What better time than the start of a new year to make change that can positively affect the rest of your life? Let’s assume you have made that brave decision, and talk therapy is part of your plan. What do you expect when you are expecting talk therapy? If you want to know how I do it, read on.
People that have never experienced talk therapy often feel a tad apprehensive about getting started. There are lots of reasons. Some wonder if it will do any good at all, and others have the odd fear they won’t be able to ‘do it right.’ Some people simply don’t know how it proceeds or what is expected of them, and they are anxious about that. Still others believe they will receive all the instructions from the therapist about how to change and be on their way—with no real understanding of the courage, persistence, and work that real change takes. And some believe a pill is the answer.
Five Things To Expect When You’re Expecting Talk Therapy
These are the five areas I address either at the beginning of therapy or near the beginning: information gathering, the demystification of the therapy process, coping skills, homework and behavioral experiments, and developing our roadmap together.
First, when a prospective client contacts me, either through email, the scheduling portal*, or a phone call, my first step is to gather information, just like what would happen if you visit any health care professional. I like to arrange a phone chat for about 15-20 minutes to get a feel for what kind of help you are seeking. I explain in detail the “housekeeping stuff.” That means insurance (if you are using it), how to open my my confidential paperwork portal, and answer any of the questions in the this-is-how-your-records-are-kept category.
This first conversation typically is the beginning of whether or not you feel like we are going to connect, essential for effective therapy to happen.–Page Rutledge, LCSW
Second, I explain my approach, hopefully demystifying the process. I start by telling you exactly what my progress notes are for, and let you know I’m happy for you to see them—just not anyone else. These are the notes you will see me taking during our sessions together. These notes help with my understanding of your worldview so that we choose what type of therapy will best help. Often it winds up being a combination of several approaches that make sense to you, hopefully somewhat seamlessly if I manage to do it with any finesse?
Third, depending on the level of your distress, which varies greatly by client, I might teach you some coping skills. We will begin to develop a toolkit where you will pick and choose what works for you to reduce your anxiety. This gives your thinking brain a fighting chance to kick in. This skill involves teaching you to acknowledge your feelings first, so that you think more objectively and constructively. In this way, problems may be put into better perspective and dealt with proactively. You will learn over time that you don’t have to react immediately, or provide another upset person with solutions on demand. These decisions are choice points for you.
I have noticed that clients often feel a pressure in their first session to tell ALL of their story, and I am there to remind you that I’m not going anywhere, and will hear you, and see you, until we both have a sense of where to start.–Page Rutledge, LCSW
Fourth, I very often prescribe various books or articles to read that connect to your challenges. This comes under the category of “Homework”—such an off-putting name for an important part of your learning. Information is power. This area may also be an experiment we agree upon in session to try a different behavior during the next week. Perhaps it will be a small, manageable change that you can experience and report back on in session. I also tend to like supporting research and will often share some in session that relates to the work you are doing. If that sounds dry to you, I’ll ask you to consider whether you just want some feel-good therapy, or an approach that might actually work.
Lastly, we will develop a plan together, an approach of how you want to make the changes you seek with goals and objectives, which are just fancy words for how we will get there. And periodically, I will check in with you to see if we are on track. I want feedback. I want to know if what we are doing is helpful, and if it is not, then we need to change it up. And if necessary, I will be happy to refer you out to someone better suited than myself to help you continue your work.
How Long Does It Take?
And then we are off to the races! Clients often want to know how long the “gestation” period is in talk therapy, AKA how long does it take for me to feel better?
On several factors, like…
- The depth of the problem, such as deep and repeated trauma vs situational depression, where something has recently occurred that you need to work your way through.
- The amount of work you are willing to put into it. Do you do the homework?
- Outside factors, like a spouse that may sabotage your efforts, either willingly, or unwittingly.
- Or a workplace that has a culture that operates from a place of scarcity vs abundance.
- Or long-standing behavioral habits you have developed that take time to notice and change. That might involve some skill-building on your part.
- There are many more factors that influence outcomes, but I can say with a fair amount of confidence that most clients I see start to feel better within the first 4-6 sessions, some earlier. That’s when they realize they need to stick with it so the changes they are working so hard on will also stick.
So that’s it. Five things to expect when you are expecting talk therapy. I hope you find the courage to make the changes you desire in 2019. Contact me at www.pagerutledge.com or here for help in making your goals reality.
P.S. You can also schedule online* by scrolling to the bottom on the homepage and pressing the blue button. Select new client if it is your first time. Existing clients may simply select “existing.”