The Process of Psychotherapy.

Psychotherapy is often referred to as talk therapy, and that’s what you’ll be doing as your treatment continues. You and your therapist will engage in a dialogue about your problems and how to fix them


What should I expect as I continue psychotherapy?

You and your psychologist will also keep exploring your problems through talking. For some people, just being able to talk freely about a problem brings relief. In the early stages, your psychologist will help you clarify what’s troubling you. You’ll then move into a problem-solving phase, working together to find alternative ways of thinking, behaving and managing your feelings. You might role-play new behaviors during your sessions and do homework to practice new skills in between. As you go along, you and your psychologist will assess your progress and determine whether your original goals need to be reformulated or expanded.

In some cases, your psychologist may suggest involving others. If you’re having relationship problems, for instance, having a spouse or partner join you in a session can be helpful. Similarly, an individual having parenting problems might want to bring his or her child in. And someone who has trouble interacting with others may benefit from group psychotherapy.

As you begin to resolve the problem that brought you to psychotherapy, you’ll also be learning new skills that will help you see yourself and the world differently. You’ll learn how to distinguish between situations you can change and those you can’t and how to focus on improving the things within your control. You’ll also learn resilience, which will help you better cope with future challenges. A 2006 study of treatment for depression and anxiety, for example, found that the cognitive and behavioral approaches used in psychotherapy have an enduring effect that reduces the risk of symptoms returning even after treatment ends. Another study found a similar result when evaluating the long-term effects of psychodynamic psychotherapy. Soon you’ll have a new perspective and new ways of thinking and behaving.

How can I make the most of psychotherapy?

Psychotherapy is different from medical or dental treatments, where patients typically sit passively while professionals work on them and tell them their diagnosis and treatment plans. Psychotherapy isn't about a psychologist telling you what to do. It's an active collaboration between you and the psychologist.

In fact, hundreds of studies have found that a very important part of what makes psychotherapy work is the collaborative relationship between psychologist and patient, also known as a therapeutic alliance. The therapeutic alliance is what happens when the psychologist and patient work together to achieve the patient's goals.

So be an active, engaged participant in psychotherapy. Help set goals for treatment. Work with your psychologist to come up with a timeline. Ask questions about your treatment plan. If you don’t think a session went well, share that feedback and have a dialogue so that the psychologist can respond and tailor your treatment more effectively. Ask your psychologist for suggestions about books or websites with useful information about your problems.

And because behavior change is difficult, practice is also key. It’s easy to fall back into old patterns of thought and behavior, so stay mindful between sessions. Notice how you’re reacting to things and take what you learn in sessions with your psychologist and apply it to real-life situations. When you bring what you’ve learned between sessions back to your psychologist, that information can inform what happens in his or her office to further help you. Through regular practice, you’ll consolidate the gains you’ve made, get through psychotherapy quicker and maintain your progress after you’re done.

Should I worry about confidentiality?

Psychologists consider maintaining your privacy extremely important. It is a part of their professional code of ethics. More importantly, it is a condition of their professional license. Psychologists who violate patient confidentiality risk losing their ability to practice psychology in the future. To make your psychotherapy as effective as possible, you need to be open and honest about your most private thoughts and behaviors. That can be nerve-wracking, but you don't have to worry about your psychologist sharing your secrets with anyone except in the most extreme situations. If you reveal that you plan to hurt yourself or others, for example, your psychologist is duty-bound to report that to authorities for your own protection and the safety of others. Psychologists must also report abuse, exploitation or neglect of children, the elderly or people with disabilities. Your psychologist may also have to provide some information in court cases. Of course, you can always give your psychologist written permission to share all or part of your discussions with your physician, teachers or anyone else if you desire.

Psychologists take confidentiality so seriously that they may not even acknowledge that they know you if they bump into you at the supermarket or anywhere else. And it’s OK for you to not say hello either. Your psychologist won’t feel bad; he or she will understand that you’re protecting your privacy.

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