How a psychotherapist works

For those who have not sought the help of a psychotherapist, it is useful to understand exactly how a psychologist works and what stages and elements psychotherapeutic work consists of.

How does an appointment with a psychotherapist go?

It all starts with the first meeting and acquaintance

As a rule, there is a preliminary conversation at which the time of the first meeting is agreed upon and, in general, the topic on which the person wants to work is clarified. The payment format and general rules of interaction are also clarified.

The first meeting can be online or offline, depending on needs and convenience. At the first meeting, the so-called initial interview takes place. General information about the life situation is collected, the background of the development of the problem with which he addressed, the request and work rules are clarified.

Since any relationship begins with an acquaintance, the first meeting is crucial for further work. The effectiveness of further work depends on how comfortable it is to communicate with a specialist. As the therapeutic relationship develops, trust in the specialist grows and deeper layers of personal information are revealed.

When signing up for a consultation, it is important to understand that the psychotherapist has specifically allocated time for you in his schedule, so it is important to notify the specialist in advance if circumstances change or force majeure occurs. Otherwise, the work is devalued and deep relationships are difficult to build since trust, which is the basis for successful therapeutic work, is broken.

It is during the first meeting that the so-called therapeutic agreement (contract) is concluded.

Such an agreement is an oral agreement between the client and the therapist to continue working within the framework of the obligations that were agreed upon. (number of meetings, their payment, passes, etc.)

Such an agreement is usually concluded for a long time (at least 10 meetings) and acts as a framework within which the psychotherapist works, but has no legal force.

The number of meetings is usually 1 time per week. Sometimes, upon request, you can meet 2 times a week, but no more, since frequent meetings, as well as long breaks, reduce the quality of work.

You need to understand that in therapy you cannot guarantee results through more frequent meetings or double payment.

There is an opinion that the success of therapy depends 30% on the therapist, 30% on you and 40% on factors that do not depend on anyone in particular.

Payment for psychotherapy itself can vary greatly depending on the qualifications of the specialist and market prices for such services in a particular city or country.

Free services are possible in some government agencies or charitable projects, but as a rule, good specialists are hired free of charge in exceptional cases.

The standard meeting duration is 50 minutes. This time can be increased by mutual agreement, but experience shows that 50 minutes is the optimal operating time.

Late arrivals are usually included in the cost of paid consultation time.

Passes, as a rule, are also paid in the amount of the full session, if he did not warn about the impossibility of coming 24 hours in advance. This is an international practice in psychotherapy. This may seem like a hard and fast rule, but otherwise the client will not take therapy seriously, the therapist will waste time that could be used for others, and your relationship will be destroyed. The same rule applies when purchasing gym memberships; if you don’t show up, you won’t get a refund.

There is also a rule of mandatory last two meetings. (I suggest one closing meeting). You can stop therapy at any time, but it is important to end the psychotherapeutic relationship normally without running away as usual.

You yourself regulate the speed and degree of frankness in therapy.

If the relationship with the therapist turns into a friendly or personal relationship, then the therapy ends, which is why there are strict boundaries.

All meetings take place at the therapist's premises (or online). Home or office visits are not practiced.

The client’s request or the formulation of the problem is what a person initially comes with for a consultation. This request may change during therapy. This happens because the client often has his own hypotheses about the causes of the problem and does not see other aspects, which sometimes turn out to be more significant.

During the first meeting, the psychologist clarifies your request, but it is important that it is present initially, no matter how well you yourself understand or formulate this request.

Equally important for understanding the problem and constructing therapeutic hypotheses is your life context, which is clarified during the initial interview at the first or several first meetings. Therefore, the therapist will ask many clarifying questions so that he has a clinical picture that allows him to outline a work strategy.

Almost any direction of psychotherapy will work well if you get to a good specialist. While certain methods may work better with your personality type than others, this can only be determined through experience. Thus, the selection of a specialist and the method in which he works occurs.

The psychotherapist talks about what worries you, paying attention to some aspects of how you experience it and how it is reflected in contact with him. Thus, a greater awareness of your life, insights and new tools and ways of behavior appear.

You will do some exercises and tasks during therapy, and I give some tasks home. They are aimed at a deeper understanding of oneself and the development of new psychological and behavioral skills.

As the therapeutic relationship develops and moves towards solving the request, the intensity of the problem and the range of issues that will be raised in therapy will change.  At the beginning of the session, new experiences and successes that have emerged are discussed. And at the end of the session there are new discoveries and feelings that were received during the meeting.

Therapy ends when the client understands that his request has been resolved and there is no longer a subject for discussion. Often during therapy new requests arise that you want to work through.

Sometimes the relationship moves into so-called maintenance therapy, when the client makes appointments as needed every few months to share his achievements or discuss some current situations.

In general, you should aim for at least 10 sessions. Sometimes the request is resolved faster, but this is quite rare and should not be expected.

Each person and his case is unique, although of course there are typical requests. Therefore, it is difficult to predict what the speed of progress will be. Much depends on the motivation and degree of neglect of the problem.

I hope this information has eliminated false expectations from the process and results of therapy.

I will be happy to help as a practicing psychotherapist online or in person in Kyiv. You can sign up by clicking the button below.

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