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What to Expect in Therapy

What brings people to therapy?

The main issues that people come to therapy for are anxiety and/or depression. Essentially, they feel bad. When these types of symptoms persist, it’s like having a fever that doesn’t go away. And just like a fever, anxiety and depression are indicators that something else is going on underneath that needs treatment. For example, a fever can be caused by various problems such as the flu, an ear infection, corona virus, strep throat, food poisoning, or heat exhaustion. The fever itself isn’t necessarily the focus of treatment, but rather the issue that is causing the fever to persist. In the same way, when someone is experiencing ongoing anxiety or depression, this is a sign that there are other factors that have triggered and are maintaining these symptoms. Just like a fever, if it continues to persist or gets worse, seeking out help is a critical step in feeling better.

Approaches to therapy

There are more than fifty types of approaches that a therapist might use to help you feel better, and oftentimes, a therapist uses a combination of techniques. Across all approaches there are common factors that are important for producing benefits in psychotherapy. Perhaps not surprisingly, the experience of a therapeutic relationship is key. There needs to be an experience of trust, understanding, empathy, and collaboration. From here, there are many approaches, but they typically fall into one of two categories. The first is where the therapist knows up front what needs to be done and uses an instruction manual in a structured way to provide treatment. This might include teaching various skills along with providing handouts and homework assignments. In contrast, the second approach takes the stance that we are exploring and discovering things about you, with you. The more you come to understand yourself, the more choice you have in creating change in your life.

To learn more about the steps involved in the second, more exploratory approach to therapy, please see the video link below.

At Active Insight Counseling, we use Intensive Short-Term Dynamic Psychotherapy (ISTDP) to discover the factors that are causing your symptoms. It is experiential in nature – meaning we look at all aspects of your experience, including there here-and-now. In this way, we get to know parts of you that may otherwise be hidden and/or avoided. Once these parts are understood, change can be made to treat the underlying issue so symptoms of anxiety and/or depression lift and you can start to feel better.

If you have questions, feel free to contact me for a free 15-minute consultation.


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