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“So How does that make you feel?” – What Really Happens in Therapy?

If you’ve never been to therapy before, there are probably a few things that come to mind when you think about it – and those things probably come to mind as a result of what you’ve been exposed to in the media and in Hollywood depictions.  Perhaps you imagine lying on a couch and being asked to talk about how you feel.  Your therapist nods his or her head, jots down some notes, glances at the time, gives you a prescription for something that will make you feel better, and then schedules your next appointment.  Or maybe you imagine being “psychoanalyzed” or having to dig up old childhood skeletons before being given instructions as to what changes you need to start making in your life.

The reality is that although there might be a couch (usually for sitting upright) and that you might actually talk a little bit about how you feel, therapy is very different than the typical portrayals you have probably seen on TV.  What we hope to do here is to give you a deeper and more realistic look at what really happens in the office . Because style and approach will vary from therapist to therapist, keep in mind that this comes from our perspective and will give you a better idea of what to expect if you decide to start therapy with “Float on Counseling”.  Although a lot of what is said here will probably apply to therapy rather broadly, your experience will certainly differ depending on the therapist you choose.

The two lists below outline things that will and will not happen if you start therapy with us.

Things that will happen:

1 – You’ll be asked to share about your life.  During the first session, you will be asked to share a little bit about your life, upbringing, family/friends, relationship status, significant events, and anything else that might be relevant to know in order to help you best.  This will allow your Counselor to get to know you better and to understand context as it relates to the problems you are dealing with.

2 – You’ll discuss some of the difficulties you’re having and goals for therapy. Early on in the process, you’ll share problems, things that are bothering you, and goals you have for the process.  This makes it possible for your Counselor to know what you need help with.  Establishing goals for the process, helps provide clear direction for moving forward.

3 – You’ll work with your Counselor to develop a plan. As a follow up to the goal-setting process, a plan will start to be developed for positive change. This plan will probably evolve over time, but it should be clear as you leave each session where you will be going from there.  A plan might involve an outline for how the problem areas will be addressed.

4 – You’ll learn more about yourself. Therapy can be a process of self-discovery.  As you share about yourself, gain feedback from your Counselor, and explore thought processes and patterns in your life, you’ll become more self-aware and clear on why you do the things you do.  This helps allow for healthier and more effective ways of dealing with current and future problems.

5 – You’ll learn new skills and new ways of dealing with and framing difficulties in your life. Counselors have training in strategies that can better help you deal with problems, difficult emotions, relationships, and unhelpful thinking in a more effective way.  They’ll share strategies they think might help you best.

6 – You’ll be heard. So much of the relief that therapy provides comes from having an opportunity to express yourself and to be fully heard and understood in the process.  Because therapy is a confidential setting, you’re given the opportunity to talk about things you might have a hard time sharing with other people in your life.  The feedback you get in therapy can be so valuable because of its objective and unbiased nature.

8 – You’ll have homework to do. Most of what happens in therapy, takes place between sessions.  Therapy is usually only about an hour each week, so the time between leaving session and coming back is used as an opportunity to practice new skills, reflect on previous sessions, and to make progress towards your ultimate goals.

Things that won’t happen:

1 – You won’t be judged.  Therapy is intended to be a place where you can express yourself and grow in an accepting and non-judgmental setting, without fear of being shamed or made to feel guilty.

2 – You won’t be directly told what to do.  Although your Counselor might make helpful suggestions at times, they won’t give direct advice regarding decisions or changes that need to be made. They will, however, help you find the answers that probably already lie somewhere within.

3 – You won’t be forced to talk about anything you don’t want to talk about. Although to be most effective, therapy involves having to talk about things that bring up painful memories or emotions, you won’t ever have to talk about anything that you don’t want to talk about.  Therapy is your space – your time, money, and energy – and can progress at a pace you’re most comfortable, dealing with the issues that YOU want to address.

4 – You won’t have to worry about your personal information being shared.  Except for a few legal exceptions (outlined in your initial paperwork and during the first session), counseling is confidential.  This means your counselor won’t be sharing identifying information or personal details about you and things you’ve shared in session.

5 – You won’t be told how long you need to come to therapy.  The amount of time you spend in therapy is ultimately up to you.  Therapy can last anywhere from a few sessions to several months (or longer).  The time-frame depends on the complexity of issues and need for ongoing support.

6 – You won’t be told you need to start medication.  For some people, the combination of therapy and medication management provides good results.  If during the process, you’d like a referral to a psychiatrist to see if medication might be helpful in managing symptoms, this will be provided.  You may be encouraged to explore this as an option, but you will not be told this is something you need to do. In many cases, talk-therapy is enough.

7 – You won’t be labeled.  Diagnoses in mental health (such as anxiety, depression, or PTSD) have a place and can be helpful in helping us better understand ourselves and the workings of our minds.  In some cases, insurance companies require a diagnosis in order to authorize payment of treatment.  That being said, diagnoses are not always necessary, nor will your Counselor be looking to assign you with a “disorder”.  If/when appropriate, diagnoses will be used to educate and as a tool for greater self-awareness and understanding of symptoms and symptom management, but will not be used as a label.  You are not a diagnosis. You are a human with an entirely individual set of experiences and characteristics that do not allow you to be categorized or labeled as such.

If you have any more questions about the work we do or how we can help, you can check out our services or send us a message directly.  You can also call or text 727-258-5231.  Our office is located in the Carrollwood area of Tampa, Florida.

Joel Schmidt, MA, LMHC

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