What to Expect in Therapy

By Beacon Care Services • 26 Oct 2018

  • Talk therapy increases self-knowledge and teaches healthy mental habits.
  • The focus should be on meeting a goal that you and your therapist have agreed upon.

What happens when you go into therapy? First, there’s the fact that it’s all about talk. Along with the conversation, you may have some homework between sessions.

But how will this make you better? That’s your real concern. After all, people go to therapy because they have an issue causing them pain. Sometimes, drugs like antidepressants may ease the pain with little talk therapy. How can therapy work as well, or even better?

The answer is in your head, literally. The brain changes nerve connections and signal pathways as it takes in new experiences. All your life it is constantly learning and adapting. This means patterns of thought and emotion are not set in stone. They can be altered. Therapy targets the patterns that are harmful. It trains your brain to choose different ones.

In this way, therapy is just another form of learning. It teaches you about yourself as you replace bad mental habits with healthy ones.

A participant, not just a person seeking help

Therapy comes in many forms. What makes therapy work is the effort of the person undergoing therapy. In cognitive-behavioral therapy (CBT), you can expect to get homework assignments. In all types of therapy, the goal is to gain self-knowledge and to act on it. First you learn, with the therapist’s help, why you think and act the way you do. Then you do the work of changing. “The goal is to teach patients to become their own therapists,” says Judith S. Beck, Ph.D., President of the Beck Institute of Cognitive Behavior Therapy.

Research shows therapy works best with “extra-therapeutic” supports. These include motivation from family and friends, and from life events (such as changing jobs). Then there is the quality of the relationship between person and therapist, the choice of method, and the person’s own level of hopefulness. Therapy can involve just the therapist and you. Successful therapy often includes the support of family, friends, and community.

From intake to outcomes

Therapy often starts with an assessment followed by a diagnosis and treatment plan. You may fill out a health history questionnaire. The questions include home, work, life, relationships, parents, partners, and other factors that affect your emotional life.

The therapist and client may decide on focused goals. They could be something like “Improve mood by doing at least one pleasurable activity per day.” Goals of this kind are typical of CBT. Or they may be more wide-ranging. This includes learning how to have healthy relationships. Both you and the therapist need to keep the goal visible and work to reach it.

Then you’ll have sessions of 45-50 minutes.

What happens in and between those sessions will depend on the therapy method. The therapist may ask questions to show issues you hadn’t noticed. These questions are important in CBT. In other forms of therapy, the therapist may mostly listen and let you talk. This can include free association. There, the therapist steps aside and you can say whatever comes to your mind.

Between sessions, especially in CBT, you may get tasks. They support the work you are doing with your therapist. A person who is out of work, for instance, might submit a job application as homework.

Time and progress

How long your therapy takes will depend greatly on the diagnosis. Some cases my only need six to twelve sessions. More complicated issues can take many more. The major thing is to have realistic expectations from the start. And that comes when you and your therapist set the right goals in the right amount of time.