There are many types (or schools) of talking therapy, so typical sessions vary. However, there are shared features & it is helpful to have some understanding of what to expect!
The First Session
The therapist usually discusses the types of therapy they offer & what these entail, which helps ensures shared expectations.
Typically discussions include the:
frequency/times /duration & location of sessions
cost (if undertaken privately)
circumstances in which contacting the therapist between sessions is permitted
any consequences of missed sessions
safeguarding situations under which confidentially might be breached
The therapist should be professional, have a clear framework under which they operate & be happy to answer questions.
When choosing a therapist in private practice, if possible, try to meet with a few therapists to find someone you feel really comfortable with. A positive therapeutic relationship is a major factor in therapeutic success!
Whilst most of us benefit from therapy, good therapists should inform us that negative effects can occur despite optimal treatment & provide information on their possible nature & frequency. This ensures informed consent & helps create an environment in which we can voice concerns in future sessions, if needed.
Achievable goals should be collaboratively generated to help create a shared understanding of what progress will look like. Therapists should regularly “check-in”, to ensure therapy feels helpful.
Therapy can be tiring, difficult &/or bring up uncomfortable feelings; this is not necessarily a sign things are going wrong. In fact, these reactions are common during effective therapy, especially in sessions addressing trauma. Negative effects should be temporary however & lead to subsequent improvement. Sometimes therapists use forms to check in on our well-being, which can be highly effective in picking-up any deterioration otherwise missed.
Strong Therapeutic Boundaries
Strong therapeutic boundaries are essential for safe therapy. Boundaries are rules/limits which ensure we & our therapist maintain a safe distance. Therapists help us, but they are not our friends. For example, therapists should not talk extensively about their own problems during our sessions, or EVER enter into a sexual relationship with us.
There is an inherent imbalance of power in the therapeutic relationship. These rules are needed to help ensure the therapist's power is used as a force for good & does not lead to exploitation or harm. These boundaries also keep the therapist safe. It is always the therapist's responsibility to maintain boundaries, but it is helpful if we know about them & can thereby monitor their appropriateness ourselves!