Meeting a new therapist can be an anxious experience. If you didn’t already have enough on your mind, there are common and natural concerns about who this stranger is to whom you are about to lay bare your soul. Worries about what the connection will be like, if you will feel comfortable in the office, or just knowing you are about to go through a story you dread telling, whether it be for the first time or the tenth time, may give you pause before getting all the way to the unfamiliar waiting room. As a therapist, I regularly meet with new clients and most of the time they share very similar feelings. My top priorities in that first session are to create a space of comfort and safety and to allow the client to be heard. While I can’t promise anyone in that first session that I will help them solve their problem, I can promise that I will help them if they allow me.
People come to therapy for many different reasons. Some use therapy as an outlet, a place to verbally process past or present situations with a person who is trained to be neutral and provide feedback. Others have very specific emotional pain or feelings that seem beyond their control and don’t know how to manage these feelings on their own. In conjoint therapy sessions, couples and families are often trying to work through conflict they have not been able to settle on their own. No matter the reason for coming to therapy, our clients are looking for the therapist to help them find answers, solutions and resolution.
Though therapists might use different language or metaphors, essentially the role of all therapists is to be a guide, mirror and catalyst. As a guide, your therapist will help move you down a path in the therapy sessions that is in agreement with your therapy goals and give you tools and resources to help you work toward your goals between sessions especially. Although there are different personalities and approaches, even a therapist who feels like an old friend should be more than just a good listener. Because of the subjective nature of our experiences, it is often easy (and important!) to explore other aspects of a client’s story, but the therapist should be doing regular internal check-ins to make sure the therapy is productive and in line with why you have come in the first place.
As a mirror, a therapist should be able to reflect to you what he or she sees as challenges toward your goals, strengths you may not acknowledge, or habits you might be engaging in that could be contributing to the problems you are dealing with. This is a role that therapists must learn to find balance as it often requires some directness, and, if not done skillfully, can leave a client feeling wounded by someone to whom they have given a lot of trust and power. Nevertheless, if a therapist sees emerging patterns in a client’s story, she or he will be better able to help the client grow and recover if reflection to the client is a part of the process.
A catalyst is, in chemistry terms, a substance that creates a change without itself going through any permanent chemical change. In human terms, however, it is just not possible that we will not be changed by one another. In my role as a catalyst of your change, I acknowledge that I can not really do the hard work for you in creating things to be new and different in your own life. But as a precipitator of your change, I can work with you in helping you create the change you want in your life. To me, this is one of the most empowering things a client can know: that you really are the one who puts into action the work done in the therapy room and the ensuing results are the fruit of your own hard work. While my change process as a therapist is a little different, I learn from you in lots of ways, too.
Now that you know the therapist’s role in the therapeutic relationship, there are a few things you can do to have a successful therapy experience. I can often make an assessment within the first session or two regarding the probable effectiveness of the therapy with new clients. For those in whom I usually see the most success in therapy, there are some common practices that aid in their success:
Do research. There are a lot of different kinds of therapy models and therapists out there. Couple that with an individual therapists personality and expertise and finding a new therapist can seem a daunting experience. There are many tools for finding a therapist who can meet your needs. A personal recommendation from a friend or family member can be a good place to begin. Search engines and therapy listing sites are a good resource as well. Psychology Today and Good Therapist are two websites where you will find many ways of creating custom searches. A few important questions to ask yourself are: what are your goals? Do you have a specific style of therapy or treatment approach in mind? Do you want someone with a lot of experience or a fresh look on the field? While asking yourself these questions can be important, I’d say the biggest factor is to go with your gut. Read therapist bios, narrow down your choices to a few that really resonate with you and then try to have a brief conversation on the phone with the therapist before scheduling the first appointment. It's also important to make the time for therapy appointments. If you are not committed at the outset of working with a therapists schedule, then find someone whose schedule works with yours. The worst outcomes in therapy are from the sessions you don’t attend.
Give it a little time. The first few sessions can be a little clunky and even awkward sometimes. Although the clinician has the skills and training to assess your needs, there is always a bit of “getting to know you” that takes time to develop like any relationship. A few key factors that should be present off the bat are: do you feel safe? Do you feel comfortable talking about personal issues? Do you feel a connection that can be built on? Can you trust this person? Not all of the answers will be ‘yes’ right away, but if you can see the potential for building a therapy relationship, allow the process to grow over the next few sessions. Depending on the therapist's style, it might take 4-6 sessions to really feel progress or see the benefit to yourself. Except in specific cases, I encourage my clients to commit to 6 sessions. Ultimately, though, it is always your right as the client to determine when therapy starts and stops.
Be open. Now that you are feeling comfortable in therapy, allow yourself to get a little uncomfortable. Change usually doesn’t happen when we stay in our comfort zone. The therapist may suggest activities that might be different than what you are used to or seem awkward and strange. While I’m not suggesting you just go along with anything, and certainly not something that violates your rights as a person, you might have to go along with some outside-the-box thinking. That might mean talking about things you feel uncomfortable with, practicing new tools like mindfulness skills, or trying a technique that is new to you such as EMDR or tapping. A tried and true therapy rule: if you want something new and different, you have to do something new and different.
Be yourself. The very best thing you can do for yourself in a new therapy relationship (or even an ongoing one) is to simply be yourself. Your therapist has no expectation of who you are or should be. The more authentic you are, the more authentic experience you will have. It's easy to get caught up in trying to please a therapist to win her or his approval. But your therapist can not effectively help you if they don’t get a sense of the real you. And something really important you will learn in the process is that you can be accepted and loved for just who you are, for just being. Even if its uncomfortable at first to say embarrassing or shame-inducing things about oneself, I’m certain you will look back at those moments when you allowed yourself to be vulnerable and open, real and honest, and will see them as moments when you made a genuine connection not with just your therapist, but truly with yourself.
As with anything new, I give my clients the most credit just for showing up on day one. The amount of courage it takes to first admit to yourself that you need help and then seek out that help is not lost on your therapist. When we are able to own our weaknesses, that is when we display our strength. The greatest outcome of a good therapeutic relationship is the more whole and healed relationship you will have with yourself.