained clinicians, most gravitate to a specific school that works well for them or the disorders they typically treat. Many professionals identify themselves as "eclectic", which means they will use whatever school of thought will work best in that particular situation. Generally, this is something to be avoided. If you have an anxiety disorder that will respond to cognitive behavioral therapy techniques, you should see someone who specializes in that work, not someone who "sort of" knows how to do it.
- What kind of clients make up the majority of the clinicians practice? If you are suffering from major depression, see someone who treats a lot of those cases, not someone who treats mostly different disorders.
- Do your homework. With the advent of the internet, you can look up almost any clinician in any state to verify their license status, look up any complaints made against the clinician, or see if they were ever sanctioned by their professional board for ethical violations. A complaint in itself may not be sufficient reason to avoid the clinician. Unfortunately, mental health practitioners are often the subject of frivolous complaints or lawsuits. If there was a sanction by a professional board, however, this should be treated as a red flag.
9. Have specific goals. Knowing what you want out of your therapy experience will help you and your clinician develop a reasoned treatment plan for meeting your needs.
10. Chances are, you need more than just "talk therapy." Good therapy is more than just talking about your problems and recounting the week's events. It is a proactive approach to life that stimulates provocative thought, motivation for changes, and providing the necessary guidance and skills to achieve and maintain that change. If you feel as though your therapy is stagnant, it probably is and you should raise that issue with your clinician.
11. Pay attention to the science. Psychology is a science, and the practice of psychology should adhere to scientific principles and rigor. In a nutshell, this means that no psychologist should administer any treatment that does not have some sort of scientific evidence for its effectiveness. There are many psychologists who would argue with this statement for a variety of reasons, but this principle is at the heart of the philosophy of what we do at PPS. Unfortunately, the practice of psychology is still subject to fad treatments which at best are harmless and ineffective, but at worst do more harm than good. The public needs to be protected from such sham treatments. There is an art and a science to good psychotherapy. The science often gets lost in the art, but at PPS, we strive to achieve an effective balance between the two and provide the highest quality services possible.