Finding the right therapist for you and your unique needs can be a daunting process. In a recent blog post, we covered a few ways to approach the issue with an eye for first deciding what role you’d like your potential therapist to take - active or supportive - to get the ball rolling. In order to further demystify the process, we’re going to break down other important attributes so that you can feel a bit more confident in approaching your intro calls and potential therapist choices with deeper information in hand.
Theoretical orientations
A potential therapist’s theoretical orientation serves as a glimpse into what general approach they’ll take for therapy sessions and how this approach will work with your needs. There are many theoretical orientations, so this section will cover a few in a general sense so that you can have some framework as basic guidance for your intro call.
If you believe there is an unconscious motivation for your behavior, you might benefit from time with a psychodynamic therapist.
If you want to work on your whole family and not just on you, then try a family-oriented systems therapist.
If you want to change your thoughts and you think doing that will change your life, and you don't believe in an unconscious, then you might want a cognitive behavior therapist.
If you want to focus on the present rather than the past, and find better ways to cope with current circumstances, perhaps narrative, behavioral, or solution-oriented therapies are something to consider.
If you’re unsure of which orientation would fit best with your needs, it’s a good idea to ask about orientation during the intro calls. If the therapist says, "I am an existentialist" and leaves it at that, ask for an explanation as to what that means and how you would experience that orientation. Keep calling until you find someone whose style resonates with you. This step is important, because identifying and accepting the therapist’s approach at the onset of the therapy experience can make the process a lot more efficient.
If you’re on the hunt for a type of therapy that is solution-oriented, you might be interested in having a look at Solution-focused therapy. Also called Solution-Focused Brief Therapy (SFBT), it’s a type of therapy that places more importance on discussing solutions than problems (Berg, n.d.). Of course, you must discuss the problem to find a solution, but beyond understanding what the problem is and deciding how to address it, solution-focused therapy will not dwell on every detail of the problem you are experiencing.
Solution-focused brief therapy doesn’t require a deep dive into your childhood and the ways in which your past has influenced your present. Instead, it will root your sessions firmly in the present while working toward a future in which your current problems have less of an impact on your life.
In-session structure
Once you’ve selected a therapist, your first session will be a bit different than the rest simply due to a few introductory tasks and various paperwork. Be sure to arrive early; that way, you’ll have ample time to locate the office and get settled in. You’ll likely have such forms as disclosures, consent forms and confidentiality, and notices about billing/cancellation policies. You can request a copy of these forms for your records.
With business aside, the therapist will ask something like: "So, what brings you today?" Here's where you give a thumbnail sketch of your story. Don't plan to give a full autobiography, just a rough draft. You'll be able to fill in the gaps throughout future sessions. You can go about this however you'd like: starting with where you were born and moving forward, or starting with your current issue and moving back. Here's where you'll really get a feel for therapy - how it feels to talk about yourself, how well they pay attention and how comfortable the conversation feels.
This first session sets the tone for how you’ll work together. The more involved and collaborative you are, the more productive your therapy sessions will be. Sessions will typically last about 50-55 minutes, and homework might be assigned for you to work on in between sessions.
Although there may be slight differences in structure based on the therapist’s orientation and style, you could expect that the time will be organized in the same general way. The structure of a session might look a bit something like this:
Check in - any significant events since last session, current mood or anxiety level significant changes (better or worse)
Review and discuss homework - difficulties encountered, what was learned
Set the agenda list - topics the client and therapist agree will be the focus of the therapy session. Include new situations or problem, further work on old situation or housekeeping related to the therapy itself.
Work the agenda
Assign homework
Self-disclosure
Every worry about a therapist spending your precious hour discussing things that don’t have anything to do with your issues? You might have even heard of situations like this when discussing therapists with others.
Self-disclosure means that a therapist might choose to share personal details about themselves and can be an effective tool during your therapy sessions. When used sparingly, professionally and appropriately, counselor self-disclosure can build trust, foster empathy and strengthen the therapeutic alliance between therapist and client. However, therapist self-disclosure also holds the potential to derail progress and take focus off of the client.
Appropriate self-disclosure is client-focused, validates the client’s experience and often prompts further exploration. Constructive disclosure is brief and focused on thoughtful meaning. Regardless of the content being self-disclosed, a therapist should be considering the possible risks and benefits of disclosure prior to disclosure and how they will keep focus on the client afterwards. Overall, mindful and intentional self-disclosure can act as a powerful technique in the therapeutic relationship that can normalize client issues, model healthy behaviors and increase clients’ own self-exploration.
If you find that any self-disclosures from your therapist are unhelpful and unproductive, pulling time away from you and your issues, be sure to speak up. If he or she doesn’t adjust accordingly, it might be time to move on.
Out-of-session structure
In between sessions, you’ve got lots of time continue your progress - and this time is a great way to apply what you’re learning while in the midst of your day-to-day experiences. Using this time wisely further develops the collaborative nature of your therapeutic alliance. Your therapist may have assigned homework, so approach that with an open mind and apply yourself to the process.
A few other ways to structure your out-of-session time? Create a list of things you’d like to discuss. You might want to keep a notebook handy to jot down ideas as they arise. Write down a few thoughts if you have any difficulties when obstacles pop up - even if you think you might remember it clearly when you’re in-session next, capturing your thoughts and feelings in the moment is really helpful for staying in tune with your process while it’s fresh in your mind. You can also supplement your sessions with some constructive reading; ask your therapist to suggest some relevant books.
Research tells us that the connection between a therapist and a person in therapy is profoundly important for change. But, as with all relationships, a good therapeutic alliance is made rather than simply found. In the Bay Area looking to match with the right therapist for you? Look to reflect - we are committed to simplifying the process and help you find the best path for better mental health. The reflect survey can help you identify what types of therapy and therapists will suit you and your unique needs - so that by the time you arrive for your first session, you’re more prepared and comfortable with whichever therapist you choose.