How To Get The Most Out Of Your Therapy Session

If you are seeking a therapy session, it is likely because you want something in your life to change and you would like expert support and guidance through the process. You want a skilled professional to help take out the guesswork and help get you to your goals.

In the past, this has meant that on top of the stress or problem(s) for which you are seeking help, you must find the time, during business hours, to leave your home or office and make it to a weekly therapy session. Packed schedules, work requirements, and congested commutes present valid obstacles to taking over an hour out of your day every week to drive to your therapist’s office. Not to mention the trouble if the expert you’d like help from lives far away from you. In today’s busy world, many people are turning to TeleHealth or TeleTherapy sessions. These video therapy sessions use HIPAA-secure formats that function similar to Skype or Facetime to make therapy more accessible.

Whatever format you select for your therapy session, your success depends largely upon the work you put in, not just on the effort of the therapist. When attending therapy, your active participation in the process will help you to get the most out of your therapy appointments and ultimately, achieve the results you want.

Treat Therapy As A Collaborative Process

We often view therapists as the expert in the room. Therapists do bring a great deal of knowledge about psychology and new ideas for how to help you. However, you are also an expert in the room. You know best about your history, what you have tried in the past, and what is happening in your present.

A therapy session will be most successful if you work collaboratively and come prepared with what you want to work on in each session. Then, work with your therapist to set goals, explore information, make discoveries, and learn how to apply new skills to your life. Ultimately, you decide what to take away from the therapy session.

 

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Apply What You Learn Outside Of Session

As you and your therapist work together, you will understand yourself better and identify new, more effective ways of behaving. It is essential to apply these new skills outside of session. Whenever possible, ask for homework and then do it. If it is too challenging (usually this is the case when you find yourself not doing the homework), ask your therapist for help. It is your therapist’s job to help you generalize the skills that you learn in the therapy office to making real-time changes in your life. This means the therapist must use their expertise to assign homework in a way that not only challenges you but also is likely that you will engage with and complete the practice(s) they’ve suggested.

Remember to communicate with your therapist about any barriers you face putting the new skills into action. Trying a new skill once and never again will not help you get to that point of lasting change. Every new skill takes practice to become a new habit, and you are paying with your time and money to get help. Use it to your advantage!

Talk To Your Therapist About Your Therapy

When people go to therapy, it is often because they want to address some concern or problem in their life. You may be focused on discussing that problem and finding solutions, which makes sense. In addition, therapy works best when you also talk to your therapist about your therapy.

This means you can reflect on what is working and share those thoughts with your therapist. If you like a new skill, let your provider know. If you are unhappy about something, talk to your therapist about it and see how the two of you can navigate this situation. Giving your therapist this feedback allows them to respond by adjusting their interventions to be more appealing to you or more relevant to your treatment goals.

Find Therapy That Fits Your Lifestyle

Nowadays, most people don’t want to travel to get to therapy appointments or lie on a couch in the room with a therapist. And you don’t have to do these things to get results. With TeleHealth therapy, you can benefit from the skilled, focused attention of a therapist when and where you need it. Even within the comfort of your home, you can access professional therapy with TeleTherapy services via video calls. Making therapy easier to access means you are more likely to stay engaged and on track with your goals.

Once you have started therapy, use these tips to get the most out of your sessions, get the results you want, and start shifting from surviving to THRIVING.


6 Most Common Questions About Therapy Answered

Going to therapy for the first time can be daunting when you don’t know what to expect. Sometimes, even if you have been to therapy before and have not received the results you wanted, you may have questions about how to return to therapy and achieve a different outcome. The answers to these frequently asked questions can help you wisely invest your time and money in therapy to achieve the success you want.

  1. Why Should I Go To Therapy?

If you’ve never been to therapy before, you might wonder why you should take the step to get treatment. Every therapy experience is different, so defining your personal goals can help to guide both your motivation to go to therapy, as well as your choice of therapy type and therapist. If you wisely choose a change-oriented therapist, treatment can be fruitful as a growth experience or to help you navigate a stressful life situation or relationship. Many people visit a therapist to discuss a specific issue or diagnosis, but you don’t need to have that all figured out before reaching out to a new therapist. Just knowing that you want help is enough. A skilled therapist can help you define your treatment goals and decide what changes you would like to see in your life for therapy to be deemed successful.

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  1. How Do I Find A Therapist?

Common ways of finding a therapist are through recommendations from family and friends, online directories, your insurance company, online reviews or often, a web search. Searching the web allows you to define exactly what you are looking for, and get to know prospective therapists through their websites, before deciding who to contact. A benefit of our technological age today is that you can choose TeleHealth, or online therapy sessions, for location independent therapy when and where you need it.

  1. How Do I Choose A Therapist?

Choosing the right therapist involves either identifying a problem you want help with or the type of therapy you want and evaluating whether the therapist is the right match for you. Some therapists have individual specialties or areas of interest that may appeal to you, such as Dialectical Behavior Therapy (DBT) or Cognitive Behavior Therapy (CBT). Ask for a phone consultation with your potential therapist to see if this is someone you feel comfortable opening up to and working with.

  1. How Will I Know If A Therapist Is A Good Match?

You want to find out if your therapist’s goals match your goals. Is this clinician results-oriented so you can focus on moving forward (not just talking about moving forward) and from therapy eventually? Can they identify your main problem areas, as well as an action plan to work on them? Can they develop a treatment plan and treatment goals with you, and help you project how long you will need therapy within the first few sessions? Therapy is a collaborative effort, and it is important to ensure your goals and vision match those of your therapist.

  1. How Do I Monitor The Progress of Therapy?

You probably want to heal, grow and progress through therapy, and it is important to know how to measure that. An experienced, results-oriented therapist will understand how to monitor progress according to the goals you set. Progress monitoring is essential because you want to make sure therapy not just helps you feel better, but also helps you get better. Using psychological measures to track your progress can help you and your therapist know whether treatment is working, how fast it is working, and whether the treatment plan needs to be altered to receive better results more quickly.

  1. I’ve Never Been To Therapy Before, What Do I Need To Know?

While it’s natural to feel nervous before your first therapy session, understand that your therapist is a professional who is trained and experienced in helping you face problem areas in your life, and promote growth, healing, and change. If you have put the time and research into choosing the right therapist, you should feel comfortable and at ease in therapy within the first few sessions. Stay open minded, and if you experience that things are not going as planned or the therapist is not meeting your needs as you had hoped, feel free to discuss this with the clinician, or to try a different therapist.

Therapy can promote profound, impactful change to your life. It is important that you are empowered to get the right help for you. Hopefully, the tips in this article will boost your confidence about starting or revisiting therapy with these frequently asked questions answered. Take a step towards the life you want today, and start shifting from surviving to thriving!


What is DBT and How Can It Help Me?

Seeking help and going to therapy can be stressful. Choosing the right approach can ensure you get the care you need to make the changes you want. In this article, I’m going to give you introduction to Dialectical Behavior Therapy (DBT), a treatment that may be helpful if you want more balance in your emotional life. DBT has become a popular technique used to help individuals cope with the stressful challenges life throws their way, and the intense emotions that can follow. The scientific research for this treatment is strong. Individuals often report huge, impactful, positive life change as a result of DBT. DBT focuses on helping people change their reactions and behaviors to create more resilience in life. Understanding what Dialectical Behavior Therapy is and how it works can help you decide if it is the right approach for you.

What Is Dialectical Behavior Therapy?

Dialectical Behavior Therapy is a form of Cognitive Behavioral Therapy (CBT) that was initially developed for people suffering from chronic suicidal thoughts and behaviors, and those diagnosed with Borderline Personality Disorder. However, implementing DBT revealed that it is helpful for people in a range of situations having difficulties managing emotions, and can help to reduce anxiety and improve coping mechanisms under stressful circumstances. DBT teaches you coping techniques and strategies to deal with difficult emotions without being caught up and swept away in them.

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What Does Dialectical Behavior Therapy Involve?

DBT is best administered by an experienced therapist, with a history of training and supervision in DBT by experts in the field. Full program DBT involves weekly individual therapy in addition to attending a weekly DBT Skills Group. Treatment length varies by person and treatment goals.

DBT includes –

  • Collaboration – working with a skilled therapist can help you identify what you want out of life and obstacles getting in your way. Bringing awareness to both your goals and challenges in a specific, systemized way is a key step toward making the changes you want.
  • Learning skills – one of the most important aspects of DBT is learning specific skills to incorporate into your everyday routine for growth, happiness, and fulfillment.
  • Practice – DBT is a behavioral therapy. This means that new behaviors must be practiced for change to occur. Practice, practice, practice, and then some more practice, is a common mantra in DBT.

The Four Modules Of DBT Skills

The four areas of skills learned in DBT are designed to help you better understand your thoughts and feelings, and change your behaviors to better achieve and support the life that you want. These modules include:

  1. Mindfulness
  2. Distress Tolerance
  3. Interpersonal Effectiveness
  4. Emotional Regulation

Who Can Benefit From DBT?

DBT has been shown to be successful in a number of different areas and for those suffering a range of issues including:

  • Relationship problems
  • Low self-esteem or shame
  • Weight management
  • Eating disorders
  • Anxiety
  • Depression
  • Borderline Personality Disorder

DBT can also be used in many other situations, even where a specific diagnosis may not be defined. Under the guidance of an experienced and well-trained DBT therapist, you can learn life-changing skills to make a profound impact on your well-being.

DBT is an inspiring treatment method that can help change your life for the better. Talking with a DBT therapist can help you determine whether DBT is the right therapy approach for you. Contact me today if you may be interested in finding out more about DBT and shifting your life from surviving to thriving!


4 New Perspectives To Free You From The Guilt And Shame Drain

Guilt and shame can hold you back from the happiness and freedom you desire, draining your energy and burning you out. Sometimes it can feel like shame is eating away at you from the inside, and you can’t even bear to face family and friends.

Fortunately, there are steps you can take to be free from the guilt and shame drain, starting today. Working one on one with a skilled Dialectical Behavior Therapist is a key way to begin letting go of these painful emotions to live a happier, more fulfilling life. As a part of DBT, you will learn specific techniques to shift your perspectives and see things in new light.

  1. Recognizing Guilt and Shame is the First Step

If you recognize your feelings and are able to label them as guilt or shame, you’ve already begun the journey to cope skillfully with these emotions. Just bringing attention and mindfulness to when you are feeling guilt or shame is a powerful step. When you realize that guilt or shame is what you are feeling, gently label and make a note of it internally, without trying to change or modify it. This act of mindfulness and recognition of emotions works into the further stages of DBT where you can learn to welcome pain and skillfully cope with it, rather than pushing it away, which often increases emotional distress.

  1. Your View May Not Be What Others See

One of the tricks that guilt and shame play on your mind is creating thoughts that things are all your fault or that everyone is blaming you. One of the first steps DBT teaches is to recognize and unglue from your thoughts. This step involves working with a DBT therapist to carefully review how you may be automatically coming to conclusions about situations and staying stuck in a rut. When you are feeling guilt and shame, take a closer look at your thoughts and interpretation of the situation that brought up these painful feelings. Recognizing these biases in interpretation is a first step to using DBT to tap into your wisdom and let go of worry thoughts.

  1. Take A Short Break From Your Feelings

When you are feeling guilt and shame, it can be easy to get stuck in a cycle of self-blame and anger. It is important to give yourself permission to give yourself a break from what can be an endless cycle. Do this intentionally, not to avoid the problem-solving process, rather, just to give yourself a break so you can come back to solve the problem at a different time. Take time off to do an activity you enjoy, to help others, or to just do or think about something else for a while. Taking a break from the intensity of emotions can give you the chance to refresh and gain a new perspective on the situation.

  1. Remember That Emotions Are Temporary

Always remember that “this too shall pass” and nothing lasts forever. Mind states and emotions – no matter how powerful – are  temporary and we can ride them out. (If emotions feel never-ending and do not feel temporary to you, a DBT therapist can help with that!) This doesn’t mean you should avoid problem-solving when necessary. Still, you may not need to treat every thought and emotion as though it is very serious and must be solved immediately. Training the mind is a process. The mind is always changing, and we can learn to let thoughts and emotions come and go gracefully.

An experienced DBT therapist can equip you with essential skills and techniques so you can learn to be free from the guilt and shame drain. Contact me today to work with me on creating a happier and more fulfilling life.


3 Dialectical Behavior Therapy (DBT) Skills You Can Use to Transform Your Life Now

Dialectical Behavior Therapy is designed to help you better understand your feelings and emotions and free you from feeling trapped by them. Rather than simply analyzing your problem, Dialectical Behavior Therapy (DBT) teaches specific skills that can be used in everyday life to give you greater happiness and wellbeing. So many people feel that they know what’s wrong, they just need the clarity and skills to work with the issues. DBT empowers you to do just that, with the ongoing support of a therapist’s guidance.

The skills learned in DBT fall under four umbrellas – Mindfulness, Distress Tolerance, Interpersonal Effectiveness, and Emotion Regulation. Here we look at three skills you can learn in Dialectical Behavior Therapy and that you can use right now to bring real change to your life.

Identify and Label

Mindfulness is the ability to know and be aware of what is going on around you and within you. With the distractions and busy-ness of modern life, this is not as easy as it sounds. Consciously and intentionally bringing awareness to ourselves and our environment is the first step to building our mindfulness muscle.

When we are beginners, one of the most effective ways to do this is through meditation or a mindful activity like slow walking. Meditation does not have to be complicated. Placing your attention on three breaths as you inhale and exhale can reap benefits. (Remember, when your mind wanders, as minds do, gently bring your attention back to your breath. Do this as many times as is needed during those three inhalations and exhalations.) As you do these mindful activities, notice what you feel, physically and internally, and identify these qualities by giving them a name, like ‘step,’ ‘breath in,’ ‘breath out’; or even ‘anger,’ ‘worry,’ and ‘self-criticism.’ As you become more skilled at doing this, you can extend it to everyday situations, like driving to work, being in a meeting or having an argument. Simply knowing and recognizing what is going on is a powerful tool to allow you to begin making changes.

Accept Things As They Are (even if you want them to change)

Once you’ve learned to recognize and understand what is going on inside and around you, it is easier to work with these feelings. In some cases, you may identify things you can change. For example, every time you walk past the bakery, you notice a craving for cookies, so you can choose not to take that route anymore. To make that decision to change your course, you had to be aware that this caused a craving in you and accept this reality. If you spent effort pushing away and denying that this craving was a problem for you, or you were not aware this desire increased when you passed the bakery, you would not have been able to apply the solution of walking a different route.

Working skillfully with our feelings is also about recognizing what we can’t change, and accepting rather than fighting against them. One way to do this is to cope with a distressing moment by having a one-mindful focus. Learning to focus on one point, like your breath, a candle or flower, or sounds, can draw your attention to this one-pointed focus and give you time to calm down. Your Dialectical Behavior Therapist can work with you to develop a range of different coping skills to help you walk through difficult moments that will inevitably arise.

Taking Care of Yourself to Regulate Emotions

When you feel angry, hurt, or another painful emotion, it is easy to feel overwhelmed. You might even feel like your emotions are out of control. Fortunately, Dialectical Behavior Therapy can teach you how to manage emotions, so you feel more in the driver’s seat of your experience. A first step you can take, even before feeling a painful emotion, is to manage your vulnerability factors.

Eating well, getting enough sleep, exercising, resting and taking time off when you need it can all help. By taking care of your body and health needs, you are making yourself more resilient to challenging situations. Imagine being cut off in traffic when you are well-rested, have had enough nutritious food to eat, are wearing comfortable clothing and had a nice walk out in the sun earlier that day. Someone cutting you off probably won’t have much of an impact. Now imagine someone cutting you off and you are sleep deprived, hungry and haven’t had any exercise. If you’re like most people, being cut off will have much more impact, and you will be more likely to experience intense emotions. Although life circumstances prevent us from always taking care of our bodies in an ideal way, the more we can do our best to take good care, the more emotionally resilient and better able to ride out life’s difficult moments we will be.

A skilled therapist can help you develop the DBT skills that work best for you to give you greater freedom and happiness in life. You don’t have to live each day as a struggle – talk to a therapist who uses Dialectical Behavior Therapy to learn more about these life changing skills today.


How do I Handle This?

 

How can we prevent crippling anxiety or depression? We need LOTS of practice welcoming in and feeling unpleasant emotions like sadness, fear, and anger. We need to lay out the red carpet for resentment, despair, and even hopelessness at times, because when we do, these emotions pass. If we open the door wide and set out the welcome mat, these emotions typically dissolve more quickly than we expect. We also don’t cling to these emotions – we feel them and let them go. Depression is that massive cloud of weighted bleh following you around. That cloud is made up of emotional buildup: thick, dense, burdensome emotions that have not been processed.

We forget that we can handle pain. In fact, we can cope with a lot of pain, often more than we expect to survive. Women engage in natural childbirth for hours on end and make it through. We survive break-ups, deaths, personal and societal tragedies, lost jobs, fever, and sickness. Through it all, we survive and usually gain self-respect in the process.

We breathe in-and-out and a new day comes. Sometimes the pain is so great all we can do is focus on just this one breath. Right here, right now. And then you know what happens? The next breath comes, and the next, and the next, and pretty soon we feel differently, and our thoughts change and shift. We welcome a new experience.

Us humans do a lot to get in the way of this process. We push away, avoid, ruminate, argue, distract, anything to not feel what is taking place in our body. (Remember, emotions are a physiological experience and happen in our physical body.) If my friend says something to me and I feel hurt, how do I process this?

  • I could avoid feeling it by thinking about it over and over (ruminating)
  • I could talk with numerous other friends about it to no end
  • I pretend it didn’t happen
  • I choose to ignore my friend hoping for an apology
  • Fill in your favorite way to deal by not dealing here ________________.

Instead, if I want emotional freedom, I could meet HURT at the door laughing and invite him (or her) in. I could treat this guest, HURT, honorably. How would this look? I might do a little self-talk that goes something like this:

“Ugh, I feel kicked in the gut. Where do I feel that? How do I know I feel HURT? What in my body is telling me HURT is here? (Take some breaths and notice sensations in my body.) I feel like the center of my chest is sinking. I almost feel out of breath. (Take some more breaths while paying attention to these sensations in my body and any other feelings that arise.) I think I feel HURT. (Some more breaths while paying attention to sensations in my body. When my mind wanders, or I zone out, I ask myself, ‘Now what is happening in my body? What do I notice?’)”

After maybe a few minutes pass, I gently decide what is most effective for me to do next. Is it to drink a glass of water? Talk to my friend about what they said prompting me to feel hurt? Continue breathing into these feelings and sensations? Get to work and put this aside until later? The key here is that I calmly ask my Wisdom what is most effective, rather than ducking, hiding and getting rid of that emotion as soon as possible. Personally, I sometimes like to set a timer for three minutes. When I do, this means that I have committed to throwing myself into feeling into my body (paying attention to sensations) for three minutes and will gently evaluate what is next when that time is up.

 

Remember, HURT is a guest, and if we want emotional freedom, we treat each guest honorably. I pour HURT a cup of tea, sit down with him, ask how he’s doing, pay attention when he talks, and we have a visit together. When he’s ready, HURT will decide to go. I won’t rush him out or even turn my back as he leaves. I will thank him for coming, and gently open the door and watch him go, letting him know he is always welcome. I may even thank him for his visit (emotions are very informative). I feel at peace.

When we push away what is uncomfortable, we create stress and even more unpleasant emotional intensity. When we welcome in our emotions and treat them honorably, we may experience pain, discomfort, aching, and we also give ourselves the gift of peace.

As with anything, reading this article will not change your life. What will? PRACTICE, of course! The next time you are feeling a painful emotion and would like help welcoming it in, listen to this short, three-minute, guided meditation to help you along. [Insert meditation link here] In fact, you can use this recording as a daily practice if you’d like to regularly engage in a skill to mitigate emotional buildup. (If you’d like to practice for a little longer, listen to this 8-minute meditation at the end of my article, The Guest House .

LIFE IS TOO SHORT JUST TO SURVIVE. THAT’S WHY I HELP PEOPLE THRIVE!

Thank you,

Amanda Gale-Bando, Ph.D.


Name that Emotion

We’ve all got things to do and people to see. Who needs unwanted emotions slowing us down? Just ignore them, and maybe they’ll go away. Right?

Here’s the hitch: emotions are hard-wired into our human experience. In other words, emotions are part of us and the more we push them away, the louder they become. When we deny and try to block out emotions, we starve them until the emotional hunger pains are so strong, we become overwhelmed with unruly, overbearing, unable-to-control feelings.  You know, that moment someone asks you something harmless like to pass the salt, and you completely lose your cool? When we suppress or don’t acknowledge emotions, they bubble up, and like water boiling in a covered pot with the burner on high, eventually they’re going to blow.

The solution? Don’t ignore the monster!

Emotions grow to become monsters when we ignore them, push through them, judge them and just plain do whatever it takes to try not to feel them. There is a better way! The next time you feel an unpleasant emotion, try noticing it and putting a name to it.

Scientists call this affect labeling. It goes something like this:

  • I am noticing a feeling of butterflies in my stomach. I’m nervous.
  • I feel a lifting, light feeling in my chest and shoulders. I’m happy.
  • I feel like it’s hard to move. I notice that I’m slumped and don’t feel like doing anything. I’m sad.
  • I can’t believe that guy just cut me off. I’m irritated.

When we give our emotion a name, it starts the process of calming it down. Instead of pushing the feelings away, we pay attention and engage our intellect to give it a name. Once emotions are acknowledged and paid attention to, they start to digest and let go of their grip. Relief can get his foot in the door, and we initiate the process of regulating emotions and feeling more in control.

 

Brain imaging studies explain the science behind affect labeling: When we experience an emotion, a part of our brain called the amygdala, gets activated. When our amygdala is very active and fired up, it is hard to access the reasoning part of our brain, the frontal lobes.

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When we use techniques like affect labeling, we begin to activate our frontal lobes (the organizing, planning, thinking-through part of the brain) and de-activate the amygdala (the “OMG!” emotional part of the brain).

 

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PRACTICE:

The next time you are “freaking out” or “stressed” or just “feeling off,” try getting specific. What emotion are you feeling? Can you put a label on it?

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Now, reinforce yourself by checking out the Reinforcement Practice Sheet and get some suggestions on how to reinforce yourself. You’ve just taken the first step toward processing and letting go of that unpleasant emotion.

LIFE’S TOO SHORT JUST TO SURVIVE. THAT’S WHY I HELP PEOPLE THRIVE!


HOW TO FIND A RESULTS-ORIENTED THERAPIST

Maybe you have never been in therapy. Perhaps you have been in therapy, and it hasn’t gotten you the results you’d hoped.  This time, you want to try something a little bit different. You may even have a particular goal(s) and know what it is that you want to change. Now come the questions, “How do I get the results I want?” and, “Who is the best person to help me?” Despite the consumer-savvy world we live in, there is little information on how to find a therapist, let alone how to find a therapist who will truly help you achieve real results and change your life in the way that you want.

Here, you will find a five-step process to help you find a therapist who will help you achieve the goals you want to reach. Stop wasting time, money and effort with treatment that doesn’t work. Set yourself on the path to success today!

 

  1. Get COMFORTABLE. – Going to therapy can be a hard process, requiring courage to step outside of your comfort zone and ask for help. At times, therapy asks you to be quite vulnerable, talking with another person about your deepest, most private experiences. Treatment often requires you to be super uncomfortable, and even want to temporarily squirm out of your skin or run for the door. After all, you are in therapy to get help with areas that are likely challenging and possibly, quite painful. To venture to feel this awkward and uneasy, you must first be comfortable! It is so important that you are at ease in the presence of your new therapist and feel understood and not at all judged. In other words, think about whether this is a person to whom you would want to open up.
    • Ask for a PHONE CONSULTATION to get a feel for the therapist. Most therapists will agree to talk to you for a free, 10-15 minute phone consultation. During this meeting, you can give the therapist an idea of what you want help with and hear his or her response. It is important to ask questions and leave time for the therapist to talk so that you can start to assess your feel for this clinician’s competency and ability to help you. Trust your instincts. The therapist should give you a choice (or you can ask) whether you want to schedule an in-person appointment right then and there, want time to think about it, or do not believe that this therapist is a good fit for you.
    • MEET IN PERSON with the idea that you are still evaluating whether this professional is a good fit for your needs. During the first session, the therapist will likely ask you questions about why you are seeking therapy and many other detailed questions about yourself and your treatment goals. The more open you are will help you to experience how the clinician responds to you and gives you the opportunity to evaluate your comfort level with this person. Their response will provide valuable information about whether you would like to proceed or seek another’s help instead.

 

  1. Ask for a CASE FORMULATION. – A results-oriented therapist will be able to discuss their conceptualization of your problem(s) and what is currently missing for you to reach your goals. Likely, this won’t be obvious information that you already know. Rather, it should add more information to your understanding of your stuck point(s) and show you that this person has the education and experience to understand your particular problem area(s) expertly. Think of the analogy of visiting a medical doctor (M.D.). You may report your symptoms (e.g., poor digestion, feeling light-headed) and the doctor will not simply repeat your symptoms back to you: “You have poor digestion and feel light headed. That must be hard.” They will tell you, based on their evaluation (e.g., examining your vitals, blood tests), what is wrong (e.g., “You have high blood sugar.” “Your thyroid is malfunctioning.”). You can expect this same kind of expert information regarding your psychological and emotional health as well. A results-oriented mental health professional will not only repeat your complaints back to you; they will add information to fully conceptualize what is contributing to the problem and why you need help in solving it. For example, you may report repeated over-eating and sudden emotional outbursts. The results-oriented clinician may suggest after their assessment (e.g., conversation with you, standardized questionnaires), they believe these problems come from deficits in understanding how to change behaviors and regulate emotions successfully.1 The results-oriented therapist will explain this to you in detail and discuss precisely how this affects you. This explanation will be in language you understand, and the conceptualization should make sense to you. If you think the therapist is off-base, does not accurately comprehend your problem, or cannot communicate in a way that you understand and agree with, openly discuss this with him or her. If you still cannot come to an agreement, it may be time to interview another therapist for your treatment needs.

 

  1. Ask for a TREATMENT PLAN, including TREATMENT GOALS, prognosis, and length of therapy. – Just as your general medical practitioner will give you an idea of your treatment options, likely results, rate of recovery, and time needed to achieve these results, you can also expect this from a results-oriented therapist. For example, a clinician may tell you that in the first three sessions2, the two of you will collaborate to reach a case formulation. At that point (by the third session) the therapist will make a treatment recommendation. They will talk with you in detail about how the treatment he/she is recommending addresses your particular problem(s), will help you reach your goals, and the time you should expect to devote to attain this outcome, including frequency and length of sessions, and expected length of time in therapy. Alternatively, at the third session, the therapist may refer you to another professional with the expertise to help you meet your goals if you and the clinician have determined that is what is needed. Again, think of the M.D. If blood tests reveal you have a thyroid problem that is relatively simple and straightforward, the doctor may express this to you and lay out a treatment plan. If, however, the problem seems more complicated, the M.D. may then refer you to an endocrinologist or another specialist to help you achieve your health goals. Defining treatment goals in therapy is important because these goals will help you know if you are making progress and whether the therapy is working.

 

  1. Understand how you and your therapist will MONITOR TREATMENT PROGRESS and ask for HOMEWORK. – How will you know whether you are moving toward your treatment goals and making progress? This is a question a results-oriented therapist will be able to answer with clarity.
  • Together, you and your therapist may choose to use standardized measures of symptoms or progress and chart them on a graph, making sure your symptoms are decreasing, and skills needed are increasing. You may also choose to track behavioral markers, such as how often per week you are engaging in a particular behavior or have the urge to do so. Successful treatment would show a decrease in those behaviors (and possibly urges) the therapist has agreed to help you decrease (e.g., over-eating). You will also see an increase in the behaviors moving you toward your treatment goals (e.g., taking three breaths before a meal, stopping eating your meal when you experience a feeling of satiation regardless of the quantity of food left). Your therapist may ask you to chart each time you have the urge to or actually engage in these behaviors in between sessions to track your progress.
  • PRACTICE, PRACTICE, PRACTICE, and then, you guessed it, more PRACTICE is needed to make changes and reach your goals. Homework will always be present in results-oriented therapy. Homework doesn’t mean that you will be sent off to write a 5-page paper about what you learned. Rather, therapy homework is a way for you to put into practice what you are learning in therapy. Typically, therapy sessions last about 50 minutes once per week. What about the other six days of the week and 24 hours each day? 50 minutes is not going to change your life in the way that you want. A results oriented therapist will send you home with something to practice (e.g., filling out a worksheet about a skill you learned at your session, practice saying “no” and noticing in detail the thoughts that come into your head or sensations in your body). If you want results, you must practice. Change does not happen in our thinking. Change happens when we do things differently over and over and over again. If you want results, ask for homework!

 

  1. CONTINUE TO EVALUATE, on an on-going basis, whether your treatment is helping you move toward your goals and achieve the results you want. A results-oriented therapist will regularly review treatment progress with you using the techniques described in Step 4. Therapy is not meant to be life-long. Remember, you are hiring a professional to help you reach specifically-defined treatment goals. At some point, if therapy is working (as you are carefully monitoring), you will have achieved those goals and will either want to develop new treatment goals or decrease the frequency of your contact with this clinician or terminate your treatment.

 

Therapy can be an enriching, life-changing experience if you choose an effective treatment. Use the five steps above to help you get the help you need and deserve, and start shifting from surviving to thriving today!

 

NOTES

 

  1. This is provided as an example only and does not imply that all causes of over-eating or emotional lability come from the same source. These statements are meant to clarify the topics addressed in this article, not to assess or diagnose.

 

  1. Not all clinicians assess within one to three sessions. This is meant as an example only. Please check with the therapist you plan to see about their individual policy and of course, ensure that it makes sense and is reasonable to you.

Frequently Asked Questions:

  • What is the difference between a Ph.D., Psy.D., LMFT, LCSW, MFTi, etc., and will it affect the quality of my treatment?

A Ph.D. and Psy.D. both have doctorate degrees in psychology. LMFTs and LCSWs have a  master’s degree. A Psychological Assistant (someone with a doctorate who is not yet licensed) and MFTi (Marriage and Family Therapist intern) indicate this person is still in training and under supervision before they can become licensed. While the degree itself may show different types of training and specialties, what is usually more informative is how the therapist works with their clients. I have results-oriented colleagues with LMFT and LCSW licenses who work similarly to myself and other contemporaries who have doctorate-level training. I also have met professionals with doctorates who are not results-oriented and do more of a supportive-type therapy. In my opinion, if you follow the five steps laid out in this article, you will significantly increase the likelihood that you will work with a therapist who will help get the results you want, regardless of their type of license. Trainees can also be good options. I personally would choose to work with a Psychological Assistant or MFTi if they met all of my requirements in the 5-steps to finding a results-oriented therapist. The quality of work a therapist demonstrates to me is more important than where they are in their education and whether they have a master’s or doctorate degree. One caveat: if your problem is quite complicated and you have been to several clinicians before who haven’t helped, you may need a skilled and seasoned eye and choose a therapist who has some years of experience under his/her belt.

 

  • Should I look for a therapist with a particular theoretical orientation?

Some of my results-oriented colleagues may argue that it is imperative to receive treatment from someone doing “evidence-based therapy,” such as cognitive-behavior therapy (CBT). I like to be careful about making this generalization. There are certainly CBT practitioners who are results-oriented, and there are those who are not. Because someone professes to work under a particular modality is not an assurance that they do. More relevant is whether the therapist helps you develop treatment goals, assigns homework, monitors your progress, etc. I am less inclined to be concerned about the modality and more interested that the therapist can give you evidence that their treatment recommendation(s) works (has been researched to be effective) and the way the therapist is applying the treatment to your problem makes logical sense to you.

 

  • What if my therapist tells me that being uncomfortable with him/her or wanting to leave therapy is as a result of my problem(s) and I should not act on this?

This answer is not a straightforward “stay” or “leave.” Rather, it is a more nuanced answer: Use your WISDOM. On the one hand, if this is a new therapist, it is important to be comfortable and feel at ease in his or her presence right away. (See Step 1.) You will already be challenging yourself to grow in various ways throughout your treatment; no need to do this with the relationship with your therapist. I have talked to countless people who have stayed with a therapist they didn’t like or felt uneasy around because they assumed they (the client) were at fault and there was something wrong with them that they felt this way. I previously had a personal experience visiting a therapist with whom I was uncomfortable. I told her so, and she stated that she thought this meant I had significant problems with intimacy and needed to sit physically closer to her than I was comfortable with and work through the problems in my relationship with her. At that moment, I felt ashamed and unsure of myself. After leaving the session, and discussing it with a loved one, I determined that the only relationship in my life that I was having a significant problem with and wanted to get out of was the one with my therapist. I left, found a new therapist who I was immediately comfortable with, and therapy was successful. I have heard some version of this story from many clients about their past therapy, and often, once they remove themselves from that clinician, they find much success moving toward their goals with much more ease. On the other hand, it could be useful to ask yourself if your therapist has a point. Does this reaction toward your therapist happen in many other relationships? After visiting a few therapists, do you feel this same way about each of them? If so, you may want to consider whether this is something you want to target (work on) in therapy and may decide to stick with this therapist. You may want to consult with a trusted loved one and get some help tuning into your WISDOM to make this decision. Also, remember Step 5 and to continuously evaluate whether this treatment is helping you.


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Dr. Amanda Gale-Bando

Dr. Amanda Gale-Bando