The Process of Psychotherapy

Techniques

Most of the time you spend in therapy will consist of talking about the issues you bring up with your therapist.  In addition to discussion, other therapy tools may be used.  These include psychological testing, homework assignments, relaxation training, communication skill training, assertiveness training, desensitization practice, role playing practice, guided imagery, hypnosis, and eye movement desensitization and reprocessing (EMDR).

Format

Treatment can involve individual, family, couple, or group formats depending upon the nature of the problem addressed.  If it appears that psychoactive medication may be a useful addition to your therapy, your therapist will refer you to a physician or other medical professional for consultation.

Therapeutic Orientation

The specific form of your therapy will depend upon your therapist’s specialty, theoretical orientation, and background.  While some treatment approaches require examination of the impact of your childhood and past experiences, others emphasize the present.  Some treatment approaches focus upon solving specific current day problems while others stress development of the insight needed to solve problems in the future.  You may wish to discuss this topic with your therapist, so that you will know what to expect during treatment.

Length of Treatment

The length of treatment varies depending upon you, your therapist, and the nature of the presenting problem.  For specific or situational problems, it is typical for psychotherapy to be conducted in 10 to 12 weekly treatment sessions.  If your problems are severe, effect many areas of your life, or have persisted for a long period of time, therapy can last as long as several years.  Usually, after your first few sessions of psychotherapy, your therapist will be able to give you some idea of the estimated length of treatment.

Frequency and Length of Sessions

Sessions are generally scheduled for once a week and last 45 – 55 minutes, giving your therapist the remainder of the hour to make notes which will aid in planning further treatment and assessing progress.  Depending upon the problem and treatment format, your therapist may recommend a more or less intensive therapy schedule.

Effectiveness

The success of your treatment depends on a large variety of factors including the nature of your problems, the effort you put into the process, the type and length of treatment, and your therapist’s skill.  On the average, research has shown that two-thirds of all patients show improvement during psychotherapy.

Risks / Benefits

At times, psychotherapy will involve giving attention to painful and uncomfortable thoughts and feelings.  Risks sometimes include experiencing feelings such as sadness, guilt, anxiety, anger and frustration, loneliness and helplessness.  Psychotherapy often requires discussing unpleasant aspects of your life.  It may also lead indirectly to the end of important relationships, such as when a patient experiencing marital difficulties decides to seek a divorce.

Psychotherapy has also been shown to have benefits for people who undertake it.  Therapy often leads to significant reduction in feelings of distress, better relationships, and resolution of specific problems.

Dissatisfaction

Psychotherapy can be a difficult process and it is not unusual to feel angry and upset at times about what happens in therapy.  Questions or concerns about the treatment you receive should first be raised with your therapist.  Exploring your thoughts and feelings, even when they are negative, is an important part of the treatment process.  If, after discussing the issues with your therapist, you are still not satisfied, you have several options.  You may seek a second opinion concerning your treatment.  Another approach is to end treatment with your therapist and to switch to a new clinician.  Competent therapists recognize and accept that they will be able to serve the needs of some patients better than others.

Ethical Issues

Psychotherapists are responsible for adhering to a code of ethical practice which includes the maintenance of high standards of professional skill and knowledge and the prohibition of practices which exploit the therapeutic relationship.  Ethical standards specifically prohibit your therapist from using his or her relationship with you for personal advantage, accepting costly gifts from you, being involved in financial or business projects with you or those close to you, developing a social friendship with you, “friending” you on Facebook or other social media and engaging in a sexual relationship with you.

Complaints

If you believe that your therapist’s behavior is either unethical or does not adhere to professional standards, you have several alternatives.  You may wish to bring your concerns to the attention of State of Nebraska Health and Human Services System Department of Regulation and Licensure, Division of Investigations, 301 Centennial Mall South, P.O. Box 95164, Lincoln, NE 68509-5164 (402) 471-0175.  Another option you may choose is to contact the appropriate national professional organization, or its Nebraska chapter.  Both the American Psychological Association and the National Association of Social Workers may be reached at 750 First Street NE, Washington, D.C., 20002-4242, (202) 336-5970 or (800) 638-8799.  The American Counseling Association may be reached at 5999 Stevenson Avenue, Alexandria, VA 22304-3300, (703) 823-9800.