12 Things Clients Should Know About Mental Health Therapy
One psychologist's take on what you should understand about the counselling process
Mental health therapy can be somewhat of a mysterious endeavour, especially for those new to the process. Aside from what appears in movies and tv shows, or what you hear from friends or family, the expectations for what therapy should ideally look like can be unclear. There are a few reasons for this including the wide array of therapeutic approaches available, the differences across therapist styles and personality, and the specific goals and preferences you are bringing to mental health counselling. This post introduces twelve important points that clients accessing mental health therapy treatment may want to keep in mind.
The therapy relationship with your mental health professional
1. Sometimes it takes a while to find the right fit
Finding the right therapist has become a bit like conducting a job search or dating. There are many different options available, especially with the growing popularity of virtual online therapy. You can flip through directories and profiles, and many mental health therapists now offer consultation calls, much like a brief initial interview to get a sense of fit and also identify if your reasons for attending therapy fit into the therapist’s expertise (also known as “scope of practice”). However, you might not really have a sense of fit until you’ve worked together over a few sessions.
2. It’s okay to switch therapists
It might go without saying, but clients can always decide to switch therapists. This can be as soon as following a single session or years into working with someone. You might decide to try a new mental health therapist if the therapy feels like it is no longer progressing, or if there is a values mismatch. It may also be recommended to consider finding a new therapist referral if your goals for therapy have evolved since starting and are no longer within the therapist’s scope of practice.
3. Areas of practice can be quite specialized
When you are looking for a therapist it can be important to consider if their expertise (known as “scope of practice”) is a good fit for your reasons for attending therapy. Your concerns will be best addressed by a clinician who focuses and has received additional training in that area.
Nerves about the mental health counselling process
4. You don’t need to know what you are going to talk about
A theme I often hear as a psychologist is that clients are nervous about coming to sessions prepared with something to talk about – if this is a concern for you, hopefully this can relieve your worry. You do not need to come prepared with something (or a list of things to discuss) although you are welcome to if you find it helpful. Part of the clinician’s role is to help you identify your goals for therapy. Those goals are then used to help develop a treatment plan forward.
5. Therapy takes time (sometimes)
Realistic expectations for the therapy process can help to improve your experience, reduce frustrated and prevent early drop-out. While single session therapy can be effective for some concerns, often short-term therapy treatment spans 6 to 12 sessions. Long-term therapy may last for 12 to 24 sessions or remain ongoing in nature.
6. Sharing your feelings about the process is not only encouraged, but important for success
It can be uncomfortable to bring up to anyone, including your clinician, that something they said didn’t land well with you. Sharing this in therapy with your psychologist is however a really great place to practice this. When you are able to discuss how something felt or thoughts you had about it, it gives the therapist.
If it feels like you're not getting anywhere (or fast enough)
7. Do your best to avoid ‘people-pleasing’ with your mental health therapist
Clients commonly seek out therapy to help work through anxiety, boundary issues, or past trauma. These concerns can make it difficult to share thoughts and feelings, especially if they believe that doing so may lead to disappointment or hurt feelings. Sometimes clients will ‘people-please’ that is, say what they believe the other person wants to hear – in this case, the mental health therapist.
If clients ‘people please’ for example, telling the therapist that “I’m feeling much better” or “that session really helped” when this is untrue or simply to protect the therapist’s feelings it can make progress trickier. Therapy is actually a fantastic setting to practice sharing thoughts and feelings that are perceived to be unfavourable. And, it has the added bonus of likely helping you get to your goals sooner.
8. Sometimes the work in therapy is the therapy itself
A really important part of the work in therapy is the relationship with the therapist (also known as the “therapeutic relationship or alliance”). The relationship you have with your mental health therapist has consistently been shown in research to be one of the determining factors in treatment outcomes. Feeling respected, seen, and heard is hugely important for our mental health.
9. It’s okay to stop and start or leave therapy goals for a later point in time
Some clients have experienced many difficult circumstances throughout their lives and may have what feels like a laundry list of issues to address. This can be especially true when it comes to early life and complex trauma. It is helpful to remember that you can choose to focus on certain goals and decide to return to therapy in the future to address other ones.
Questions or uncertainty about the mental health therapy you are receiving
10. Boundaries in therapy are the role of the therapist
Boundaries in therapy include aspects such as:
(a) what are appropriate ways to communicate outside of appointments,
(b) expectations for how interactions in session will look,
(c) managing privacy and confidentiality, and
(d) managing the timing and pacing of sessions.
These are the role of the mental health therapist and not something that clients should feel responsible for. If you’re unsure about expectations, it’s always a great idea to clarify with your therapist.
11. You have a lot of rights as a client
As a therapy client you have quite a few rights you might not even be aware of. These include:
(a) the right to informed consent
(b) the right to confidentiality and to be informed about situations where confidentiality is limited
(c) the right to be included in treatment decisions (ie. goals and focus of therapy, type of therapy approach)
(d) the right to always be treated with dignity and respect and to receive treatment that is sensitive to your individual cultural, beliefs, and values
(e) the right to upfront transparency about session fees and billing practices
(f) the right to withdraw consent or choose to leave therapy at any time
12. If you believe you have received problematic therapy, there are avenues to resolve this
Occasionally, there may be situations in which clients question if therapy they received was appropriate, ethical, or even harmful. While these instances tend to be rare, it is important for clients to know that there are steps they can take. If you are comfortable, you can choose to bring up concerns directly with your therapist. Clients can also contact the therapist’s college or association and inquire about the concerns and what options are available to them.
Regulated mental health professionals are part of colleges (ie. Registered Psychologists, Provisional Psychologists, Social Workers, Registered Nurses, and Psychiatrists) which focus on ensuring clients receive good care. Where necessary, these organizations can help clients navigate the complaint process. While counsellors are currently in the process of regulation in Alberta, you may be able to seek guidance about concerns from their association (ie. CCPA).
Conclusion
In conclusion, it is important to recognize that life transitions can be challenging and overwhelming. It is normal to feel anxious and stressed during these times, but it is crucial to have self-compassion and realistic expectations. Finding the right supports for your needs during a period of transition or change is key. Therapy support groups or individual counselling can be an important component of coping with anxiety during these times.
Disclaimer:
The information provided in this post and across this website does not, and is not intended to, constitute medical, mental health, or therapeutic advice; instead, all information, content, and materials available on this site are for general informational purposes only. This information does not create any therapeutic relationship and should not be used as a substitute for professional diagnosis and treatment. Consult with a licensed mental health provider for advice or support regarding diagnosis and treatment.
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