The following 4 steps guide you through the initial steps of therapy:
Psychotherapy begins when you contact me and we speak briefly about your concerns.This is a good time to ask any questions you may have that you need to have answered before you can feel comfortable making an appointment. For example, you may wish to know if psychotherapy can help you with your problem, or you may wish to know more about my training or approach.
Following your preliminary questions or concerns, an appointment is made and we meet to talk about what is worrying you. All therapies, adult and child, go through a beginning phase of getting to know one another, including gathering the history of the problem, meeting important family members (usually child therapy only) and investigating your and my own thoughts and feelings about the experiences that you bring. There is some structure to this, as I do need to find out certain things in order to make a good assessment, but it can also be very custom-made (this applies to therapy as well). This phase of “assessment” can be four, five, or even ten sessions (one session is 50 minutes), and it allows us time to sit and talk and see how it feels to you and to me, before you decide to begin therapeutic treatment, or I decide that psychotherapy with me is the best treatment for you.
If you think you would like to start therapy, there are further options: you or your child can attend once per week, or it may be more frequent than this. The frequency of your sessions usually depends on the seriousness of a problem, as well as the need that you may feel for more intensive psychotherapy, whether it is because you need more support, or you are simply curious about yourself and wish to have a more in-depth experience. It is not uncommon for people to attend therapy multiple times per week, but once per week is common as well.
There are many kinds of psychotherapists/counselors, depending on their theoretical orientation, i.e. cognitive behavioural therapists, psychoanalytic psychotherapists, gestalt therapists, behaviour therapists, etc. Which orientation you choose as your own therapist depends on your personal preference. You can research the different types of therapy, or meet with a therapist to assess the fit between you and this person.
A good fit with your therapist, or liking this person and trusting in their capacities, has been shown to be more important to the outcome or effectiveness of the therapy, than the specific type of therapy that they practice.
The psychoanalytic orientation which I belong to (more specifically the orientation of relational psychoanalytic psychotherapy) views the reasons for behaviour as very complex and multiply determined. There are deep-seated reasons for why we do things that are often quite resistant to change through conventional means. We often can not change just because we want to, or just because we can see that our behaviour is self defeating or damaging to others. Change can usually not occur without professional assistance. Understanding the problem intellectually is not enough (if it was, we could change our behaviour by reading self-help books, which rarely works!).
The psychoanalytic tradition seeks to develop mutual and collaborative understanding with the patient of the specified problem, through the therapist’s empathic, listening stance and capacity to be with the other person in the present moment. A therapeutic relationship may develop that the patients finds to be unconditionally supportive and useful in a way that they had not experienced before. The patient's difficulties are often brought into the room and understood in this new context. The psychoanalytic therapist makes interpretions, or evidence-based, educated guesses about what the patient presents, and understanding progresses through the collaborative negotiation of these ideas. With this said, what therapy is and how it works can be difficult to grasp without personal experience. Therefore, trying a few sessions with a therapist is the best way to know what therapy is.
There is no commitment in the initial phase to commence with treatment if you choose not to, for whatever reason. In fact, this time period is as much for the patient as to is for the therapist, as choosing the right therapist for you or your child is an important decision that does matter and does affect therapeutic progress.
