Mental Health

Frequently Asked Questions About Therapy

Many people only have a vague idea what therapy is about. They don’t really know what therapy can do for them or what is involved in having therapy.  This page attempts to address some of those issues.

How do I choose someone to see?

The most important thing to remember when choosing professional help is that you are a human being and so is your prospective treatment provider. You will face the same issue you face when selecting a friend or partner — personality. You may have to see several professionals before you find one you feel comfortable with. It is vital to realise this and not be discouraged if you don’t like, or don’t feel comfortable with, the first professional you see.

Interview prospective treatment providers — they should expect you to and be happy to answer your questions. It will save you, and them, time and disappointment if you take a few minutes to interview them first and move on if you don’t feel they are compatible with your personality.

Make sure they are qualified then ask them a few questions to get a feel for how they are likely to treat you and respond to you. It’s their job to make you feel listened to and respected. If they are not able to make you feel that way in an interview you need to keep looking.

What will happen when I go to see them for the first time?

The first step can be the hardest. You will need to tell them as much as you can about you and your problem. The more details you give them the better they can help. This will be hard for some people because they are not used to talking about themselves.

It is part of your therapist’s job to make you feel comfortable enough with them to be able to talk. They are trained in how to help you talk.  I have had clients who could not believe they had been able to tell me so much as they had never been able to talk to other people so easily before. Don’t worry about your shyness or lack of verbal skill. If you are willing to talk your therapist should be able to help you do so.

People often say they have not told this or that to their therapist for various reasons. If you are not comfortable telling your therapist everything, even your most shameful thoughts or feelings, you are with the wrong therapist! You will not be expected to tell all in the first few sessions, or ever if you do not wish to, but the more secrets you keep the less help you will be able to get.

Think of your therapist as a psychological Sherlock Holmes you have hired to find out what is wrong and help you fix it. If you give them all the pieces they can do their job but, if you withhold vital information, they have less chance of solving the problem.

Don’t assume anything about you, your thoughts, your feelings, your past or present is not important or is too trivial to be worth mentioning. You wouldn’t go to a doctor and fail to mention the niggling pain in your side just because you think your broken leg is all that matters would you?

Psychological signs, symptoms and clues include experiences, thoughts, feelings, behaviours and beliefs so don’t assume anything about you is not important enough to mention. If it matters to you it is, automatically, important to your therapist.

Many people find, after a good session with a therapist, they feel either elated and full of hope or utterly drained and exhausted. Both of these feelings will wear off and do not mean anything about the end result. They are simply common reactions to a deep and meaningful connection with another human being.

WARNING

I would be failing to equip you with all you need to know if I do not include one word of warning here.

All professional people operate under the laws applying in their country. In Australia and many other countries it is required by law for any professional person to report certain things to the authorities. If your therapist is convinced you pose a serious threat to yourself, to someone else or to a child they must report you.

This does not mean you cannot say you want to kill yourself, your neighbour or your child but it does mean you will be reported if your therapist believes you WILL kill yourself, your neighbour or your child.

Therapists are, or should be, trained in how to tell the difference between someone who is letting off steam and someone who has serious intentions to harm themselves or someone else.I have been practicing for many years now and it has never yet been necessary for me to report anyone despite many declarations of intent to commit suicide or murder. We do not like to report our clients so we tend to do so only when there is no other way to protect them or the people they pose a threat to.

The second thing you should know is that, unlike lawyers, what you say to us is not protected by law. Courts can order us to hand over our case notes if they know they exist. If we refuse, or they think we might refuse, the notes can be made the object of a court order and confiscated.

If you are worried about this happening because you are involved, for example, in a nasty divorce the best protection is to ensure nobody knows you are seeing someone. If they do not know case notes exist they cannot ask for them.

What can I expect treatment to involve?

Here is the bad news — treatment will not involve your therapist waving a magic wand to fix everything for you.  Whilst I, for one, regularly scour eBay and other potential sources no such wand appears to exist.

What treatment will involve is change.  YOU will have to change something.  It may be something you do, something you think or something you believe but you WILL have to change something.  If you do not make a change of some kind nothing about your problem will change and therapy will have been a waste of your time and your therapists.

The good news is we are trained to help you WANT to change and to help you be able to change.  More good news is that, often, the change required to fix everything is not a very big change all things considered.

Sometimes all that is needed is to change what you believe by learning something you did not know before.

Sometimes you will have to simply change treatment providers and see a doctor or a psychiatrist for the medication that is what you actually need.

It is possible to change a life that is a complete mess and misery to one that is happy and satisfying simply by changing a few basic false beliefs or learning a few basic life skills such as how to handle other people.

In some cases, like mine, where everything that could go wrong did go wrong a lot of changes will be needed in every area.  Changes to beliefs, thoughts, behaviours and a lot of new skills will need to be learned.

How long will therapy take?

The best predictor for how long your therapy will take is to look back over your life.  How long have you had the problem?  How were things before the problem started?

If you have been quite happy all your life and this is something new with a cause you can point to you may only need one session of good therapy to put you back on track. I can’t count the number of times a person’s depression has turned out to be caused by physical exhaustion and was swiftly cured by taking a decent holiday!

If things are pretty good in most areas of your life but there is one thing causing you a lot of problems you may just need to learn a simple life skill, such as how to negotiate or how to problem solve, and all will be well.

At the other end of the scale are people who have been miserable their whole lives.  In those cases it may turn out to be a simple life skill that is missing and therapy can fix things as fast as the person is able to learn the skill.

In cases where the person’s growth and development as a child has been sabotaged by abuse, ignorance, poor parenting or traumatic life experiences treatment may take a long time.

The person will need to learn to trust others for starters.  They will need to learn all the things they should have learned as a child.  These include new ways of thinking that don’t include self-hate.  New ways of coping such as anger management or how to problem solve.  New beliefs such as “It was NOT my fault”.

The more changes you need to make the longer your therapy will take.

How much will therapy cost?

Charges for therapy vary widely depending on what kind of therapy you choose.  In Australia it is possible to get up to ten sessions of therapy through Medicare if your doctor refers you to someone under the allied health providers scheme. Many community health centers offer free, or cheap, counseling and some counseling services offer a sliding fee which will depend on how much your income is.

Check out your employer too.  Many employers offer counseling through their employee assistance provider.  An employee assistance provider is usually an independent counseling service the company hires to offer employees counseling.  The benefit to the employer is in reduced sick or personal leave and happier, healthier, more productive workers.

The recommended fee for an hour’s consultation with a psychologist is $251.00 but many will not charge that much.  Most psychologists know people can’t afford to pay that so charges, as of writing this, tend to range from around $80.00 an hour up.