WHAT IS THERAPY LIKE
Once you decide to begin therapy, it is helpful to discuss what therapy might look like for you -from the time you request a consultation; coming in for your initial appointment; and how the remaining sessions may look like. It is important to keep in mind that the phases of therapy sessions described below are guidelines of how therapy typically flows. The therapy sessions may vary depending on the needs and goals of each client; the severity of presenting issues; and new issues which might arise during the therapy process.
Request a Consultation
For clients who have not been seen by me, we start by scheduling a 15 minute video consultation where I will briefly obtain background as to what is bringing you to therapy as well as what your goals are for therapy. This helps us to determine your therapeutic needs and if I can meet those needs as your therapist. You are able to schedule through through the client portal as a “new client”. If you do not find a time that works for you to schedule the video consultation, you may email me with a brief background and I will respond typically within 24-48 business hours.
Gathering Information and Creating a Therapeutic Alliance
During the first few sessions, we will gather information about presenting symptoms/issues and explore present and past events that may be contributing to the current symptoms/issues and impact on functioning. We will be using assessment tools and information gathered during our session time to aid with the diagnosing and treatment treatment goals. It’s a time where I will be asking a lot of questions but also providing you ample opportunity to discuss -in as little or as much detail as you are comfortable with -the reason(s) that brings you to therapy.
The therapeutic alliance is notably one of the most important elements in therapy. The early sessions we have together will also provide you the opportunity to determine if I will be a good fit for you as your therapist. Some things you may want to consider during this time are: Do you have a felt sense of emotional safety and comfort in the sessions? Do you feel you are being heard in the sessions? Have I demonstrated that I have the knowledge and skill-set needed to treat your issues? When reflecting on these questions, I encourage you to trust your inner wisdom to help guide you.
Psycho-Education on: Treatment Modalities, Diagnosis, and the How and Why of the Symptoms
Once we have gathered present and historical data, we begin on-going discussions about the treatment modalities that will be used in the sessions; education about your diagnosis; and learning about the “how and why” the symptoms may have emerged.
Treatment Modalities – Although I typically integrate a mix of modalities throughout the course of treatment, when working with traumatic events and PTSD, I rely heavily on the preferred therapies of Eye Movement Desensitization and Reprocessing (EMDR) and Hypnotherapy. During your sessions, I will discuss in more detail how these two modalities differ from other modalities and why they are helpful to get to the source of the your presenting issues.
Diagnosis – When providing psycho-education about your diagnosis, I reference the Diagnostic and Statistical Manual (DSM-5) to review with you the criteria based your presenting symptoms —which also guides our treatment goals for therapy.
“How and Why” – In addition to providing psycho-education on your diagnosis, it is important to provide you with context to the how and why issues you are struggling with are occurring. By referencing empirical-based theories, you can learn how trauma (or any other life distressing event) impacts the brain and the autonomic nervous system; why it is important to a incorporate a mind-body approach in treatment of symptoms; how adverse childhood experiences impact current functioning; how early attachment from caregivers impacts relationships and emotional regulation or dysregulation; and why learning about your sub-personality traits provides a better understanding on your thoughts, feelings and behaviors about self and others. In other words, learning about the how and why provides a better understanding of how past experiences impact today’s physical and mental functioning.
Skills Building for Resourcing and Stabilization
Considered the “working phase” of treatment, we move to phase 2 of treatment where we explore external and internal strengths and needs; emotional wounds; cognitions about self and others; relationship and behavioral patterns; current coping skills; and triggers. This helps us to identify areas to target skills-building for resourcing and stabilization. A few skills that may be areas of focus are —learning new self-soothing, relaxing, and coping techniques; connecting somatic experiences to aid in regulating the nervous system; learning new techniques to navigate difficult situations; learning effective problem-solving and communication skills to enhance relationships; creating healthier boundaries; and strengthening positive internal states —just to name a few. As you discover new skills in your sessions and practice them in between sessions, this will increase the sense of self-control and the ability to handle more difficult situations easily and confidently.
Healing through Processing, Desensitization, and Integration
For those who have been sufficiently resourced and stabilized with new coping and regulating skills and want to go “deeper” in therapy to get to the source of the issues for optimal healing, we move to phase 3 -the processing, desensitization of intrusive thoughts, memories, and/or body sensations, and then integration of healthier beliefs and perceptions about self and others.
The length of time we spend in processing, desensitization, and integration will vary depending on the number of identified targets we will be working through; the level of distress the targets are causing; how long it takes to clear the targets; and if new targets emerge during the course of treatment. It may be helpful to think of therapy like an onion, we have to peel back each layer of the onion so that we can get to the core. Once we get to the core, or the source of the issue(s), that is were optimal healing and growth can occur.
As we progress through the phases of therapy, we will re-evaluate progress of treatment goals and re-assess level of functioning. It’s a time where we can make changes to therapy goals, determine new goals, or determine if treatment goals have been met.
When there is neutrality and resolution towards the disturbing event and a broadened capacity to effectively respond to day-to-day stressors, we know we are ready to transition out of therapy.