What will Happen in Therapy?

If you have not had therapy before, it can be quite daunting to put yourself in front of a stranger just at the time when you feel most vulnerable, often with an issue about which you feel ashamed. Not knowing what to expect when you do go for therapy can add to these concerns. This week’s blog entry is designed to allay some of those understandable concerns by letting you know what will and will not happen.

What will NOT happen in therapy

Ignore all comic representations of therapy, even many drama based representations of therapy.

I will NOT:- 
- shout at you/belittle you (Local Hero, Anger Management), 
- have sex with you (Prince of Tides). 
- enter into a social relationship with you, 
- tell you what you should do or how to live your life, 
- judge you, 
- ignore you, 
- tell you my problems (various TV comedies), 
- try to change your sexual preferences (a small number of therapists recently believed 
this to be acceptable, however the vast majority of the profession are against it and 
sanctions are now in place to prevent such behaviour), 
- try to change your religious/secular/philosophical/political beliefs.

NB. The BACP Framework for Good Practice provides a code of ethics by which our work is evaluated. Breaches of this practice which are not resolvable directly with your therapist can be addressed by raising a complaint with the BACP (provided the therapist is a member of the BACP). Before starting therapy, find out with which body the therapist is registered. Under proposed legislation soon to be implemented there will be registers (“Assured Voluntary Registers”) for any practising therapist to ensure all are operating within an agreed code of ethics. It is reassuring to note that not many complaints are made each year and most clients find therapy beneficial.

Each client will have their own individual way of presenting, influenced by their normal patterns of relating, the current circumstances & how the therapist is with the client. Thus, it is not possible to exactly say how things will be. Some clients need space to be witnessed, unjudged, & calmly contained in their silence, others may feel the need to offload the pressure of things they want to talk about & feel heard. There is no prescriptive right or wrong way of being for the client in therapy. However you present, you will be saying (not necessarily verbally) something about yourself and that is what we will be working with.

What will happen in therapy?

In the way that I personally practice, the initial session is different from all later sessions. I usually offer to start by outlining my service (weekly, 50-minute, individual sessions), how I handle holidays & illnesses, the limits of confidentiality, agreements on payment. This normally takes around 5 minutes. 

I then offer the space up for the individual to tell me a bit about why they are here? I may ask several questions to try to understand how the issues they bring sit within the bigger picture of their life as a whole. I may ask questions about the degree of risk that the individual represents to themselves or others e.g. self-harming/suicidal thoughts or behaviour, drug & alcohol use, any psychiatric history. I usually try to give the individual some sense of what it will be like to be in therapy with me. Thus, I will endeavour to offer a reflection on my experience of being with the individual (how I resonate as a “tuning fork”). 

In the last 5 minutes, I would invite the individual to tell me how the session has gone for them, whether they wish to continue our sessions, on what basis (open ended, short term), and if so to agree a set time and day of the week for our sessions. I usually ask, “How will you know when you are ready to end our sessions”? For differing individuals this may be easy or difficult to answer and may change over time, but nevertheless it is an important question to keep in mind, so we can hold some focus for the work. 

If the nature of the issue is one for which I feel would be better addressed by a specialist agency I would try to provide the appropriate contact details, e.g. issues around adoption legally require specific training and qualifications, similarly children under 16 require specialist support.

Subsequent sessions are not structured by me. Having welcomed you to the session, I leave it for the individual to express themselves in whatever way they wish and I will work with that. Some individuals find this a challenge and so I would support them through that challenge encouraging them over time to trust themselves. This in itself would be part of our work. Whilst I will ask questions in subsequent sessions, these will be very much to aid in the exploration of whatever the individual brings rather than me directing the individual.


If you have any questions about this blog or any of the issues raised please feel free to contact me via my website: http://www.garycooktherapy.co.uk