Psychotherapy is a process in which the therapist and client
talk and work together to try to resolve the client's problems.
Sometimes the "client" is more than one person at a time, such as a
couple or a family.
In the first few sessions, the client
and I will try to identify what is bothering the client (the
"presenting complaint"), what he or she would like to get out of
therapy, and what efforts the client has already made to resolve
the problem. I also ask the client about current life issues and
During these first few sessions, the
exact nature of the client's problem may become clearer, and the
client may realize that issues other than the presenting complaint
should really be the focus of treatment. For example, a client may
come for help with a sleep problem, and might soon realize that the
sleep problem is the result of anxiety about work.
client and I have a reasonable agreement on what the problem is and
what the desired goals of treatment are, we will discuss a treatment
plan. The plan involves some general or specific goals, a
description of the treatment approach I'm recommending, and usually
a ballpark estimate of how long treatment might take. If there are
several possible treatment options, I try to provide an overview of
each so that the client can decide which one to pursue.
After the initial sessions are completed, the client is
in charge of what is to be discussed in each session. Although clients
like to make notes about what to discuss, most of the time
psychotherapy goes better when clients start each session with what
is foremost on their minds.
Although I usually wait for the
client to start each session, I am not a passive therapist. You can
expect me to ask questions, to ask for further details, to try and
help find words for feelings, and to make links between things
you've said at different points in the therapy. At times I will
gently challenge how you see things, or your resistance to trying
something new. I will provide plenty of feedback about what you're
Clients who take an active part in their
psychotherapy will make more progress than those who wait for pearls
of wisdom to drip from the therapist's lips. Although some clients
come to therapy expecting a "magic pill" to make their problems go
away, they soon find that they must actively think about their
problems and try new behaviors. Some kinds of psychotherapy ask the
client to complete homework assignments in order to try new things,
and clients who complete the homework will make better progress.
Especially when therapy continues for an extended period of
time, clients often develop strong feelings, both positive and
negative, towards their therapist. Although it may be uncomfortable
to discuss these feelings, it is always a good idea to bring
them up during the therapy session. Discussion of these feelings
may help the therapist to do a better job. In addition, discussion
of these feelings may help the client to understand other relationships
in their lives.
What Psychotherapy is NOT
usually not about giving advice. In contrast to what television
and movie therapists do, psychologists usually do not tell
to do. I don't tell clients whether to get married, to stay married,
or get divorced. I don't tell clients whether to have children,
whether to change jobs, whether to have contact with family
or what sexual orientation they "ought" to have.
addition, psychotherapy is not about taking control of the client's
life. Clients make their own decisions, and I do whatever I can
support their independence and maturity.
relationship is different from other relationships. It is not the
same as friendship. The relationship with a therapist happens
in the therapist's office; there are no social meetings during
treatment or after treatment ends. Also, psychotherapy is never
a sexual relationship. Sexual behavior by a therapist towards a
is always unethical and in some states illegal.
relationship with a therapist is mostly one-sided. Clients talk
about their lives and problems, but therapists say little or nothing
theirs. Although a therapist may occasionally mention a personal
anecdote to make a point, this is done to aid the therapy, not
get the client involved in the therapist's personal life.