Scoring a Great Deal in Therapy

by Dr. Krista Nabar, PsyD, LP

Scoring a Great Deal in Therapy

As a therapist, referring to my clients as "consumers" and thinking of the work that I do with them as a business transaction does not allow room for the humanity of our interactions and the genuine caring and concern I have for my clients. When we step back and look at a therapeutic encounter, however, on a simplified scale it is a professional relationship in which one individual purchases a service from another. As a savvy coupon-clipping clearance-aisle-browsing shopper, I love knowing that I am getting the biggest bang for my buck. Being a consumer of therapy is no different. You want to put your time and money into someone who helps you reach your treatment goals, whatever they may be, with as few wasted resources (both time and money) as possible. Below I have compiled a list of suggestions to help you do just that.

  1. Have a clear idea of what you want from therapy and seek out therapists whose areas of competence match the areas you want to focus on in therapy. If you need help managing anxiety, choose a therapist who advertises anxiety as an area of interest or competence.
  2. Feel free to meet with multiple potential therapists until you find one with whom you feel comfortable. It is about goodness-of-fit. That being said, research shows that it takes 4 sessions to build an effective therapeutic alliance (the factor in therapy most responsible for positive change), so try to give each therapist you meet with at least a few sessions before you decide if they are the right therapist for you.
  3. When you find a therapist with whom you can see yourself working, try to have an idea of what you want to get out of each session before you go in. If you want to ensure that you get what you need each week, you need to first know what you need and second communicate that to your therapist.
  4. Be open and honest with your therapist. Although it may be uncomfortable or downright embarrassing at times, they cannot be fully helpful to you unless they know what is going on. Therapists are trained to be nonjudgmental. It's kind of our thing. So if you are going to air your dirty laundry to anyone, your therapist is probably a good choice.
  5. Be authentic with your therapist. This is similar to #4, but I am referring less to honesty in what you choose to share and more about not putting on a facade with your therapist. Your job is not to please or protect your therapist, but rather to be fully yourself in the therapeutic relationship. That means cry when you want to cry, express your anger when something makes you mad, and definitely do not feel the need to agree with your therapist on everything they say. You are the expert on you and anything your therapist offers is up for discussion. And most therapists have healthy boundaries that keep them from taking things personally.
  6. Ask questions! I am a big believer in transparency in therapy, meaning that you have the right to know why you are doing what you are doing in therapy and how it relates to your treatment goals. If you know why you are doing something, it will be easier for you to engage with the process.
  7. Give feedback. If therapy is not going as you had hoped, talk to your therapist before throwing in the towel. Your therapist will likely be open to the feedback and will want to work with you to address your concerns. Although it may be challenging for some people to share the news that things are not working, let's return to the idea of being a savvy shopper. Scrapping your current therapy prior to reaching your goals means ditching the work you have done so far and opportunities for further growth and either leaving your goals unattained or starting all over with someone else. While this is sometimes necessary, it should be a last resort. Besides, there is no safer place to practice your assertive communication skills than in the therapeutic relationship. You can also tell your therapist if there is something that has been working well for you to ensure that they continue to incorporate it into sessions.
  8. Do your homework! Not all therapists assign it, but it is important to prioritize it if your therapist does give you assignments. Homework is a way to keep the progress you are making in therapy alive throughout the week. What you don't want is to compartmentalize your therapy to one hour a week and not think about it after you leave the office. I would even recommend that if your therapist does not assign homework, figure out your own way to keep your progress in therapy close at hand, whether that be journaling, sharing your experience with others, or practicing skills you have been building in therapy.

The bottom line is you need to own your therapy and play an active part throughout the process. Be a savvy shopper and score big when you change your life for the better.

Krista Nabar, PsyD, LP

has a doctorate in clinical psychology and is a Certified Sex Therapist (CST) by the American Association of Sex Educators, Counselors, and Therapists (AASECT). She earned her Bachelor's degree from the University of Wisconsin - Madison and both her Master's degree and Doctoral degree from the Chicago School of Professional Psychology. She completed a two-year postdoctoral fellowship at the Program in Human Sexuality at the University of Minnesota's School of Medicine in Minneapolis ... (read more by Dr. Nabar)

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