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What should I expect if I opt for therapy?

Experiences of being in therapy naturally differ greatly from one individual to another: some find it very straightforward and natural to speak to another person about their emotional or mental health challenges; for others, talking about their difficulties may feel embarrassing or even painful. Therapy isn’t for everyone. Of course, the person who finds it particularly difficult to open up about their feelings may be precisely the type of person who benefits most from finding someone who will lend a sympathetic ear to their troubles.

How someone experiences therapy will also depend, not just on their personality, but on the type of therapy they choose. There is now a range of psychological therapies available, each of which has its own strengths and is likely to be more suitable for specific people with specific problems. In recent years, a number of time-limited therapies have become more popular; these seek to provide help to people in a more structured way than traditional psychotherapy, by focusing specifically on individual problems. 

Someone attending cognitive behavioural therapy (CBT) or interpersonal therapy (IPT), for example, is likely to attend weekly (usually hourly) sessions for a period of weeks or months; IPT is based on a 12- to 16-week schedule. Time-limited therapies usually seek to provide techniques that clients can continue to practise once therapy has ended. On the other hand, person-centred therapy (or counselling) may continue for longer than this, and psychodynamic psychotherapy will almost certainly do so, and may involve more than one weekly session.  At the end of the spectrum is personal psychoanalysis, which traditionally involves four or even five sessions a week over an extended period.      

Not all therapy is based on individual treatment; most types of therapy also offer group therapy (focused on a specific challenge or condition which affects all the participants – say, addiction), and family therapy is also widely used to address problems within the family which may stem from some systemic dysfunction rather than the individual challenges of one of the family members.  

Of course, whatever type of therapy is chosen and in whatever format (personal, family, group), what matters most is that the patient feels comfortable with the therapist and certain that they can relate to them and talk to them in complete confidentiality (see also, What to look for in a therapist).

The nature of the relationship with the therapist will also differ quite markedly according to the type of therapy (though in every case there should be clear rules in place which set out the boundaries of the patient-therapist relationship, in order to ensure the relationship retains its integrity, and to protect both parties).  A psychotherapist, for example, does not usually ask questions of their clients; instead, they encourage them to talk about what is on their mind.  In person-centred therapy, however, the relationship between therapist (or counsellor) and patient is considered key, and the therapist may draw on their own experiences as a means of relating openly and honestly to the client. It is also important that both the client and the therapist have matching expectations of what the therapy is seeking to achieve: it would be unwise to enter into a programme of CBT which is designed to last for say a maximum of four months and expect to examine every aspect of your psyche; equally, if you’re embarking on psychodynamic psychotherapy, you should be prepared to commit to a longer-term treatment.

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