about What Even is Therapy and the Therapeutic Process?

Welp, it’s the first week of 2024, and if you’re like most folks, you’re simultaneously trying to recover from the sensory overload and weird pacing of the last two weeks, deal with all the family triggers that you’d shoved down for years, and also maybe do some goal setting for 2024. Frankly, it’s a weird place to be, this collision of past, present, and future.

Happily, I can report that therapy – or more formally psychotherapy – is a tool for working through and/or managing all of these factors and more.

So what is therapy, and what should you expect?

By now, most people have had some exposure to therapy or a therapist, but that doesn’t always mean you’re getting accurate intel about the process. For instance, my biggest complaint about the show Wednesday was how unrealistic, unprofessional, and unethical the therapy was – monsters, an animated hand, and ‘the sight’? – no big deal, but somewhat realistic portrayals of terrible therapy makes it so we can’t have nice things.

The formal definition of psychotherapy is a collaborative and structured process that involves a trained therapist and a client – individual, couple, family, or group – to explore and address psychological and emotional challenges. These challenges might look like childhood trauma, they might look like neurodivergence, they might also look like grief and loss. And while I’d love to tell you that we only experience these hardships one at a time, the reality is that we’re usually pinging between multiple issues, doing our best to put out multiple fires without running out of water or getting too burned. Therapy teaches more skills, allowing us better balance, less urgency, and a chance to breathe.

Simply, the goal of therapy is to instigate long-term, sustainable, positive personal change. By building a safe and supportive therapeutic relationship, we aim to alleviate distress, enhance mental well-being, and foster personal growth. This journey happens within a safe and confidential space, where you can openly express your thoughts and feelings without judgment. 

And here we’ve arrived at one of the biggest deterrents to folks seeking therapy: fear of judgment. Self-judgment is a given, but the perceived judgment of a therapist could be devastating. 

It’s true: therapists are people, and it is impossible for us to be completely objective; however, this is where unconditional positive regard and therapist fit come into play. With unconditional positive regard, therapists have an obligation to prioritize your well-being and safety, believing what you say, understanding your motivations, exercising empathy, and putting your growth above their personal beliefs. Therapist fit considers how well your personality and values mesh with those of your therapist – as well as their skill set to meet your therapeutic needs; therapist fit is key to establishing safe and trusting therapeutic rapport as well as actually making positive growth. Let’s be real: you have to like each other at least a little bit to do any meaningful work. When unconditional positive regard and therapist fit are in sync, we have the makings for some great therapy.

And how do you find the right therapist? Research and, unfortunately, trial and error. Have an initial idea of what you’d like to work on, and narrow your options by folks’ specialties and by any other factors you might find important (racial identity, gender, LGBTQIA+ identity, etc.) A good Google search will get you started – and there are several databases that list therapists’ details – but the best way to assess for fit is to request a phone or video consultation. Have an actual conversation. See whether they make you laugh, how comfortable you feel talking with them, whether they are patient with your questions and concerns. It might take a while as therapists are notoriously terrible at returning email and phone calls, but when you find the right therapist, you really find the right therapist.

This is the part where you become an official Client and start the Therapeutic Process, which is pretty similar to any other interaction you’ve had with a medical professional. 

At Prism, we have a patient portal that houses all your personal health information, and we use a battery of standard questionnaires and assessments to help give our therapists background information before you come in for your first session. It’s our way of getting to know you so we can meet you where you are in that very first intake appointment rather than you with questions that dredge up all the trauma you’ve ever experienced.

During the intake session, we review Informed Consent, which is an explanation of therapy and what you can expect from your therapist as a mental health professional. The therapist will also begin asking about your history, presenting concerns, and goals for therapy. This process and transparency helps establish a baseline understanding of what you’re seeking in therapy and formulate a tailored treatment plan. It also helps establish the therapeutic alliance – i.e. the trusting and secure relationship you have with your therapist that lays the groundwork for any future interventions to actually stick.

Psychotherapy encompasses a diverse range of modalities, such as dialectic behavioral therapy (DBT), psychodynamic therapy, humanistic therapy, and more. Each approach offers a unique lens through which the therapist and client explore thoughts, feelings, and behaviors. Often, therapists employ several different methods to help you achieve your goals because therapy is not a one-size-fits-all sort of treatment.

Generally, the therapeutic process involves self-reflection, gaining insight into patterns of thinking and behavior, and developing coping strategies to manage challenges. Sessions may explore past experiences, current dilemmas, and future aspirations. Therapists employ various techniques, including active listening, reflection, interpretation, and empathetic communication to guide you in your self-discovery and growth.

As therapy progresses, you may experience shifts in your perspective, improved self-awareness, and the development of healthier coping mechanisms. We also aim to help improve your relationships with yourself and others. The therapeutic environment serves as a supportive space for exploring and understanding your emotions, thoughts, and relationships; basically, it’s a judgment-free container to practice new skills before you take them out into the wild, wild world. Through this process, you gain tools to navigate life’s challenges, enhance interpersonal skills, and foster positive change.

The duration of psychotherapy varies, with some individuals achieving their goals in a relatively short time, while others benefit from longer-term engagement. It’s the unknowable equation of (What You Came in With + Your Investment in the Process) x How Much Life Throws at You in the Meantime. The ultimate aim is to empower you to lead a more fulfilling life, build resilience, and navigate the complexities of your unique journey. Therapy not only addresses symptoms but also promotes holistic well-being, emphasizing personal growth and the cultivation of a more satisfying and meaningful existence.

So that’s it: Intro to Therapy 101. If you have any questions, the best thing to do is ask. And we’re always here to answer. Seriously, if you need anything, head to the Contact page and we’ll do what we can to help because we know that starting is the hardest part.