There are different options when it comes to therapy. If you’ve never seen a therapist before, you might be wondering what the experience is like. I think (and in my experience talking with people who have never been in therapy) most individuals have the classic media and Freud-produced image of laying on a couch, freely associating thoughts, while the therapist is jotting down notes.  While this actually was a method that was once practiced back in the Freudian days, the likelihood of presently encountering a therapist who approaches treatment in this manner is very rare.  Nonetheless, the media has done a very good job of creating this nostalgic but largely false image of therapy.

What is true is that every therapist practices differently. While there might be similarities between two therapists who share the same theoretical orientation, their actual method of practice and your experience will differ based on factors such as the therapist’s personality style, personal and training background, geographic region, transference issues, years and type of experience, beliefs and values, etc. (and it’s important to note that years of experience does not necessarily correlate to better treatment outcomes – but we can save that for another blog!).

So what can therapy in my office look like?  One of the most common questions I am asked is how many sessions will be needed to achieve goals. Any knowledgeable, realistic, and reliable therapist will tell you that there is absolutely no way to define the number of sessions needed.  The most basic reason for this is because we are working with thoughts and emotions, which are very complex and fluid.  I always try to give an estimate of the number of sessions needed based on the approach we are using, but again it is an estimate. It can often take more or possibly less sessions.

So this leads me to my approach to treatment: in my practice, I use of combination of insight-oriented therapy, supportive therapy, and evidence based treatments.  In some cases, we select one particular approach while in others, I use a combination of these methods.  It is typically my preference to utilize evidence-based practices, such as cognitive behavioral therapy, as the likelihood of positive treatment outcomes increases when utilizing approaches that have empirical support.  Most evidence based treatments have a specific number of sessions required to complete the treatment, but again this does not necessarily mean that symptom reduction will be significant by the end of the treatment; it is possible that additional evidence based or supportive therapy treatment will be required.

It is also my belief that people do not need to be in therapy forever; however, the only way to help individuals achieve that goal is by teaching them strategies that they can use when distressing situations occur.  In other words, I want my patients to feel confident that they have skills they can utilize in the moment rather than needing to wait until our next appointment to find a way to think differently or feel better about a situation (this is often why outcomes from evidence based treatments are more promising). It is my hope for patients to be self-sufficient and not reliant on treatment.  This ultimately means I want them to live a very satisfying life while possessing important cognitive, emotional, and behavioral skills.   Therapy is the place where those skills are learned. It is important to add that staying in therapy for years is not in anyway a bad thing, as there are some individuals who truly need that support. If I am able to help someone with a short episode of treatment, then I try my best to do so.  If both the patient and I agree longer term treatment is warranted, then I will be there to help the patient grow along the way. This flexible model guides my practice.

Further, evidence based treatments do not work for all problem areas. In many cases, it is important to take a more free-flowing approach where the patient comes in and talks about recent situations or things on their mind.  It is then my job as a trained and licensed psychologist to process through this content in order to increase understanding and meaning, which can then lead to instrumental cognitive, emotional, and behavioral change.  This is what we call supportive or insight-oriented therapy.  It is always helpful when the patient has particular goals they would like to work on, but it is common that patients initially are only able to describe their difficulties and are not specifically aware of what needs to change.  It is also my job as a psychologist to help you sort through your difficulties, help you develop treatment goals,  and formulate a plan of action for therapy.

There are still many more important aspects to the complex therapy process;  if you are reading this blog and have any questions, I would be happy to answer them. Either write a comment or email me at for any therapy related questions.  If you are interested in setting up an appointment, or would like a free consultation, please give me a call.

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