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Starting psychotherapy
Usually you'll go to a therapist's office for psychotherapy sessions. A therapist may have an office in a medical clinic, an office building or even a private home. Psychotherapy also can take place in a hospital, if you've been admitted for treatment. You usually meet with your therapist once a week for a session that lasts about 45 to 60 minutes.
Your first psychotherapy session is usually a time for the therapist to gather information about your situation. The therapist may ask you to fill out forms about your current and past physical and emotional health. All of this information helps the therapist gain a deeper understanding of your situation and whether you might benefit from combination treatment, such as medications. It might take a few sessions for a full evaluation of your situation and issues.
At any time during therapy, especially in the beginning, feel free to ask the therapist questions about his or her approach, the goals of your treatment, how long therapy may last, when and how to contact your therapist during a crisis, and other details about your therapeutic relationship. Know that in general, conversations with your therapist are confidential. However, there are certain situations in which a therapist may be required by law to report any concerns to authorities. Talk to your therapist about any worries you might have about confidentiality.
Types of psychotherapy
Some therapists are trained to provide several types of psychotherapy. Your therapist evaluates your situation to determine which may be best for you, along with any preferences you may have.
Common types of psychotherapy include:
- Art therapy, also called creative art therapy, uses the creative process to help express thoughts and feelings and may include music, dance and movement, drama, drawing, painting, and poetry.
- Behavior therapy focuses on changing unwanted or unhealthy behaviors, typically using a system of rewards, reinforcements of positive behavior and desensitization.
- Cognitive therapy is designed to help you identify and change distorted thought (cognitive) patterns that can lead to feelings and behaviors that are troublesome, self-defeating or self-destructive.
- Cognitive behavioral therapy combines features of both cognitive and behavior therapies to help you identify unhealthy, negative beliefs and behaviors and replace them with healthy, positive ones.
- Dialectical behavior therapy is a type of cognitive behavioral therapy whose primary objective is to teach behavioral skills to help you tolerate stress, regulate your emotions and improve your relationships with others.
- Exposure therapy is a form of behavior therapy that deliberately exposes you to the very thing that you find upsetting or disturbing to help you learn to cope effectively with it.
- Family therapy helps families or individuals within a family understand and improve the way family members interact with each other and resolve conflicts.
- Group therapy brings together a small group of people facing a similar illness or situation for discussion facilitated by a qualified leader or mental health provider.
- Interpersonal therapy focuses on your current relationships with other people to improve your interpersonal skills — how you relate to others, including family, friends and colleagues.
- Marriage counseling, also called couples therapy, gives partners — married or not — the tools to communicate better, negotiate differences, problem solve and even argue in a healthier way.
- Play therapy, geared mainly for young children at specific developmental levels, uses a variety of play techniques to encourage children to more easily express emotions and feelings if they're unable to do so with words.
- Psychoanalysis is an in-depth, Freudian-based therapy that guides you to examine memories, events and feelings from the past to understand current feelings and behavior.
- Psychodynamic psychotherapy, based on the theories of psychoanalysis, focuses on increasing your awareness of unconscious thoughts and behaviors, developing new insights into your motivations, and resolving conflicts to live a happier life.
- Psychoeducation teaches you — and sometimes family and friends — about your illness, including treatments, coping strategies and problem-solving skills.
During psychotherapy
For most types of psychotherapy, you and your therapist generally sit facing each other during sessions. Your therapist encourages you to talk about your thoughts and feelings and what's troubling you. Don't worry if you find it hard to open up about your feelings. Your therapist can help you gain more confidence and comfort.
Sometimes a therapist may ask you to do "homework" — activities or practices that build on what you learn during your regular therapy sessions. Over time, discussing your issues can help improve your mood, change the way you think and feel about yourself, and improve your ability to cope with problems.
Because psychotherapy sometimes involves intense emotional discussions, you may find yourself crying, upset or having an angry outburst during a session. You may also feel physically exhausted after a session. Your therapist is there to help you cope with such feelings and emotions.
How long you have psychotherapy depends on your situation. In some cases, you may need therapy for only a few months. In other cases, you may continue therapy for a year or even more.
Length of psychotherapy
The number of psychotherapy sessions needed per week and the length of therapy depend on such factors as:
- The type of disorder or situation
- How severe your symptoms are
- How long you have had your symptoms or have been dealing with your situation
- How quickly you make progress
- How much stress you're experiencing
- How much support you receive from family members and others
