What to Expect from Therapy – and What Not to Expect
Therapy is often seen as a mysterious and questionably helpful art. But it should be none of those things – it shouldn’t be mysterious; it shouldn’t be questionably helpful; and it’s not an art. Psychotherapy is a field of committed professionals who train for years and operate according to a code of conduct designed to make the process of care as transparent and helpful to patients as possible.
But unfortunately, inaccurate perceptions of therapy are strong and keep people from getting the help they need. So, let’s clear up these misperceptions: Here’s what happens in therapy, what to look for in a therapist, and what to expect from therapy.
What to expect from therapy
You can expect respect, not judgment.
Most people who seek therapy are just going through rough patches, like everyone experiences: rocky relationships, job stress, grief, life changes. That they need a little help dealing with these rough patches doesn’t make them crazy – it makes them normal and proactive.
There should be absolutely no – none, nada — blame, shame, or belittling of your experience and struggle. As an example: Dr. Phil is the exact opposite of what a therapist should be. A good therapist knows that it is hard enough to come in for treatment; the last thing a client needs is judgment. Your therapist’s own preferences and lifestyle should not have a bearing on the way they work with you. In fact, nothing about their life should factor into your discussions.
If you experience any of these emotions or impessions from your therapist, find a therapist who is a better fit.
You can expect credentials and experience – ask your therapist about them.
Therapy isn’t mind reading or mind control; therapists should have legitimate training and accreditation that includes a Master’s degree (at a minimum) and several years of experience and supervised practice (all the way up until a PhD). In certain countries without strict credentialing, an undergraduate degree and certification course are common; in that case, it’s more important than ever to ask questions to make sure the therapist has the experience to help you. You can expect your therapist to be open to sharing their credentials when you ask.
They should also be willing to explain how they work – whether they focus more on the past or the present, or focus more on teaching or skills. You can expect explanations in response to your questions because…
You can expect to understand therapy.
Talk therapy isn’t a magical or mystical art that only the therapist can know; it does not involve palm reading, gem stones, or past life regression. Therapy is about self-improvement and wanting something to be different in your life, but not quite managing the shift on your own. Kind of like hiring a trainer to help you meet fitness goals; it’s not that you can’t get fit on your own, but when you set aside the time and invest in learning new approaches, you’re more likely to be successful.
Talk therapy involves talking about your experiences and having the therapist ask you questions in order to make clear things about yourself that, on some level, you already know. Therapy helps patients connect their experiences, understand their patterns of behaviour, and learn ways to be more effective and skillful in their approach to life’s struggles. Depending on when you come in, it can be preventative or corrective.
See? It’s a simple premise.
You can expect confidentiality – no exceptions.
What happens in therapy, stays in therapy; no matter who you’re seeing or what your situation is, the information you share should absolutely not leave the room without your permission. It doesn’t matter if the therapist is a family friend (if so, someone else might be more impartial and therefore a better fit), or if a parent or spouse came with you to the first appointment or pays for your therapy – as long as you are 18+ years of age, you, and only you, decide who is privy to what you discuss in therapy. For kids in therapy, parents can be as involved as is helpful, depending on what you and your child’s therapist decide.
The only exception to this is in the unlikely event that you are planning to harm yourself or someone else; in that case, your safety takes priority and your therapist may alert your whole “team” (family members, other doctors) so they can be involved to prevent harm.
You can expect progress.
In a month’s worth of weekly sessions, you should see a shift in how you’re feeling and feel you have learned something about yourself. If you do not, something about the therapy is not working, and you should discuss this with the clinician. Therapy isn’t instantaneous, but it also isn’t endless; you should know the goals you’re working toward and have scheduled check-ins with your therapist to discuss progress and reassess timeline to make sure you attain them.
That said, therapy is an experiential process, and if you are expecting things to change without effort, you might be there longer than expected. It’s also collaborative, so you’re as responsible for your progress as the clinician and you should hold each other accountable.
You can expect consistency – as long as you are consistent yourself.
For therapy to work, you have to show up regularly and actually do what the therapist asks you to do between sessions; you get what you put in. Consequently, you can expect your therapist to be consistent in return by making time for you, providing insights and alternative skills, as well as keeping you accountable.
You can expect to be in control.
While you can expect progress, you can also say if and when the therapy feels like it is progressing too slowly or too quickly, or whether you are comfortable or uncomfortable. And you should speak up; you’re the expert on you, and your intuition and opinions are important. You give the therapist the information necessary for curating effective, individualized treatment. Which means …
You can expect to feel comfortable with your therapist.
A therapist may ask uncomfortable questions, but you should feel comfortable in their presence and in the setting. Ask yourself: Are you comfortable? Do they seem like they understand and care? Do you feel like coming back? If the answer to these is yes, then commit to a few sessions and see how it goes. But if the answer is no, it’s okay to try out different therapists to see what styles you like. Therapy is not a one-size-fits-all thing, and neither are therapists. It doesn’t mean that therapy isn’t for you, it just means you haven’t found the right therapist.
But that said …
What not to expect from therapy
You can’t expect friendship with your therapist, or any kind of relationship outside of therapist-patient.
While you can expect to feel comfortable with your therapist, you can’t expect them to be anything other than your therapist. You are paying for their expertise, experience, attentiveness and objectivity, which your friends and family don’t have. You are paying them to be a stranger – because it is often easier to be honest with a stranger than with the people you are closest to.
Sharing personal feelings and experiences can make it easy to mistake the relationship. You might develop a feeling of closeness or affection for your therapist at some point during treatment. This is a normal thing called countertransference, but it’s not a lasting connection, simply a passing appreciation for someone who is caring for you in a way you haven’t experienced before. Because you know nothing about your therapist as a person, the feelings you have are based on how you feel from therapy — not on what is between the two of you as individuals.
For this reason, you can’t be friends with your therapist or share a romantic relationship with them – ever. They need to stay neutral in order to be most helpful to you.
Going into therapy with an understanding of what happens in therapy and what to expect from therapy is the best start to achieving your goals. With these expectations clarified, you’re well set.