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Saturday, December 16, 2017

Why It's Important For Psychotherapists to Provide Clients With Psychoeducation About How Psychotherapy Works

No one knows how to "do therapy" before they've ever been in therapy.  Even clients who have been in therapy before need psychoeducation about the particular therapy modalities that the current therapist uses and how these modalities work.  So it's important for the therapist to provide clients with this information during the initial stage of psychotherapy (see my articles: Psychotherapy is More Than Just VentingStarting Psychotherapy: It's Not Unusual to Feel Anxious or Ambivalent, Common Myths About Psychotherapy: Therapy Takes a Long TimeCommon Myths About Psychotherapy: Going to Therapy Means You're "Weak" and Common Myths About Psychotherapy: Therapy is All Talk and No Action).

Why It's Important For Therapists to Provide Clients With Psychoeducation About How Psychotherapy Works
It's common for clients to begin therapy with a certain degree of anxiety.  But when clients have an idea of what to expect in therapy, it helps to ease their anxiety.

It's also important, if possible, for clients to say what they would like to get out of therapy.  I say "if possible," because there are times when clients start psychotherapy and they're not sure what they want from therapy or they might only have a vague idea or, during the initial stage of psychotherapy, they might not know how to articulate their needs and they might need help from the therapist to explore and define their needs (see my article: When You "Just Don't Feel Right" and It's Hard to Put Your Feelings Into Words).  

Psychoeducation About How Psychotherapy Works
The type of information that the therapist provides will depend on the type of therapy that she does.

It's helpful for clients to know how particular treatment modalities work and why it's more effective to work with a psychotherapist than it is to talk to a friend (see my article:  How Talking to a Psychotherapist is Different From Talking to a Friend).  

The following topics, which are listed by therapy modality, are some of the most important areas to discuss as part of the psychoeducation process.

Psychoanalysis and Psychodynamic Psychotherapy 
If the therapist does psychoanalysis or psychodynamic psychotherapy, she might talk to the client about transference/countertransference issues (see my article: Psychotherapy and the Positive Transference).

She will also probably discuss the importance of the unconscious mind, dreams, and the intersubjective process in therapy (see my article: Making the Unconscious ConsciousDiscovering the Unconscious Emotions at the Root of Your ProblemsThe Therapy Session: A Unique Intersubjective ExperienceEmbodied Imagination DreamworkTransforming Nightmares Through Creative Dreamwork and Working With Dreams to Develop Your Creative Imagination). 

Also, within psychoanalysis and psychodynamic psychotherapy, there are various ways of working.  For instance, I work as a Relational psychotherapist, which is a contemporary, interactive form of psychoanalytic/psychodynamic psychotherapy. Another psychotherapist who does psychoanalysis might use a Classical Freudian method or do Kleinian therapy, and so on.

EMDR Therapy 
If the therapist does EMDR therapy, she could talk about how EMDR can resolve trauma through memory reconsolidating and what are considered Big-T and Small-T trauma (see my articles: What is EMDR Therapy?, Overcoming Trauma With EMDR Therapy: When the Past is in the PresentBig T and Smaller T Trauma, and What is Adjunctive EMDR Therapy?). 

Somatic Experiencing/Somatic Psychotherapy
If the therapist uses Somatic Experiencing or Somatic Psychotherapy, she would probably talk about the mind-body connection, and how the body holds unconscious memories (see my article: Mind-Body Oriented Psychotherapy: Somatic ExperiencingThe Body Offers a Window Into the Unconscious Mind, and What is Somatic Psychotherapy?).

Clinical Hypnosis (also known as Hypnotherapy)
If the therapist uses clinical hypnosis, she would probably not only explain hypnosis, but she would also dispel some of the myths about hypnosis that have been perpetuated in movies and TV programs (i.e., the myth that hypnosis is a form of "mind control") and also about how clients maintain a dual awareness during hypnosis about being in the here-and-now as well as in the space of whatever comes up in the hypnosis (see my articles: What is Clinical Hypnosis?Clinical Hypnosis and the Mind-Body ConnectionHypnosis and Creative Visualization to Manage Stress and All Hypnosis is Self Hypnosis).

Cognitive Behavioral Therapy (CBT)
For the therapist who uses cognitive-behavioral therapy (also known as CBT), depending upon the problem, she might explain how desensitization works or why there's usually homework in CBT treatment.  She would probably explain when she uses CBT.  For instance, I use CBT for phobias and certain forms of anxiety.

Ego States Therapy (Parts work)
For the psychotherapist who does Ego States therapy (also known as Parts work), she could talk to the client about the different aspects of the self, dissociation, and shifting self states (see my articles: Parts Work in Therapy: Is a Split Off Part of Yourself Running Your Life? and How Shifting Self States Can Affect You For Better or Worse).

Integrative Psychotherapy
If the therapist uses Integrative Psychotherapy, as I do, she would explain how she integrates the various treatment modalities for the most effective treatment (see my article: The Therapeutic Benefits of Integrative Psychotherapy and Contemporary Psychoanalysis and EMDR Therapy: A Powerful Combination to Overcome Trauma).

Treatment Frame
There are other issues to be discussed during the initial stage of therapy, including the treatment frame (the fee, length of sessions, policies about missed sessions and payment of fees, and so on) so the expectations are clear at the beginning of therapy.

Feedback to and From the Psychotherapist
I believe psychotherapy should be a collaborative process between the client and the therapist.

One of the best predictors of a good outcome in therapy, regardless of the treatment modality, is a good rapport between the therapist and the client, which develops over time.

The Importance of Feedback to and From the Psychotherapist

Regardless of the therapist's experience and skills, if the client and therapist aren't a "good fit," chances are that the therapy won't go well.  That being said, as previously mentioned, most clients feel anxious at the start of therapy because it's uncomfortable for them to talk to a stranger--even the most empathetic stranger, so the client might need to give the process time before deciding if it's a "good fit" or not.

Most therapists are aware that not every therapist is for every client, so they're not offended if the client feels it's not a "good match."   

An open dialog between the client and the therapist is important, especially with regard to whether the therapy is working for the client.  It's important for the therapist to know what's working and what's not working.  

If the client was already informed about the treatment modalities that the therapist uses and how these modalities usually work for the client's presenting problem, he will not be as likely to expect a "quick fix" for a complicated problem.

But if there are areas that might need to be adjusted or if there are things that the therapist might not be aware of (e.g., the client becomes highly activated between sessions and has problems sleeping), this dialog provides the therapist with information to make adjustments to the therapy, if necessary (see my article: Asking For What You Need in Therapy).

If the client doesn't initiate this dialog, I believe it's important for the psychotherapist to "check in" with the client every so often.

Not only does an open dialog provide the client with the important message that the psychotherapist wants and welcomes feedback--even negative feedback--it also reduces the possibility that the client, who has problems expressing his feelings, will leave therapy prematurely (see my article: Ruptures and Repairs in Therapy and When Clients Leave Therapy Prematurely).

The client can also ask for feedback from the therapist about how the therapist thinks the therapy is going from the therapist's perspective.  This helps the client to understand the therapist's thinking about their work together (see my article: A Psychotherapist's Beliefs About Psychotherapy Affect How the Therapist Works With You).

Getting Help in Therapy
As I've mentioned in prior articles, it takes courage to admit you have a problem, even admitting it to yourself, and to get help (see my article: Developing the Courage to Change).

When you know that continuing to do what you've been doing that hasn't worked for you is prolonging your suffering, you owe it to yourself to get help from a licensed mental health professional (see my article: The Benefits of Psychotherapy).

Rather than becoming overwhelmed by the process, it's important to take it one step at a time.  After you've acknowledged to yourself that you have a problem, the next step is to contact a psychotherapist for a consultation (see my article: How to Choose a Psychotherapist). 

During the consultation, you can give an overview of your problem and ask the therapists questions.

An experienced psychotherapist can help you to work through your problem so you can liberate yourself from your history and have a sense of well-being.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist who provides integrative psychotherapy to individual adults and couples.

To find out more about me, visit my website:

To set up a consultation, call me at (212) 726-1006 or email me.














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