How Therapy Works

A general breakdown of the progression of therapy, from the first session to the last, and some important therapeutic factors.

The General Progression of Therapy

Whether therapy involves individual, group, EMDR, or telehealth options (note: see the Services section about these options), the general progression tends to be similar:

Problem Identification Icon

Problem Identification

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Treatment Planning and Implementation

Attainment of Clients Goals Logo

Attainment of Clients Goals

Throughout this progression fostering and strengthening a good “treatment alliance” is important. My general stance is to demystify the therapeutic process and help clients be comfortable with it. Collaboration between parties is emphasized.

The Importance of the Therapeutic Alliance.

This alliance refers to having a good working relationship between a client and a therapist. It is one of the most significant factors in increasing the potential for a positive therapy outcome.

Certainly, it is my hope that such a relationship develops, though readily appreciate I may not be the right provider for someone. In such a case, I will likely recommend a referral to another provider that might provide a better “fit” for both persons.

In addition to having a good treatment alliance, having the right experience helps foster a beneficial therapy effect. An example of this is through doing, eventually, what a person really wants to do, but cannot yet do given his/her social fears and anxieties, lack of social skills, depression, etc.

What Can You Expect From the First Session?

For the first session I ask a lot of questions based on a structured clinical interview.

This interview addresses a client's reasons for seeking therapy and his/her presenting issues. These questions, and the answers to them, help create a diagnostic intake and point toward treatment recommendations and treatment goals. Some questions include: a history about a client's problems, how often such problems occur, and what has already been tried to help these problems. If more in-depth information is needed, psychological testing may be warranted.

What happens after the first session?

For the sessions following collaboration about treatment goals and more-in-depth discussion about presenting problems are addressed. Understanding a person's experience, on cognitive and emotional levels, is important. I like to help clients identify, and then resolve, particular internal conflicts they struggle with. An emphasis in therapy is on practicing—that is, practicing new, beneficial ways of thinking and acting until they become second nature to a person.

The therapeutic process ends for clients at different times. For some, a person may come in for one session, or a few sessions, to discuss a brief problem and a course of action. Most clients, though, come in for a bit longer, sometimes for years given their particular struggles. Weekly sessions tend to be the most common though sessions every two-weeks, and sometimes one time per month, occur. The end of therapy is usually determined by adequate resolution concerning a particular problem, or if a client decides to hold off on an issue for the time-being, or if he/she wishes to seek services elsewhere.

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