What to expect from therapy

Most people come to therapists or counselors looking for relief. These individuals have identified areas of concern that get in the way of their happiness, freedom from worry, and overall state of mind. Often, but not always, the prospective client has a pretty clear idea about what it is, specifically or in more general terms, that’s causing the psychological or situational discomfort.what to expect from a therapist

At times, though, people present with a constellation of symptoms that simply translate to “unhappiness“ with no clear understanding of what’s causing this downturn in their state of being. In any case, an accurate and detailed understanding of the presenting problem(s) is an absolute prerequisite of successful, purposeful therapy.  One way or another, it’s the job of the therapist to shape and guide the initial therapeutic dialogue in such a way that both therapist and client understand what the focus and objectives of the therapy are, and what possible outcomes might result. It is here that therapist and client must agree as they embark upon their journey.

Therapy is serious business. When it’s done well it’s all orchestrated. If the therapist is on his game, every word, every silence, every shift in body position, change of tone, use of language etc. should be calculated and geared to facilitating the dialogue. The dialogue, while at times feeling “lighthearted“ or “social,“ is never empty and always purposeful. The light banter serves the purpose of opening the door to discussion of the serious matters at hand.

At times I’ve heard clients complain that they sometimes feel worse walking out of my office than they felt walking in. That’s OK by me… usually. The work of therapy often involves exposing painful, uncomfortable memories, feelings and realities that have escaped the awareness and attention of the client but which are, nonetheless, getting in the client’s way. This material needs to be uncovered and discussed. Hopefully, with improvement in the client’s insight and understanding, more successful and adaptive strategies can be adopted and the old ways of doing things… or NOT doing things… can be discarded. Getting to the material and arriving at solutions often takes the client into unfamiliar, uncomfortable territory; thus, the sense of unease which translates to sometimes feeling worse than when they walked in. It’s all part of the work of therapy, and if this occasional discomfort is never present, then I seriously question whether any real work is being done. Remember, therapy is always about change, and change often creates discomfort.  If the work of therapy is done well, whatever happens along the way will be well worth it.

At the end of the day, therapy should be a positive and worthwhile experience that, at least, meets the client’s stated need(s). When it’s really good, it should exceed expectations.

Whatever the case, the client should expect greater insight and understanding of himself, his life-situation, his relationships and relationship style. He should understand how he operates and how he participates in the creation of his problems. Moreover, he should learn to avoid creating new problems, develop new patterns of behavior, and master strategies for problem resolution.

The client should, ultimately, come out of the therapeutic encounter wiser, happier and better off.

- Mark B. Dunay, LICSW, LADC 1

On October 1, 2012, posted in: counseling, psychotherapy by
Comments are closed.