How psychotherapy works

Any time your quality of life isn’t what you want it to be, psychotherapy can help.

Some people seek psychotherapy because they have felt depressed, anxious, or angry for a long time. Others may want help for a chronic illness that is interfering with their emotional or physical well-being. Still others may have short-term problems they need help navigating. They may be going through a divorce, facing an empty nest, feeling overwhelmed by a new job, or grieving a family member’s death, for example.

Signs that you could benefit from therapy include:

• You feel an overwhelming, prolonged sense of helplessness and sadness
• Your problems don’t seem to get better despite your efforts and help from family and friends
• You find it difficult to concentrate on work assignments or to carry out other everyday activities
• You worry excessively, expect the worst, or are constantly on edge
• Your actions, such as drinking too much alcohol, using drugs, or being aggressive, are harming you or others

Psychologists and patients work together, so the right match is important. Good “chemistry” with your psychologist is critical, so don’t be afraid to interview potential candidates about their training, clinical expertise, and experience treating problems like yours. Whether you interview a psychologist by phone, during a special 15-minute consultation, or at your first session, look for someone who makes you feel comfortable and inspires confidence.

The best way to make initial contact with a psychologist is by phone. While you may be tempted to use email, it’s less secure than the telephone when it comes to confidentiality. A psychologist will probably call you back anyway. And it’s faster for everyone to talk rather than have to write everything down.

Psychologists are often with patients and don’t always answer their phones right away. Just leave a message with your name, phone number, and brief description of your situation.

You may feel nervous about contacting a psychologist. That anxiety is perfectly normal. But having the courage to overcome that anxiety and make a call is the first step in the process of empowering yourself to feel better. Just making a plan to call and sticking to it can bring a sense of relief and put you on a more positive path.

Don’t worry that you won’t know what to do once the session actually begins. It’s normal to feel a little anxious in the first few sessions. Psychologists have experience setting the tone and getting things started. They are trained to guide each session in effective ways to help you get closer to your goals. In fact, the first session might seem like a game of 20 questions.

As your psychotherapy goes on, you’ll continue the process of building a trusting, therapeutic relationship with your psychologist.

As part of the ongoing getting-to-know-you process, your psychologist may want to do some assessment. Psychologists are trained to administer and interpret tests that can help to determine the depth of your depression, identify important personality characteristics, uncover unhealthy coping strategies such as drinking problems, or identify learning disabilities.

Psychotherapy is different from medical or dental treatments, where patients typically sit passively while professionals work on them and tell them their diagnosis and treatment plans. Psychotherapy isn’t about a psychologist telling you what to do. It’s an active collaboration between you and the psychologist.

So be an active, engaged participant in psychotherapy. Help set goals for treatment. Work with your psychologist to come up with a timeline. Ask questions about your treatment plan. If you don’t think a session went well, share that feedback and have a dialogue so that the psychologist can respond and tailor your treatment more effectively. Ask your psychologist for suggestions about books or websites with useful information about your problems.

Psychologists consider maintaining your privacy extremely important. It is a part of their professional code of ethics. More importantly, it is a condition of their professional license. Psychologists who violate patient confidentiality risk losing their ability to practice psychology in the future.

Successful treatment is the result of three factors working together:

• Evidence-based treatment that is appropriate for your problem
• The psychologist’s clinical expertise
• Your characteristics, values, culture, and preferences

When people begin psychotherapy, they often feel that their distress is never going to end. Psychotherapy helps people understand that they can do something to improve their situation. That leads to changes that enhance healthy behavior, whether it’s improving relationships, expressing emotions better, doing better at work or school, or thinking more positively.

While some issues and problems respond best to a particular style of therapy, what remains critical and important is the therapeutic alliance and relationship with your psychologist.