I've decided to begin writing here in order to educate about various mental health topics, reflect on current issues in mental health, share a little about my career as a clinical social worker, and work toward the de-stigmatization of mental health. I will try to keep my quirky sense of humor to a minimum, but no promises.
Photo by L. Kinstad, 6/2014, do not reproduce w/out permission.
Therapy is a big investment in yourself--an investment of time, money, and emotional energy to name a few. For some, it can be really difficult to make the decision to even begin therapy. But once you've decided to give it a try, how do you get the most out of each session? For adult and older adolescent clients, here's a few thoughts about that:
#1: Find the right fit.
It may take some extra time on the front end to make phone calls, play phone tag, and set up free consultations with a few potential therapists. But this will save you in the long-term. Therapists/counselors/psychologists are trained to understand the importance of a good therapeutic fit, and are usually happy to meet for 20-30 minutes at no cost. Ask them questions about their experience, what they specialize in, and talk about what you are looking for in a therapist. If it doesn't feel like a good fit, ask them who else they know who might be a good fit.
#2: Use documentation to remember the learning, and what you want to share.
Get a notebook (electronic or the old fashioned paper kind) and designate it for documenting the learning that happens during your time in therapy. Between sessions, write down issues/thoughts/situations that felt important, or future situations that will be difficult, so that you remember to talk about them in the next session. Your therapist might give you assignments, recommendations, or resources that you'll want to explore. Sometimes I recommend to children and adolescents (or creative adults) to draw or paint a picture after the session about what they learned, or what they felt about themselves. The point here is to recognize what is meaningful, and generalize all of the new learning.
This doesn't need to take much time, just pause for 60 seconds before heading to your appointment, and reflect on yourself, how you've been doing, what changes have you noticed since the last session, and glance at your notes (see #2). If you have nothing to talk about, or don't want to go that day, then just notice that. Whatever you bring to the session that day is all okay. Just being aware of it, and communicating those thoughts and feelings, will be helpful to the process.
#4: Show up.
Literally and figuratively speaking, showing up to the appointment with your body, mind, and heart, will help you attend to yourself during the session. Turn off the volume on your phone. If letting go of distractions in sessions is a struggle, tell your therapist, and work together to find strategies so that you can be present.
#5: Don't give up at the first sign of difficulty.
If you found someone who you feel is a good fit (see #1), you've made some progress, but encountered some bumps in the road, talk about it with your therapist. When people share with me past experiences they've had in therapy, it's usually positive, but sometimes things sound...off. Sometimes it feels stagnant, or too intense, or mixed up. They might feel judged, aren't seeing the change they hoped for, or feel like the conversations are off-target. When they brought up these issues with their therapist, if they did at all, there were mixed results, or they had difficulty being honest. It's disheartening for me to hear this because there's a lot to gain from the experience of working through those barriers and putting words to what is happening in the room. You don't have to be articulate about it, just notice out loud that something feels off. It's the therapist's job to help you put words to the specific experience, and be supportive and professional about it. Maybe the therapist needs to change something, maybe you do, maybe both of you do. Whatever the answer, it's important to pay attention to those feelings. The difficult parts of the therapeutic relationship can often mirror real life. And so addressing the "off" feelings within a therapeutic setting might be exactly the breakthrough that you need.
by Lori Kinstad, MSW, LICSW