Chit-Chat Chronicles: Exploring the Wonders of Talk Therapy
When we hear the word therapy, what do we tend to picture? The initial image is probably what is portrayed in movies, TV shows, or even newspaper comics. A long couch with a client laying down staring at the ceiling. A seemingly half-interested or judgy bald therapist with a small notepad – why are male therapists always bald? Oh well. I digress –. No eye contact being made between therapist and client. Maybe some Rorschach inkblot images. You get the picture… The American Psychological Association (2023) defines psychotherapy as a treatment that is relational in nature and is a collaborative effort between the client and the therapist; within this therapeutic relationship, the therapist is a neutral and nonjudgmental party who creates a supportive environment in which the client can freely talk. Collaborative and relational. That paints a much more accurate picture.
Underneath this umbrella definition there lies a long list of various theories, methodologies, and interventions from which your therapist has formed his or her chosen orientation to operate under. To list a few, there is: psychoanalysis, Adlerian therapy, cognitive behavioral therapy, existential therapy, solution-focused therapy, and the list goes on. These theoretical approaches to therapy are essentially different lenses from which therapists may choose to view and treat their clients’ concerns. It all can get quite confusing, so here is all that you need to know as a client: Therapy should feel supportive, genuine, and collaborative.
How long does therapy usually last?
The answer is simple but vague…It depends. It depends on many factors, such as the needs of the client, the therapist’s chosen theoretical orientation, whether or not the client is receiving adjunctive treatment along with therapy (e.g. psychotropic medications or transcranial magnetic stimulation) and so on. With regard to varying client needs, one person may be attending therapy for treatment of complex Post-Traumatic Stress Disorder (PTSD) which could require longer term and/or more frequent therapy while another person may be seeking therapy to get help developing self-care skills which could, arguably, require shorter term or less frequent therapy visits. The results of one study by Knekt et al. (2016) supports the argument that short-term psychotherapy (which they defined as 100-120 sessions) may be less effective than long-term psychotherapy (240-260 sessions); however, the authors of the study note that short-term therapy in combination with taking prescription medications is about as effective as long-term therapy. These researchers were also clear in stating that they believe much more research in this area needs to be conducted before any truly definitive conclusions can be made about the optimal length of therapy (Knekt et al., 2016).
In my experience, I have seen clients achieve what they wanted from therapy in anywhere from 2 months to over a year. Some of them came to see me for a few weeks, stopped for a couple months, and then came back when they realized they wanted to talk more. Others came to my office once a week for 13 months straight. All of this is really a mouthful just to again say…it depends.
What can you expect to gain from therapy?
If the idea of seeing a therapist makes you feel scared or anxious then you are not alone. Maybe you’ve never tried therapy and are going in with some skepticism, or perhaps you have tried it before and had negative experiences with it. I hear both of these quite often from my new clients. Research has been conducted to better understand what clients most commonly take away from their experiences in therapy. One such study by Elliott (2008) found that clients got the most benefit from therapy when they had a good therapeutic relationship with the therapist, their therapist listened to, empathized with, and validated their experience, and the therapist provided relevant techniques to help the client work through challenges. As a client, you should expect the same from therapy.
What you can also expect from a healthy therapeutic relationship is authenticity. “A wealth of clinical and theoretical writings underscores the critical role that self of the therapist work plays in the training and formation of effective therapists” (Aponte & Kissil, 2011, p. 1). In other words, there is significant evidence arguing that the ‘self’ or the humanity of the therapist is clinically valuable. Therefore, what you can expect to gain from therapy is this: A safe environment in which you can voice thoughts, ideas, questions, struggles, hurts, failures, successes, the good, and the bad with someone who wants to connect with you and will nonjudgmentally listen to and talk with you as well as provide you with tools to help manage challenges.
American Psychological Association. (2023). Psychotherapy.
Aponte, H.J. & Kissil, K. (2011). “If I can grapple with this I can truly be of use in the therapy
room”: Using the therapist’s own emotional struggles to facilitate effective therapy. Journal of Marital and Family Therapy, 1-13. doi: 10.1111/jmft.12011
Elliot, R. (2008). Research on client experiences of therapy: Introduction to the special section.
Psychotherapy Research, 18, 239-242
Knekt, P., Virtala, E., Harkanen, T., Vaarama, M., Lehtonen, J. & Lindfors, O. (2016). The
outcome of short- and long-term psychotherapy 10 years after start of treatment. Psychological Medicine, 1-14