Psychotherapy is a professional relationship between you and your therapist, devoted to your well being and psychological healing. Relieving your emotional pain, reducing your symptoms, improving relationships, or changing your behavior or lifestyle may be parts of that goal.
The main way we achieve the goals of psychotherapy is by talking together. Clients are most likely to improve if they trust their therapist, feel understood by their therapist and experience a genuine concern and support from their therapist. Clients can facilitate this by disclosing any concerns they have about psychotherapy or about the therapist’s perceptions or comments.
Sometimes other kinds of “expression” can be used, such as art, play (most often used with children) or writing in a journal. Other methods (such as relaxation training, meditation, and so on) may be suggested, but your therapist will use only approaches with which you agree. You have a right to be informed and to understand the purposes of these activities, as well as any risks, and reasonable chances of success of any approach.
Some therapists recommend “homework” for the client to do between sessions. Homework may include reading, writing in a journal, practicing assertive communication, exploring job options, spending quality time with a partner, or any other activity designed to help the client learn something new, practice new skills or overcome anxiety. You should always let your therapist know if you are uncomfortable with, or confused by, any homework they suggest.
Regardless of how they approach psychotherapy, all MAPS therapists begin by identifying what brings you to therapy and what goals you wish to achieve. They will ask you for specific symptoms in order to make a clinical diagnosis (required by insurance companies), and they will ask you about your history, including any previous counseling or mental health treatment you may have had.
At MAPS, we believe that a spiritual assessment is also important, and your therapist will likely ask about your understanding of spirituality, your spiritual or religious heritage, your religious or spiritual practices, and the importance or spirituality or religion in your life. MAPS therapists understand that there may be things that you are reluctant or unwilling to disclose or discuss at the beginning of psychotherapy, but may be shared later as you learn to trust your therapist or gain confidence in the process of therapy.
MAPS therapists also are sensitive to the importance of cultural factors in how people perceive their world, their problems and possible solutions. Sharing information about your specific cultural background or values is one way to improve the benefits of psychotherapy.
The therapeutic relationship is not a social relationship, and therapists are discouraged from providing psychotherapy to individuals with whom they have personal or social connections. Psychotherapy rarely, if ever, involves physical contact other than a handshake or a pat on the shoulder. Personal relationships, especially intimate relationships, are inappropriate and possibly illegal both during and after therapy has ended. Although you may feel very close to your therapist, please understand that the boundaries they place on the relationship are a necessary part of psychotherapy.
Therapy is often challenging work. You may learn to pay attention to your thoughts, your feelings, and your relationships; to honestly acknowledge them (including feelings you may wish you never had); to work with unwanted aspects of yourself, to learn to feel painful things and to face painful realities; to talk candidly and respectfully with people you’d rather avoid; to accept difficult but inevitable situations; to confront frightening but important realities. The therapist may guide and support you during this process, but ultimately the work is done by you.
The therapist’s job is to listen carefully, to point out strengths that have been unnoticed and weaknesses that have been ignored, to look for hope when you are hopeless and danger when you are naive, to allow you to be dependent when you fear depending and to challenge you to be self-reliant when you would love to have someone solve your problems. In short, the therapist’s job is to assist you to learn to meet your needs, satisfy your desires, and live more freely in this world.
Known Benefits of Psychotherapy
Research has shown that most of the common approaches to therapy are about equally successful. In general, psychotherapy clients are better off after therapy than they were before it, and they are better off after therapy than 80% of untreated persons.
Therapy is very helpful when the client is depressed, anxious, unhappy, a survivor of trauma, or suffering from a life-problem which requires lots of emotional energy. People who can talk and listen reasonably well, who are comfortable being alone with another person, and who are willing to pay attention to their own feelings, thoughts, and motivations probably will do well in psychotherapy. Sometimes, the benefits of psychotherapy can be enhanced by medications designed to decrease depression or anxiety symptoms.
Common Risks Associated with Psychotherapy
There are potential risks to psychotherapy. People may initially feel worse as the therapy progresses. In rare cases, psychotherapy may even trigger some people to have thoughts about wanting to hurt themselves or end their lives. When this happens, your therapist will be able to help you understand and cope with these feelings safely, and can direct therapy to be more supportive until you are feeling stronger. It is always important that you tell your therapist if you are having any frightening or dangerous thoughts or feelings, or if you are considering harming yourself or someone else.
Some clients develop strong feelings about their therapists. This is especially true in longer therapies. Such feelings are normal, even if sometimes uncomfortable or confusing. Any feelings are possible, and the rule for them all is to talk them over with the therapist. They are experienced with this and will help you understand how this is part of your progress.
Therapy can complicate your life.Therapy is often about making changes or about looking at yourself differently. Therapy can change how you live, and it can change how you feel about your relationships. Your therapist will help you to anticipate these changes and will let you decide what changes are best for you, and when.
Psychotherapy is not free and for many there is a personal financial cost. Usually, if you have health insurance, it will pay some portion of the fee. Prior to beginning therapy we recommend you speak to your insurance representative and find out how much you are expected to pay and if there are limits to the number of sessions your insurance will provide.
Insurance companies have the right to ask about your counseling to determine if treatment is necessary and appropriate. Your therapist will be required to provide a diagnosis and may need to submit a report outlining what you are working on and how long it is likely to take to achieve your goals. If there is anything you wish to discuss in therapy that you do not want shared with anyone, including your insurance company, please discuss this with your therapist.
Insurance also requires that we provide a diagnosis, using the nationally approved DSM 5 criteria. Your diagnosis, like all of your medical information, is protected by privacy and confidentiality rules and practices. However, some clients fear being labeled or “stigmatized” by their diagnosis, or fear that it could limit their career options or insurance rates. If you have any such fears, please speak about them to your therapist.
Some research suggests that when one spouse or partner meets alone with a therapist to discuss problems involving the other partner, there is a chance that this could increase tension for a couple. For this reason, many marital or relationship problems are best addressed with both individuals coming to therapy together.
While your therapist could offer suggestions and advice when asked, research shows that a therapist’s advice about life problems is often no more helpful than anyone else’s. Helping you find your own solutions to your life’s problems is a far more effective approach.
Finally, not all therapy is effective. If you have been in therapy for several weeks or months, and it does not feel like you are making progress, you should speak to your therapist. It may be that you would do better with a different approach to therapy, or even with a different therapist. As therapists, we know that we cannot be everything to everybody, and we are comfortable helping you make a change if needed.