The Mental Emotional Health Blog

I decided today would be a good day to write about the basic steps involved in the therapy process. My hope is that for those of you that want to know what to expect in therapy, this entry and others on this website will provide some guidance. After all, it’s easier to feel comfortable in a new place once you get your bearings. 

Mental health services generally include 4 defined steps to therapy. Each provider or clinic will vary in style and procedures.  But these are the stages you can expect. 

1.  Initial contact.  This is the first contact you have with the therapist or agency.   Initial contact usually means talking to a receptionist, intake worker, or the therapist directly over the phone or in person.  At this point, an appointment may be scheduled,  you may be asked a few questions about what kind of help you are looking for, possibly asked about a brief history of the problem, and how urgent you feel the need is to see someone.
2.  Intake.  During this stage, all the necessary information is obtained from you in order to start therapy.  You are usually informed what the fees will be for the service, asked to fill out some forms about your insurance or income information,  possibly an individual or family history form, and forms where you give consent to receive services.  At intake, you also should receive information explaining policies governing confidentiality and the privacy of your records.  Sometimes an office worker or receptionist leads you through the intake process.  Other times, the therapist you will work with goes through intake with you directly.
3.  Therapy.  Congratulations, you are now free to dump your questions onto another human being who is trained to listen to you and help you.  I used the word “dump” because I sometimes think of a dump truck and how at first only a trickle of stuff comes out.  As the truck bed lifts higher and higher, the force of gravity eventually exceeds the force of friction holding the stuff in. 

To explain this metaphor to therapy, each person has a truck bed containing stuff to talk about.  At first, only a little seeps out.  You’ve just met this counselor.  Trust and rapport are being developed.  It is natural to say a few things and test your new therapist to see how he or she responds.  After trust and rapport have been established well enough, the gravity of therapy overcomes your natural resistance to opening up and discussing your deeper thoughts and feelings. (I love metaphors, don’t you?)
4.  Termination.  That sounds so brutal doesn’t it?  Termination is just a word that simply means the therapeutic relationship is coming to an end.  Depending on the length and nature of the therapy you have been involved in, the ending of this relationship usually brings a mix of feelings, somewhat like a personal relationship.  It is normal to feel loss, relief, doubt, closure, fear, hope, or any number of emotions.  These emotions are present in the therapist as well as the client.

Those are the basic steps to therapy. I left out more details because each place is going to handle these steps in their own way, and providers change their procedures from time to time.

 Feel free to leave a comment or question.