1. Why therapy?
2. What is therapy like?
3. How long will therapy take?
4. What’s the difference between all the different helping professions?
5. How much is a typical therapy session?

1. Why Therapy?

Some people might think, "Why do I need to go to therapy when I have family and friends I can talk to?" Talking with a therapist is different. Therapy is a unique relationship. In Carl Sherman’s book, How to Go to Therapy: Making the Most of Professional Help, he describes therapy as a balance in which two people are "collaborating on a single project: helping you deal with your problems and achieve the change you want. There is no other agenda." This fact alone – that the therapist is there to help you and is not expecting anything in return – sets therapy apart from any other relationship. Other perks of talking with a therapist include a regular meet time, confidentiality, safety, and trust. Thus, from this perspective, seeking help from a therapist is seen as a sign of good health rather than of weakness or being "sick." Your commitment to therapy is saying to others that you’re ready and willing to change.

In addition to helping you deal with your problems and achieve the change you want, there are other benefits of the therapeutic relationship.

Safety – Feeling safe with your therapist makes a big difference. When you feel safe, it is easier to talk about your fears, dreams, and fantasies. And unlike telling your family or friends, your words to your therapist will not come back to hurt you.

Confidentiality - People would have a difficult time opening up to a therapist if they knew that what they said was not kept confidential. Thus, your therapist is bound by ethics and law (except in a few cases) to keep what is said in sessions private. As a result, therapy provides a safe haven, where you and your therapist can engage in an open and honest dialogue to help you explore your problems in more depth. You can trust that your therapist is there to guide you, without judgment, criticism, or hidden agenda.

Learning - The therapist can help you look within to get a better understanding of who you are – why you do what you do, say the things you say, think the way you think, and feel what you feel. Ultimately, the more you know yourself, the more equipped you are to handle the things of life, like relationships, stress, loss, change, and unpleasant feelings. The therapist can also help you examine how you see and interact with the world and help you have a new and positive perspective. Together with your therapist, many discoveries will be made about yourself and your experiences, all in the hopes that you can learn to live life more fully and with more confidence and success.

(Adapted from Emotional Wellness Matters)

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2. What is therapy like?

I bet one of the first images that pop in your mind is of a patient lying on the couch with his/her therapist sitting off to the side, either jotting down notes or falling asleep. My best guest is that most of you have had glimpses of psychotherapy in books, on television, in movies, and in comic strips. Well, I want you to forget about all that. It’s likely that what you know to be therapy is not what really goes on.

If you’re like most people, you’re thinking about therapy because you’re experiencing significant distress or emotional pain in your life. You may have tried going to your loved ones and friends, but this time, their advice and encouragement just isn’t enough. Or you may be afraid to share your deepest concerns for fear of being ridiculed or looked down upon. Or you may have tried many things to either deal with or fix the situation to no avail. During these difficult times, it is not unusual to want and need to feel safe and supported. This is where therapy can help. You don’t need to feel the pain forever.

Therapy sessions vary, depending on who you are, your life circumstances, your current issues, your therapist’s working model, and your relationship with your therapist. Despite these factors, a “typical” course of therapy may look something like this:

1. Getting to know each other and discussing your concerns

The first few sessions are generally a chance for you to see if you are a "good fit" with your therapist. Here are some questions to keep in mind. Does your style of communication matches that of the therapist? Do you feel comfortable talking about your problems? Do you feel safe in the room? Do you get the sense that your therapist is there for you? At the same time, it is a chance for the therapist to better understand you. The therapist will likely ask many questions, some of which may feel very personal to you. You are not required to answer every question, but know that the more you can talk about yourself and your circumstances, the better able the therapist is in helping you. Remember, you know yourself the best! Upon entering therapy, many people are unclear about what they are feeling or what the exact problem is; don’t worry about it. You and your therapist can figure that out. Just allow yourself to be part of the process. Through the working relationship with your therapist, you will get past your uncertainties and reach your goals.

2. Finding the major issue you will be dealing with in therapy

As the discussion continues, your therapist will be listening and asking questions to help you identify areas to focus on in therapy. During this time, goals for therapy may be created along with specific ways of measuring those goals. For example, your therapist might ask you, "How will we know when you have reached your goal? How will your life look different?"

It is important to know that therapy does not provide a quick fix. In fact, many people find that they feel somewhat worse during the first few sessions. This is because emotional pain is often felt more intensely when a person starts to look more closely at their issues. If this happens to you, don’t run away from therapy. It is a natural and normal part of the process. You are coming to terms with life issues that hurt and what better place to deal with it than in therapy, with a person you feel safe with and can trust. No judgments. No criticisms. No strings attach. It takes courage to stay in therapy during your most vulnerable time, but if you stick to it, your therapist can guide you through the healing process and teach you tools to cope more effectively on your own. And for most, the emotional distress significantly decreases at some point along the way.

3. Tuning into the issue

During this phase, you will have the opportunity to understand yourself and your difficult issue much deeper. You may begin to see yourself or the issue in a different way or have a different attitude about yourself or the issue. You may realize that you are in a pattern that keeps repeating in your life, that your current behavior is linked to something that happened in the past, or that you are avoiding someone because of the feelings that come up for you when you are around that person. Though the discovery may be painful, many people start to think, "My feelings make sense now," "Now I understand why I do what I do," or "I thought I was over that, I guess I need to work on it some more." Whatever discoveries you make in therapy, remember that you are always learning more about yourself, which will only serve you well in the long run! It doesn’t hurt to “know thy self.”

Once the issue has been clarified, then you can start focusing on what you want to do about it. For example, some people want to learn skills to better deal with their situation and will practice in session and then talk about the thoughts and feelings that came up for them. Others may need to learn to let go of lies that they have been telling themselves, like "I’m worthless," "I’m unlovable," or "I’m not good for anything." Still others may need to talk about a certain event that happened to them over and over again until the event no longer has a hold on them. These are just a few examples of ways that people can work through their issues and reach their goals. Each person is different and will work towards their goals in their own way.

4. Checking-in

During the course of therapy, your therapist may ask you how you think therapy is progressing. The goals you made at the beginning of your therapy experience isn’t set in stone, so if things in your life change, your focus and goals can change too. Also, if something isn’t working for you, let your therapist know. Your therapist is there to help you and work with you, not against you. So be honest with your therapist about your experience in therapy. Rest assured, honesty pays off in therapy.

5. Graduating

There comes a time in therapy when both you and your therapist believe that your work is done. There’s no formula to know when someone is done, but it’s something you will know. When that time comes, you will have the opportunity to review your progress in therapy and talk about ways to keep and practice what you’ve learned. It is also a time to say goodbye. For many people, this is difficult because the relationship you have with your therapist is a special one, like no other kind of relationship. You were heard, understood, and supported. Your thoughts and feelings were seen as important and were validated. You weren’t judged or criticized. You weren’t expected to be anyone but yourself in the room. Your therapy hour was just for you; you were allowed to talk about whatever you wanted to talk about. So it is understandable if you get sad during your last session. This is the kind of relationship we all wish we could have in our lives. Just remember that saying goodbye is a good thing in this case because that means you have grown during the process – you are not the same person as you were when you first stepped into your therapist’s office. Also, though you may not need any more guidance with your current issue, other life events may come that may cause you to struggle and you are always welcomed back into therapy.

(Adapted from "Make Every Session Count" by J. Preston, N. Varzos, and D. Liebert)

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3. How long will therapy take?

Therapy can be as brief as a few sessions or as long as a few years. It depends on many factors, including but not limited to who you are, the goals you set, the severity of the problem, how engaged you are in the process, and the types of resources you have. There are times when people come back to therapy after graduating for some time, as they face another struggle in their life.

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4. What’s the difference between all the different helping professions?

Psychologist (Ph.D.) – Doctoral degree in clinical or counseling psychology

This is the traditional psychology degree post college. The average length of a Ph.D. program is 6-7 years. The program is more focused on research and theory than on clinical work (the art of therapy). Many Ph.D. psychologists pursue careers in academia post graduation. In order to use the term “psychologist,” the person must be licensed in their particular state. To be licensed in the state of Colorado, the practitioner must earn a doctoral degree in psychology, pass an exam, and complete 12 months, 1500 hours post degree, supervised experience.

Psychologist (Psy.D.) – Doctoral degree in clinical psychology

This is a newer degree for individuals interested solely in the practice of psychology. The average length of a Psy.D. program is 4-5 years. It is typically more clinically-focused than research-based, so training is focused on psychotherapy techniques and psychological assessments. As a result, psychologists who have earned their Psy.D. typically have more clinical, therapy experience than psychologists with their Ph.D. In order to use the term “psychologist,” the person must be licensed in their particular state. To be licensed in the state of Colorado, the practitioner must earn a doctoral degree in psychology, pass an exam, and complete 12 months, 1500 hours post degree, supervised experience.

Psychiatrist (M.D.) - Medical degree with a specialty in psychiatry

Psychiatrists are medical doctors who specialized in mental health issues (completed a residency in psychiatry) and are licensed to prescribe medications. They are also trained in psychotherapy, but because they are in high demand, they typically only do medication management.

Social Worker (M.S.W., L.S.W., L.C.S.W.) – Master’s in social work

Social workers are trained in psychotherapy and social work (integrating individuals with community resources). They typically pursue careers as social workers or general psychotherapists. To become a licensed social worker (L.S.W.) in the state of Colorado, the practitioner must earn a master’s degree in social work and pass an exam. To become a licensed clinical social worker (L.C.S.W.) in the state of Colorado, the practitioner must earn a master’s degree in social work, pass an exam, and complete 2 years, 3360 hours post degree, supervised experience.

Licensed Professional Counselor (L.P.C.) – Master’s degree in counseling psychology

Licensed professional counselors are trained in psychotherapy techniques, but are not trained in psychological assessments. The program is typically 2-3 years in length. To become a licensed profession counselor (L.P.C.) in the state of Colorado, the practitioner must earn a master’s degree in counseling psychology, pass an exam, and complete 2 years, 2000 hours post degree, supervised experience.

Counselor/Psychotherapist

In the state of Colorado, anyone can call themselves a counselor or psychotherapist, regardless of their training. Individuals that would like to use this title in Colorado must be registered with the State Department of Regulatory Agencies as an “Unlicensed Psychotherapist.” Exception: practitioners who have earned their Psy.D. or Ph.D. and are working on their hours towards licensure may be registered as a “Psychologist Candidate.” They have 5 years to complete their hours to become licensed. Unlicensed practitioners are required to be supervised by a licensed clinician.

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5. How much is a typical therapy session?

In most cases, a mental health professional will see a client for 50 minutes. On average, the price for a doctoral level, licensed psychologist in Colorado is $100-150 per session; for a licensed professional counselor, it is $50-90 per session.

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