A Few Things I Wish My Clients Understood

When clients finally take the plunge and visit a therapist, they may have preconceived notions about what therapists should and should not do and/or what therapy is or is not.  Clients may have expectations or assumptions that may be distorted, or they may just not know anything about the process. This list will hopefully dispel some of those misconceptions and educate clients about what therapists do and what therapy is about.

Many times, people engage in therapy to avoid pain. A therapist can’t help you until you’re ready to face your pain and learn how to cope with it. The truth is, therapy will probably hurt. However, you reap what you sow. Only when you invest in your treatment and are ready to face discomfort can you make lasting change.

A therapist can’t “fix” your life, only you can. When clients enter into therapy and put all their faith into their counselor to “fix” them, it’s almost sure that little change will occur. While therapists guide clients along the path of self-discovery and recovery, the work is really done by the client.

Therapists are not mind readers; they can only help you with what you bring into the room. It’s up to the client to talk about all the relevant details of their lives in session. If it’s difficult for a client to remember on the spot about everything that is contributing to his or her presenting problem(s), it may be helpful for him or her to keep a list, or journal, of things that occur between sessions.

Therapy isn’t about looking your best. It is about getting down and dirty to the darkest places within you. Therapists are trained to be non-judgmental and to see you for the complete person that you are, valuing you and helping you understand and work through your impulses and beliefs.

Vulnerability might be excruciating for you, but a therapist respects and admires your courage and your desire to face your problems and make positive change. We won’t condemn you for your deepest darkest secrets or symptoms that you might think make you “crazy.” We applaud and encourage you to be straightforward and authentic. Honesty, no matter how different or wrong something may seem to the layperson, is valuable currency in treatment.

You cannot shock your therapist, and he or she won’t think you’re “crazy.” No matter what your story is, we’ve probably heard worse. We won’t judge you or think that you’re a “loser.” Your story makes you who you are, and we’re trained to see the whole you and understand why you’ve adopted the behaviors that you have.

Therapists do not make decisions for you. If you want advice about what you should do in a particular situation, talk to a friend or mentor. It’s your therapist’s task to help you figure out what you want or what makes the most sense for you to do, but it isn’t our job to tell you what to do.

Therapists do not have all the answers. We aren’t all-knowing or all-powerful. We’re only privy to whatever information you bring to us. We might have a false impression about something because we simply don’t have enough information; we see your world through your eyes, as you report it to us. We may have better perspective, as we are objective, and/or we can perceive patterns and symptomology that can explain what you describe.

It’s okay to disagree with your therapist. It’s perfectly acceptable to question what we say or what we suggest. In fact, most of the time, it’s welcomed. We do not want to plant false ideas or explanations in your mind. If we propose an interpretation that does not sit right with you, please challenge it.

Your job in therapy isn’t just talking; you must do homework and apply skills as well. If you limit your work in treatment solely to what occurs in the counseling session, you likely will not make the kind of changes in your life that you are looking for. You need to take what is discussed inside the therapy room and implement it in your life.

Growth and progress aren’t linear. Therapy and “healing” is a process; setbacks don’t mean that you are back to square one. Clients oftentimes get frustrated with themselves when they have a slip-up, an “episode,” or they engage in behavior that they thought they’d kicked. Just because you were “doing so well” and now it seems like you “haven’t accomplished anything,” it really does not mean that you have “lost” all that you worked for. It simply means that you need to reroute and reorient yourself. Nothing was lost.

Many times it’s the circumstances in a client’s life that are difficult, and it appears as if there is no resolution. You may not be in control of what happens or what other people do, but you do control your perspective regarding it all. That understanding can make all the difference. Perspective-shifting may be what you need to focus on in treatment, not complaining about other people or things that you cannot change.

Therapy is a collaboration of the client’s efforts and the therapist’s; therefore, there must be open communication within the therapeutic relationship for therapy to work. Tell me if you’re feeling offended or upset at me, don’t feel valued or heard, you disagree with something that I’m doing, or if what we’re doing simply isn’t helping you. As aforementioned, I cannot read your mind, so if I’m not getting your hint, you need to be forthright.

The counseling relationship is a professional relationship. You may enjoy your weekly session with your therapist, but you aren’t friends with him or her. Therapists are bound by strict ethics guidelines pertaining to client-therapist boundaries. Please don’t ask me about my life or my beliefs; the therapy process and focus is about you. Don’t call or text me in the middle of the night, and if you “need to talk” in between sessions, journal and bring it with you when you see me next. I am available if you are in crisis, but if it’s life-threatening, 911 is your first point of contact. Don’t invite me to your birthday party, ask me out, or fill up our therapy hour with meaningless chitchat. We aren’t allowed to accept gifts, but positive verbal feedback is always appreciated.

Your therapist will take cues from you if he or she encounters you in the community outside of his or her office. I will not acknowledge you or say hello unless you do so first. To many clients, their therapy is private and they do not want other people to know about it. It may be embarrassing for them if they have to explain to others who we are to them. If you say hello, I will certainly engage, but not before.

Please don’t just vanish. If you decide that you don’t need therapy anymore, or that therapy isn’t for you, please stay long enough so that you can process your experience and get closure. We aren’t exploiting you for money when we ask you to come back for a termination session.

Your therapist won’t just forget about you. Most therapists really care about their clients and often think about them outside of work hours. Even though we are paid to listen and to help you, a good therapist truly empathizes and is concerned about your welfare but detached enough to help you work through what is going on in your life. We mentally separate between work and our personal lives, but sometimes we do worry about our clients when we go home at night.

To my substance abuser, court-ordered client, adolescent, and any other resistant client: I’m on your team. I’m not your probation officer, parent, or anyone else that has the power to “get you in trouble.” If you want to lie and tell me things are great, you have no problems, it’s the people that sent you here who do, etc., that’s fine. I’ll play your game and believe it; we work on whatever you bring into the room. However, you might as well use your time with me to your advantage. Whenever you are ready, I will be here waiting to do actual therapeutic work and stop playing games. After all, I follow you.

Remember, each therapist has a different approach and a distinct style, and it has to click for you. If you don’t feel like therapy is making a difference after you’ve given it a fair shot, maybe you need to look for a new therapist. Therapy is an investment, and it certainly isn’t easy. If you’re going to devote your time, money, and energy, you might as well do it right.