What is Psychotherapy & What Can I Expect From It?

As becomes clear when searching for a therapist, there are many different types of psychotherapy: Psychodynamic Psychotherapy; Cognitive-Behavioral Therapy (CBT); Interpersonal Therapy; Dialectical Behavior Therapy (DBT); Emotion Focused Therapy; Schema Therapy; Self Psychology; and many others.  This can become very confusing for a new consumer of psychotherapy.  However, there are some characteristics that are both crucial and common to most kinds of successful psychotherapy.  Studies have shown that one of the most important variables common to effective psychological treatment is what is termed the "therapeutic alliance".  This term refers to the collaborative relationship between the professional and the client where the focus is on the shared goal of helping the client to both feel and function better.  Successful therapy usually involves both an increase in self-understanding as well as improved coping capacities, leaving the client with more tools to deal with problems that arise in the future as well as for resolving current issues.  Understanding and insight alone are not sufficient.  The goal is that the client be more effective in his or her own life, that s/he have a greater capacity to deal with current stresses as well as a higher level of resilience when future stresses arise, and that the accrued self-understanding helps the client make choices that will reduce unnecessary conflict and stress in their life as a whole.


One of the most common questions asked by new clients is "How long will this take?"--how long will I need to be in therapy?  Although no therapist can always accurately predict the length of therapy, part of the answer comes from the nature of the presenting problem.  If the problem is both acute and recent in onset (e.g. problems functioning after a recent loss), then it is likely that the therapy can be reasonably brief: 10 to 20 sessions.  If the problems presented by the client are long-standing and are disrupting multiple arenas of the individual's life, then it is likely that the therapist may recommend a fairly long-term treatment.  This is in order to address the current symptoms as well as the underlying emotional conflicts or deficits with the objective being that the person will leave therapy much more prepared to deal with the expectable disappointments and stresses of life.  Whatever the case, it is perfectly reasonable to ask your therapist what is her/his estimate of the probable length of treatment for your problems.


Finally, it is important to choose a therapist wisely as this may be one of the more important relationships of your current (and perhaps future) life.  Generally, I recommend that a new client speak with several therapists by phone or make a couple of initial session appointments in order to find someone who is a good match.  Frequently, a person may choose a therapist solely by location or cost without more a more careful investigation as to whether the therapist's areas of expertise match the needs of the client as well as whether the therapist feels like a "match" for the person seeking help.  Questions to ask a potential therapist might include the following: 1) their level of experience with the client's type of problem (e.g. are they trained to work with substance abuse?); 2) how active are they in the session: will the client be doing most of the talking or will it be more conversational in manner?; 3) does the therapist typically recommend homework or outside reading as an adjunct to the therapy sessions? 4) what is the expected frequency of sessions (weekly; twice a month, etc.)?  As in choosing any professional for consultation, it is important to be a wise and active consumer, be open about any concerns, and be direct with the therapist about what kind of help you are seeking.  For additional information about how psychotherapy works, check the following: Recommended Reading.  If you have additional questions, feel free to contact me by phone or email.