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Therapy? What is it, anyway? posted Apr 17, 2018

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Let’s be clear. There are many ways to do effective psychotherapy, also known as talk therapy. Talk therapy is just that—a collaborative conversation between you and a therapeutic professional using a common form of language. The language is usually verbal and non-verbal and may also be signed when necessary. The relationship should be supportive, neutral and nonjudgmental.

There are many therapeutic traditions: psychiatry, psychology, mental health counseling, social work, and family therapy. All are valid ways to help engage clients, but you, as the client, determine which is most appropriate for you and your situation. When looking for a professional online,  you want to work with a platform that gives you access to several types of therapists, giving your an authentic choice of professionals. You choose your therapist based on what you think will work for you. It’s just that simple. This brief article will give you an overview of what most therapists ( from any educational background) might do in practice.

What are the basic qualifications of a psychotherapist?

Mental health professionals will have the following credentials: 

1) a trainee or intern with a Clinical Masters degree working to perfect her/his therapeutic skills before or after taking the state board examination or

 2) a licensed practitioner who holds a Masters or Doctorate degree, and has met all of the standards to practice within her or his state.

Confidentiality

The relationship that you have with your therapist is confidential—no one else has to know that you are going to therapy or what goes on in your sessions unless you tell them. Your therapist will keep everything is a secret, unless it breaks the law. This means there are limits to your confidentiality in place to protect you and the others. Generally, a therapist has to break confidentiality for the following reasons:

  1. If you are in immediate danger to yourself or someone else
  2. If you are endangering a population that cannot protect itself, i.e. child, elder, or disabled, etc.

Otherwise, what happens in therapy stays in therapy!

The problem and the goal

After the confidentiality speech, your therapist will  ask you about the problem that brought you to therapy “today.” She or he might ask you to tell your “story.” Not the story of your life, but the circumstances directly connected to the problem that you are there to solve. After you share the problem, she or he will inquire about your goal. This is a critical question because the goal gives therapy its direction. It’s the destination or the “outcome” you want to achieve. Everything else you do in therapy is the map, and your therapist is the guide, sort of. You, however, determine where the guide takes you. In the field of family therapy, this is called leading from behind.

 This is critical because what you say determines how your therapist guides the journey. For example, if you say you want to go back to school to get your GED, then your therapist will ask you questions related to just that--getting your GED. If you change and say that you are not interested in going back to school because you hate school, then your therapist will ask something like: “So, your goal is not to go back to school now, correct?” What you say after that will determine a new direction of therapy. So to sum it up, you are the author of your story. You decide what is important to discuss. Someone else might say that you are the expert in your own life. Either way, the therapist follows your lead.

Listening

Notice above that the therapist changed the direction of the therapy based on what you said. This means that she or he is listening. Of all the behaviors that your therapist will display, this one is perhaps the most important. Be on the lookout for cues that she/he is listening. Here are some of the signs: eye contact, appropriate responses to your statements—concerned looks when you seem to be struggling or smiles when you are expressing excitement. If she or he does not match your expressions, then she or he is not listening very well. You could talk to a stranger in a shared Uber ride if you wanted to talk just to talk. The therapist must be engaged.

Questions. Great questions

Penetrating, thought-provoking questions will take your therapy session to another level. Another required skill of a good therapist is asking poignant questions. It’s a reflection of good listening skills when the therapist is able to ask questions that you will not ask yourself. 

NOTE: The specific value of therapy is that the therapist is removed enough from your problem that she or he will see and hear things in your story that you don’t or can’t because you are too close to it, to connected or involved with it. You’ll know a good question as soon as you hear it. It will ring true. It may even leave you speechless for a few seconds. Expect this question to change everything for you. I love it when this happens.

There are many other attributes that you will find in well trained and gifted therapists. But, please know that NONE of this will work unless YOU come with the intention to change. At the end of therapy, it’s what YOU do with what you discovered, that will result in change for you. Change is the therapist’s goal, but YOU MAKE IT HAPPEN. Of course, effective therapy is when both you and your therapist are fully engaged. Your therapist does his or her part and you do yours. In the end, therapy--healing--happens when the relationship with you, your therapist, and your problem is transformed based on the goal you set and the things you do based therapeutic relationship you created to make that happen.

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