In her book Maybe You Should Talk to Someone Lori Gottlieb makes a very good case for going to therapy to deal with life‘s problems. She talks about her own therapy and why it’s important to consider therapy rather than dealing with one’s challenges on your own. The book was a best seller, and her case for therapy convinced thousands of people to give it a try.
While it’s great that more people are going to therapy to get help, they often don’t know what to do when they get there. Friends and clients alike tell me that they didn’t know what to talk about, their therapist just sat and listened and nodded, and they felt like it was a waste of time and money.
As a psychologist, this is obviously discouraging to hear. This is why my first session with new clients not only gathers background information about them, but it educates them about therapy. I like to give them some things to consider so they use their time and therapy well, whether it’s six sessions, six months, or six years. Because some clients are having their first experience with therapy when they come into my office, I consider it a priority to help them understand how therapy can be helpful and how it looks different than talking to a friend. I like to call it a roadmap because most people who make the initial phone call to schedule an appointment have decided they should be in therapy, but it’s my job to help them learn what to do once they get there and how to make it productive.
Here are some steps you can take to create your own roadmap for therapy.
Find someone that you like talking to
Not everybody can pick any therapist they want. If you can go out of network and get reimbursed or can pay out of pocket, you can chose your favorite out of as many therapists as you can find. If you’re limited by your health insurance network, you may only have a few to chose from. But within those limitations, it’s still important to pick the best therapist for you.
Once you’ve identified somebody that is a practical, good choice, make sure that you enjoy talking to them. Therapy will be a chore if you don’t feel like you’re connecting or that they understand you. Ask questions on the first visit to make sure they have knowledge of the issues you would like to discuss, and ask how they conduct therapy to make sure you are comfortable with it. For example, some therapists just talk to you and expect you to bring up subjects that you would like to discuss. Other therapists are more interactive, giving advice or using theoretical orientations for which they’ve been trained, such as cognitive behavior therapy. Learn as much as you can about the way that they practice so that you can make a decision about whether to keep looking.
I advise people to give the same therapist at least three sessions because sometimes it’s hard to fit in all your questions and gather all your info on the first visit.
Identify how you want to use therapy
There are a number of ways that you can use therapy. Ask yourself what you want to accomplish.
Many people are quite content to go to therapy for an indefinite amount of time and have a safe space to talk about their feelings and thoughts. They may not have anyone at home that can be their unbiased sounding board. Many people also want to find solutions to their challenges, or they want to learn how to behave differently and change patterns of behavior that are unhealthy. Still others want to learn specific skills to cope with difficult and negative thoughts and emotions. Each of these goals for therapy is valuable, and there are therapists out there who can help with all of these things.
It’s possible that you may not be completely sure how you want to use therapy, so that gives you a good opportunity to ask your therapist for guidance. Explain to them what is hard about your life and what challenges you are facing. A good therapist will help you brainstorm and figure out how you want to get started in making positive changes, or they will validate your desire to talk about subjects that are difficult to discuss with members of your family or your friends.
Think about your therapy when you’re not in session
Many clients have told me that from one session to the next they don’t think about what we’ve discussed or even remember what we discussed. I explain to them that they will find therapy more valuable if they reflect on things that have been discussed in between sessions. If it’s hard for them to remember from one session to the next, I recommend they take notes during the session. Therapy often leads to a process of change for clients, and it becomes harder to make changes if they don’t connect what they’ve talked about in therapy with what happens in the real world.
Clients also come to the sessions saying it’s hard for them to remember the important things that have happened since the last session. In these cases, I recommend the clients take notes on what happens outside of therapy, so when they come to a session they can describe situations that may have affected them emotionally. Some clients choose to get a “therapy notebook“ where they keep their reflections after sessions and topics for future discussions, so when they come to therapy, they have material to discuss.
Come prepared to be present for the entire session
Some people say it’s hard for them to tune out their lives and make time for therapy sessions. They arrive at the appointment and their phone constantly buzzes with texts and emails. In order for therapy to be helpful, it has to own a space on your calendar. Schedule regular appointments, arrive on time, and turn off your devices while you are in session. Some therapists will start the session with a mindfulness meditation, which can be helpful in tuning out distractions so that you can be fully present in the moment. If your therapist doesn’t offer this, you could ask them about it, or you could do a brief meditation yourself in the waiting room. Feeling distracted during therapy makes it harder to remember what you discussed afterwards, and it may affect your opinion of the value of therapy.
While therapists vary in their level of expertise and experience, the quality of the therapist is not the only reason therapy may not feel valuable. Think about what you’d like to get from therapy and make a plan. Be intentional, and therapy can be a valuable tool in improving the quality of your life and your relationships.
This blog was originally posted on Psychology Today.
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