Adultos

For your first session, your therapist may ask you to come in a little early to fill out paperwork if you haven’t already done so. Don’t worry that you won’t know what to do once the session actually begins. It’s normal to feel a little anxious in the first few sessions. Therapists have experience setting the tone and getting things started. They are trained to guide each session in effective ways to help you get closer to your goals. In fact, the first session might seem like a game of 20 questions. Sitting face to face with you, your therapist could start off by acknowledging the courage it takes to start psychotherapy. He or she may also go over logistical matters, such as fees, how to make or cancel an appointment, and confidentiality, if he or she hasn’t already done so by phone. Then the therapist may ask a question like, “What brought you here today?” or “What made you decide to come in now rather than a month or a year ago?” It helps to identify your problem, even if you’re not sure why you have it or how to handle it. For example, you might feel angry or sad without knowing what’s causing your feelings or how to stop feeling that way. If the problem is too painful to talk about, the therapist shouldn’t push you to say more than you’re comfortable sharing until you get to know each other better. It’s OK for you to say that you are not ready to talk about something just yet. Your therapist will also want to know about your own and your family’s history of psychological problems such as depression, anxiety, or similar issues. You’ll also explore how your problem is affecting your everyday life. Your therapist will ask questions like whether you’ve noticed any changes in your sleeping habits, appetite or other behaviors. A therapist will also want to know what kind of social support you have, so he or she will also ask about your family, friends and coworkers. It’s important not to rush this process, which may take more than one session. While guiding you through the process, your therapist will let you set the pace when it comes to telling your story. As you gain trust in your therapist and the process, you may be willing to share things you didn’t feel comfortable answering at first. Once your therapist has a full history, the two of you will work together to create a treatment plan. This collaborative goal setting is important, because both of you need to be invested in achieving your goals. Your therapist may write down the goals and read them back to you so you’re both clear about what you’ll be working on. Some therapists even create a treatment contract that lays out the purpose of treatment, its expected duration, and goals, with both the individual’s and therapist’s responsibilities outlined. At the end of your first session, the therapist may also have suggestions for immediate action. If you’re depressed, for example, the therapist might suggest seeing a physician to rule out any underlying medical conditions, such as a thyroid disorder. If you have chronic pain, you may need physical therapy, medication, and help for insomnia as well as psychotherapy. By the end of the first few sessions, you should have a new understanding of your problem, a game plan, and a new sense of hope. Psychotherapy is often referred to as talk therapy, and that’s what you’ll be doing as your treatment continues. You and your therapist will engage in a dialogue about your problems and how to fix them. What should I expect as I continue psychotherapy? As your psychotherapy goes on, you’ll continue the process of building a trusting, therapeutic relationship with your therapist. As part of the ongoing getting-to-know-you process, your therapist may want to do some assessment. Therapists are trained to administer and interpret tests that can help to determine the depth of your depression, identify important personality characteristics, uncover unhealthy coping strategies such as drinking problems, or identify learning disabilities. You and your therapist will also keep exploring your problems through talking. For some people, just being able to talk freely about a problem brings relief. In the early stages, your therapist will help you clarify what’s troubling you. You’ll then move into a problem-solving phase, working together to find alternative ways of thinking, behaving, and managing your feelings. You might role-play new behaviors during your sessions and do homework to practice new skills in between. As you go along, you and your therapist will assess your progress and determine whether your original goals need to be reformulated or expanded. In some cases, your therapist may suggest involving others. If you’re having relationship problems, for instance, having a spouse or partner join you in a session can be helpful. Similarly, an individual having parenting problems might want to bring his or her child in. And someone who has trouble interacting with others may benefit from group psychotherapy. As you begin to resolve the problem that brought you to psychotherapy, you’ll also be learning new skills that will help you see yourself and the world differently. You’ll learn how to distinguish between situations you can change and those you can’t and how to focus on improving the things within your control. You’ll also learn resilience, which will help you better cope with future challenges. A 2006 study of treatment or depression and anxiety, for example, found that the cognitive and behavioral approaches used in psychotherapy have an enduring effect that reduces the risk of symptoms returning even after treatment ends. Another study found a similar result when evaluating the long-term effects of psychodynamic psychotherapy. Soon you’ll have a new perspective and new ways of thinking and behaving.