Understanding Your Therapy

Now that you are starting psychotherapy, you may feel a little confused about the process and about what will be expected of you.  Therapy varies depending on you and the therapist, but some elements are likely to be similar for all.  Therapy begins with some kind of assessment process.  The therapist gathers most of the information from interviews with you.  A lot of questions will be asked.  A therapist occasionally may use a formal psychological test, but this does not mean you should expect one.  Interviews, observations, and sometimes questionnaires usually provide enough information.  Although the questions a therapist chooses to ask vary depending on his or her theoretical orientation, some are standard.  You should expect to discuss:  your history, specific descriptions of the problem you came to solve and its influential factors, what you've tried before and what has or hasn't worked.

What To Expect

Some practitioner's styles of therapy change depending on the therapist's theoretical orientation.  Whatever the orientation, however, the therapist should tell you:

- something specific about your problem and what may have caused it
- what concerns will be addressed and how
- what channels of communication exist between the therapist and you
- what the involvement will be of others (spouse, parent, etc)

You should expect to improve over time.  If you do not, talk to the therapist to make sure you understand what the problems are and why therapy does not seem to be helping.  Remember, you and the therapist are in a partnership for your best interests.  You deserve to know if there are complications.

Coordination with Other Professionals

Some kind of coordination is important between the therapist and other professionals closely involved with you.  This may include your PCP or Psychiatrist.

The Therapeutic Partnership

There is always a partnership.  Your therapist needs your input and insights to help you as effectively as possible.  However, the therapist may ask you to change some of your ways.  The therapist also may suggest family therapy, or marriage counseling to improve the overall functioning of the family system.  Working on family behavior together often improves the outcome.  Make sure that you are comfortable with your therapist.  If you are not, either for personality or theoretical reasons, you should consider switching therapists rather than pulling yourself from therapy altogether.  Many problems are not "just a phase" therapy is often important for your best interests.

Medication

Only MD's or D.O.'s can prescribe psychotropic medications.  Primary Care Physicians (PCP) should not, over a long time, prescribe drugs designed to treat mental health issues.  In general, providers are cautious about prescribing medication.  If medication does seem necessary, make sure that physical tests are done beforehand and that you are monitored carefully after beginning medication.  Make sure you are informed about the drug.  Following are some questions you may want to ask the prescribing physician and your therapist:

- is the therapist familiar with the drug(s) you are taking?
- are there likely to be side effects?
- if so, how will they be monitored?
- does the medication need to begin immediately or can we think about it for awhile first?

You are less likely to need hospitalization unless diagnosed as a "danger to self or others."  Occasionally, however, hospitalization may be necessary for careful monitoring of less obvious problems, for example, with medication.  At times, there are questions that can't be answered in an outpatient setting.

Coordination with Other Professionals

Some kind of coordination is important between the therapist and other professionals closely involved with you.  This may include your PCP or Psychiatrist.

The Therapeutic Partnership

Therapy is always a partnership.  Your therapist needs your input and insights to help you as effectively as possible.  However, the therapist may ask you to change some of your behaviors.  The therapist may also suggest family therapy, or marriage counseling to improve the overall functioning of the family system.  Working on family behavior together often improves the outcome.  Make sure that you are comfortable with your therapist.  If you are not, either for personality or theoretical reasons, you should consider switching therapists rather than pulling yourself from therapy altogether.  Many problems are not "just a phase" therapy is often important for your best interests.