What happens during the first therapy session?
There is usually one specific event that has triggered a multitude of problems. For example, parent's divorce or death, break up of a relationship, abandonment, abuse, etc. So, the pschy will want to know what brought you to them. After all, we do all have problems, but we don't sit there and go "Well, I don't get along with my boss." That's not the root of the problem. For your time and money, you must get to the root of the problem right away. Don't delay thinking you are being a cool "Good Will Hunting." You are only delaying your wellness and wasting money. Most importantly, realize that a psych will put things in perspective NOT solve your problems. You need to learn the coping skills to deal with your problems instead of using a psych as a long-term crutch. Remember, psychs are people with problems, too, they do NOT have all the answers.
First Therapy Appointment (Psychologist)?
Before I answer... I'm a mental health therapist so I think I am qualified to answer. :) 1) Expect an assessment. The therapist is going to want to know a lot about you, your history, drug usage, suicidal ideation, relationships, prior therapy experience, medications, medical history... He/she could have some assessment tools which are simply preplanned questions that cover these areas. This is totally normal procedure, this way the therapist can simply get to the point of why you are there. Just be honest. 2) Just bring honesty and openness. 3) Establish a clear boundary with your mother. She has absolutely no right to know what goes on in therapy (unless you're under 12 or are going to physically harm her). Tell her you don't feel comfortable or you don't like being that vulnerable or whatever. 4) If you don't like her you can ask to switch therapists if that option is available. I would encourage you to instead simply tell her that the relationship is not working and then explore that. It might be something totally different but for some reason is coming up as not liking the therapist. But it might be you don't like her or the way she works and that can be dealth with. Totally acceptable and normal. 5) Just be honest with yourself and the process. I can tell you have some anxiety about it. It's really not that scary. Feel free to tell the therapist anything and everything, including any fear you have about starting therapy or the therapist herself.
Help with psychology question?
In all of the years that she had been a resident in the hospital, Helen had never made her bed or straightened her room. A new psychologist on the floor surprised her with instructions to do so before they met for the morning session. He would inspect the room and give "commissary bucks" to patients who completed the task on time. The psychologist is using A. A token economy B. Contingency contracting C. Aversive conditioning D. Systematic desensitization
How do psychologists manage to close the therapy session in an hour?
I watch the clock during the entire session. I try to have it where the client won't see. It's not like I'm WANTING it to be over but I need to pace it to be responsible for our time.I typically sit back comfortably during the bulk of the session but in the last 5-10 minutes start leaning forward a little then shifting slightly to the edge of the chair. This is communicating to the client's subconscious that we're making a shift, even while they're still talking. In the first part I ask more open ended questions which encourages exploration and the last part I recap more. In my mind a session looks something like:first 5 min warm up chat (how are you? fine etc etc)then shift to ok how are you reallythen around 10 min in we're getting an idea of the main events that happened since last session and I'm thinking how they fit into the themes we've been working with30 minutes in we should be deep in the work40 minutes in the client should be getting tired and starting to come up to a slightly lighter level or they might be deep in discovering new things45 minutes I'm shifting to the edge of the chair and summarizing the session, hitting the high points, anything new we learned, then we're discussing what is going to happen between now and next session - homework, challenges, positive thoughts I want them to keep in mind50-55-60 minutes we're paying and scheduling next appointmentIf anything new or big seems to be coming out late in the session I made a big point of labeling how important it is and how I really want to "unpack that" next time when we have time to properly address it because its really important. Clients have never appeared to feel cut off by that because I think they believe me (which is good because I'm being sincere) that it really is needs more time than we have. If someone is still very emotional when our time is running out I just tell them that. I tell them that we're down to about 15 minutes and I want to help them get a little relief before they go, so we may do a little relaxation, self havening, mindfulness, etc to calm them emotionally be they walk out.
Is it okay to miss my therapist so much between sessions?
I see my therapist twice a week and I still feel like I miss her in between. She gave me everything including a will to live. She stood with me when no one else did and I find myself very attached to her. This week she is taking the week off for a short vaction and I m not seeing her at all. I am feeling such confusing feelings right now. Although I just saw her two days ago, I need to see her again and I don t know how I will manage another whole week without her.
What happens if a client walks out of a therapy session not because she is angry with the therapist, but because she felt overwhelmed? Will the therapist refuse to see that client again?
A therapist should never refuse to see you because of a coping strategy you’ve used for years.We understand that in times of high stress, everyone is doing the best they can. Sometimes the way people attempt to cope is dysfunctional……but people tend to repeat dysfunctional patterns because they work in the moment. That’s true of almost every dysfunctional way of coping - drug use, self-injury, and certainly physically leaving the scene.Physically escaping likely relieves some of the intensity for that person.If you’re overwhelmed and feel like physically escaping - that’s something I actually want to know more about…because I would bet it repeats a pattern you engage in outside of therapy as well!It’s not an effective way of coping, but that’s why you’re in therapy.We’d halt whatever topic we were on…and I’d encourage you to stay, sit with it, and we’ll hash this out.A good middle ground, if the person just couldn’t manage, would be to have a “physical break,” and then come back in after 5 or 10 minutes.Not being able to tolerate emotion isn’t uncommon, but replicating unhealthy patterns isn’t something I’d want to do.So, we’d start immediately by shifting that pattern….either by taking that physical break (and making it limited), or having them stay - but either way, we’d be hashing that out.Will it be uncomfortable? YES.Will it be hard? YES.But that’s what I’m there for. To give you a safe space, the tools to cope with with that emotion (to have better distress tolerance), and to come out the other side of it feeling like you can manage.No one likes feeling overwhelmed, but it’s really powerful the first time someone can not run from it and be okay in the end.
Does talk therapy with a psychologist really work????
First off, congratulations on taking a positive step for yourself. I am a psychologist, and I have been to psychologists. I've seen it work with my patients, and it was certainly helpful for me as well. There are many forms of talk therapy--some of which work very well, some of which are less effective. But all forms are dependent upon how honest YOU are about what's occurring for you, and about following through and really trying to do some of the things that the therapist suggests outside of your sessions. What usually happens is that the psychologist or psychotherapist does an assessment and diagnosis during the first session with you. Then s/he will develop a treatment plan to help you understand the issues that you are going to work on together. Part of that treatment plan may include referrals to various resources, for example, to a psych MD for an evaluation for medication. Usually, fairly early on in your treatment, the therapist will give you a referral to a psych MD for medication evaluation if that is appropriate. As an alternate, if it seems that you may not need meds at first, the therapist may treat you without meds. If it seems as if you are not making much progress, s/he may refer you later for a medication evaluation. It sounds to me, just from the little that you've told me, that you would do well with an evaluation for medication right at the start because you are describing many symptoms of depression. The most effective treatment for depressive disorders is a combination of medications and "talk therapy". Good luck!
What happens in a final therapy session? I want to be prepared and informed so I can move on quickly. How is the session usually structured?
As other Quorians have pointed out there is no specific script, procedure or protocol for a final therapy session. While there will be similarities for the final session (or sessions), every therapist has their own unique way in working with termination.The Freudians with their three sessions a week for two or three years for psychoanalysis, prepared the client by working on termination issues for months before the final session. One of the major themes to address was with abandonment issues and how the client would cope with the ending of a long, emotional therapeutic process. Needless to say, this model has, for the most part, fallen out of favor under the advent of managed care.As funding started to dry up in community mental health too, therapy became “solution focussed”, time limited, goal specific. With long term therapy becoming another casualty in the endless quest for increased productivity, the important work was done up front with the development of a collaborative treatment plan that stressed progress assessed in terms of behavioral markers.Termination became for many therapists a one session affair. Patient progress was reviewing initial treatment goals and how well these were achieved.This all sounds very perfunctory and grim. I was taught that the final session should also contain a celebratory note- to illumine the work the client did and the changes made. This wasn’t just “shining the client on” with false praise but an honest and sincere evaluation.If little work was accomplished, the client and I would explore reasons for this and what I might have done different. One client suggested that I could have listened more. That stung but it was true.Of course, there are recommendations for continuing care, further treatment and the setting up of what the client might see or do or feel if the mental health issues that brought him into treatment start to return.If possible or relevant I would also discussed how our therapeutic journey effected me and what I was taking away in terms of lessons learned.I’m not a “good-bye” kind of person and at times I have to struggle with my own sense of loss. Fortunately I live in a small town where I will run into former clients for years and our relationships endure.