Know Before You Go

My own path to becoming a counselor was somewhat non-traditional. It had never occurred to me in my younger days to pursue a career in mental health, and my brief encounters with the field as an adolescent did not adequately prepare me to understand what therapy even was, much less whether or not it could benefit me. It wasn't until my 30s when I entered a therapist's office, and when I did I immediately wished I hadn't waited so long to begin.

Everyone comes to therapy for different reasons, and there is a wide range of possible outcomes that can result. As a new therapist, I gently encouraged those I knew who were struggling with mental health to consider therapy. As I gained more experience, I added more qualifications to my advice by encouraging others to pursue good therapy, whatever that might look like for them.

The process of choosing a therapist is a personal one, but one worth investing in as the results can be quite different between "good enough" therapy, bad therapy, or quality therapy. It's important to remember in this process that you are the paying customer, and as such you have the right and responsibility to speak up if things aren't going the way you would like.

Unless the first visit or two is abysmal, I encourage patients to try at least three sessions with a therapist before making a decision about whether or not to continue. This gives the therapist a chance to complete a session or two rather than just doing the intake paperwork. 

How can you know if therapy is working? For one, you can judge by the way you are feeling while in session and between sessions. Is the therapist really hearing you? Do you feel understood? If you've made a request such as expressing a desire for homework to complete between sessions, was that request heard and attended to?

Therapeutic rapport is meant to model other relationships in the sense that a therapist will be respectful, listen and empathize, and give you the attention you deserve for the time you spend with the therapist. Occasionally there may be misunderstandings at any point in the therapy process. How these concerns are handled can be a good indicator of what kind of rapport you have with your therapist, and as the two of you work to heal ruptures between you it can provide a model for how to heal ruptures you may experience with others.

A therapist should be willing to acknowledge fault at times, express a desire to improve and follow that up with making appropriate changes. If you are doing your part as a client (completing assignments, bringing points of discussion to sessions, speaking up about problems, paying on time and attending regularly) and therapy still isn't working, it may be time to make a change.