We all need our safe spaces where we can just “be” and speak freely. Psychotherapy may be that space.
You might or might not be surprised to learn that what you may have considered a therapy staple is, in fact, a rare occurrence. Few psychotherapists really have a chaise lounge for you to lie on.
In fact, not all psychotherapists work in the same way or offer the same services. The psychotherapy experience can vary widely depending on the therapist, modality you choose, and your goals.
The duration of therapy can also vary. It could be short term, or it could go on for years, depending on your needs and preference.
And with the ebb and flow of life, it’s not uncommon for many people to go through short-term therapy many times during their lifetime.
It’s also not uncommon to have questions and even reservations when deciding if and when to start psychotherapy. Learning more about what therapy entails and what the options are may help you feel more at ease when making a decision.
Psychotherapy is often referred to as talk therapy. It’s a term used to define an intervention or treatment for various mental health conditions and everyday challenges and concerns.
This intervention or treatment can involve different methods and strategies, and it’s usually tailored to your needs, too.
Psychotherapy is structured on sessions that can last between 40 and 120 minutes and repeat from a few times a week to once a month.
According to Stephanie Rojas, LMHC, “therapy is a protected space to work toward improving your mental health.”
This space can be a solo endeavor, or one where your whole family or partner work as a team with you.
In some instances, group therapy can also be effective, and this caters to individuals with a common goal or diagnosis.
Rojas explains that during your first few sessions of individual therapy, a therapist may ask a series of personal questions.
“This is to understand you best, and that’s what therapy is – a personal journey that requires time, strength, and patience,” she explains.
You may also have questions for your therapist during these first few sessions.
In general, it’s important to pay attention to how each session feels at first, says Rojas. “Notice if you’re feeling welcomed, accepted, validated, and understood. A therapist should work toward making you feel seen and heard.”
Building a rapport with your therapist may or may not happen in the first or second session. Once rapport is built, however, you may feel reassured in your decision to start therapy, Rojas says.
The therapeutic relationship is part of therapy and can make a world of difference in measuring your own progress toward meeting your mental health goals.
Psychotherapy has benefits for everyone, but typically, people seek out therapy to solve a problem.
Both adults and children can attend therapy and work through emotional, psychological, and mental challenges. These can include difficulty concentrating on tasks or feeling sad or confused about life.
Unlike what many people believe, therapy isn’t for “severe” cases only. Anyone can begin therapy at any time to improve or work through common concerns.
For example, you might be wondering how to improve your relationship with your parents. Therapy can help you with that.
Or, you may want to become more determined when aiming to meet your goals. A therapist can also support that process.
Psychotherapy can help you change specific behaviors or thought patterns, and it can also help you overcome challenges.
Sometimes, therapy might help you become aware of who you are or why you do some things.
When you start therapy, you might have your own goals, or you might express what’s on your mind, and your therapist can help you set those goals.
Regardless, Jeffrey M. Cohen, PsyD, believes it’s important to always work with a therapist who sets goals.
“Make sure that your goals for your therapy are clear,” he says. “You set the goals, and your therapist helps you reach them.”
Setting goals might make therapy feel more effective for you. You can often revise them and reflect on how far you’ve come since you started.
Ideally, the goals you set for therapy should be “measurement-based,” so they allow you and your therapist to monitor your progress.
Therapy is not limited to those times you’re seeking or working through a specific diagnosis. It also offers benefits for everyday challenges, and therapy can often be set for a short period of time.
Why you begin therapy is entirely up to you, and most therapists will work with you even when you’re unclear on what you want to get out of it.
Some of the most common reasons to seek therapy include:
Cohen explains that unlike talking with a loved one, therapy is “clinically validated to work.” That’s because it’s rooted in science and based on evidence.
“An evidence-based therapist is utilizing strategies and techniques that are clinically validated to help people,” Cohen explains. “Psychotherapy empowers people with coping skills to navigate life’s challenges.”
Research shows that many psychotherapy approaches are effective for a variety of instances.
A literature review, for example, found that long-term psychoanalytic therapy is highly effective for both reduction of specific symptoms and changes in personality. These effects seem to be long term.
Therapy is also effective for conditions that might take years to develop and are sometimes challenging to treat.
For example, another literature review showed that psychodynamic and cognitive behavioral therapies were effective in treating symptoms of different personality disorders.
How effective therapy is also depends on how much work you do during and in between sessions.
Even though a therapist might help you identify practical ways to change or improve behaviors, it’s up to you to do the “homework” and follow the guidance.
Therapy isn’t always the same. Many approaches look at human behavior and the psyche differently. Consequently, their strategies vary greatly.
These are a few common psychotherapy approaches:
Cognitive behavioral therapy (CBT) helps you identify thoughts and behaviors you want to change, and the therapist helps you create a plan to make those changes.
Acceptance and commitment therapy (ACT) is about accepting your thoughts and feelings without trying to change them. This therapy helps you do what matters to you in life by committing to action steps.
Dialectical behavior therapy (DBT) incorporates a dialectical worldview, which means two opposite ideas can be true simultaneously. DBT focuses on replacing problem behaviors with effective behaviors.
Psychoanalytic therapy seeks to access your unconscious mind to understand why you do what you do.
There are dozens of psychotherapy approaches. Which one is the best psychotherapy type? The one you feel most comfortable with!
Identifying what works better for you might not be a straightforward process, Rojas says. She recommends asking yourself these questions before deciding on a therapy approach:
- Do you want to go to therapy on your own, or do you want a family member to attend or your partner? Are you interested in being in a group with other people focusing on a similar goal? This will help identify if you want individual, family, couples, or group therapy.
- What do you want to work toward? For example, if you want to reduce your anxiety, it’s important to seek a therapist who has experience working with clients with this condition.
- Are you looking for medication in addition to therapy? If so, you’ll want to look for a psychiatrist, someone who is trained in mental health and can prescribe medication.
Once you’ve narrowed down a therapist who can speak to your needs, that individual will have an idea of which modality may be best for you.
This doesn’t mean you have to agree. In fact, sometimes you might want to try different approaches first before settling down with one.
There is also the possibility you might like a therapy approach, but you don’t connect with the therapist you’ve found.
“Finding the right therapist might be overwhelming, but it is important to keep in mind how comfortable you feel with this therapist and if you can continue to over time,” says Rojas.
Despite the possibility of the process being overwhelming, the benefits of therapy outweigh the possible roadblocks in your search.
Although many people prefer a one-on-one therapy format, the choice might not be as clear if your goal is to work through a relationship-based challenge.
In many instances, you’ll be able to combine formats, such as having some individual sessions and a few family or couple sessions, too.
You might want to begin with individual sessions and then work your way through integrating your loved ones into the process.
These are the therapy formats:
- Individual therapy: A series of one-on-one sessions with a therapist. Many modalities can be applied.
- Group therapy: Sessions in which many people working toward the same goals express their thoughts and feelings while being guided by one or more counselors or therapists. “In a group setting, psychotherapy may focus on skills to help participants build the life that they want,” Cohen explains.
- Couple’s or family therapy: A series of sessions where family members meet with a therapist to provide experiences and concerns about a common topic.
Having the option to attend therapy from your home is essential. Still, you might wonder if online therapy sessions are as effective as in-person ones.
Experts believe that telemental health, or online therapy, is as effective as face-to-face therapy.
A few things you might want to keep in mind if you go with online care:
- Verify your therapist’s credentials.
- Save a quiet time and space for those sessions, if possible.
- Double-check your internet connection and make sure you have a “plan B,” such as a phone number to call if you get disconnected.
The potential concerns about online therapy can often be corrected, says Brittany Johnson, LMHC.
“One drawback could be that the person’s home environment is not conducive to a therapy setting,” she says. If this is the case, sitting in your closet or your car could allow for privacy.
“It’s harder for the therapist to read the body language or pick up the nonverbal behaviors,” she adds. The solution, which many therapists have found, is asking probing questions that allow for deeper connections.
It depends. Because there are many reasons to attend therapy, the duration may vary according to your goals. Some people stay weeks in therapy and find their goals have been met. Others stay for years.
Duration of therapy might be a good topic for your first session. A few factors that may affect duration of therapy include:
- personal goals
- life situations that may be contributing to the challenge you want to work on
- how long you’ve experienced symptoms
- whether you’re working on a specific challenge or a general personal growth process
- overlapping symptoms from different mental health conditions
- frequency of your sessions
Sometimes, like many other relationships, a therapeutic bond might not work out. This can stem from different reasons, from chemistry to a therapist’s misconduct. Still, this doesn’t mean therapy cannot help you at all.
If you’re not feeling at ease in your therapy process, you could consider a different therapy approach or another therapist with different or more experience. You might also explore other types of therapy if talking isn’t what you want to focus on right now.
If your symptoms are severe, medication can help. Otherwise, approaches such as art therapy might provide a healing space without talking that much.
“For some people, talk therapy works great, while others may not want to talk or process their somatic or psychological reactions,” says Johnson. Either way, therapy does take participation.
Johnson recommends incorporating self-help books and coaching, if necessary.
Psychotherapy is a space and a relationship established between you and a professionally trained therapist. It can be a one-on-one experience or one for the whole family.
Psychotherapy has been deemed effective for treating a variety of mental health conditions and challenges. A diagnosis is not required to start therapy, though.
Therapy can also help you work through common challenges, from developing resilience to improving your memory or learning new coping mechanisms.
Both face-to-face and online therapy are effective in supporting your processes.
To learn more or to take the first step toward starting therapy, consider visiting these resources:
- American Psychiatric Association’s Find a Psychiatrist tool
- American Psychological Association’s Find a Psychologist tool
- Asian Mental Health Collective’s therapist directory
- Association of Black Psychologists’ Find a Psychologist tool
- National Alliance on Mental Illness Helplines and Support Tools
- National Institute of Mental Health’s Helpline Directory
- National Queer and Trans Therapists of Color Network
- Inclusive Therapists