How does therapy work?

Also called psychotherapy, counseling or talk therapy, therapy refers to a variety of approaches to address emotional, psychological, behavioral, or social problems. This is a topic that brings up many questions. What will I talk about? What kind of therapy would work for me? How long will it last and will it help me at the end?

Finding a therapist in New York City can pose its own unique conundrum: There are so many to choose from. How do I choose? Who will be right for me? Will they help me solve my unique problem or problems? Will they be the best fit for me?

Does seeking therapy mean that something has to be explicitly wrong, or is it also OK to see a therapist to get to know myself better, to understand my patterns and ensure that I am living life to my own expectations?

Whether you are considering therapy for the first time, or have been in therapy in the past, these questions likely may have crossed your mind. Here are some thoughts on how to connect with a therapist that fits your individual needs and suggestions to make the process go as smoothly as possible.

The first phone call or consultation:

Reaching out to a therapist, whether through a call, an email or other inquiry is your first step on the path to growth, and it may not be an easy one to take.

You are likely looking for help when in the midst of a difficult or painful period. Your motivation may be low. Your anxiety may be high. You may worry about opening up to someone that you have never met. Taking that first step to ask for help takes a lot of courage, but it is also a choice to pursue positive change.

Because choosing a therapist can be daunting in general, and in New York City in particular can be overwhelming, many therapists offer potential clients a free phone consultation prior to scheduling an initial visit. This first contact is a chance to share why you are looking to start therapy and for both you and the therapist to get an initial impression of whether their skill set is a good fit for what you are seeking help with.

The initial phone consultation is a great time for you to ask questions and to get a feel for how you and a therapist might work together.

Research has shown that the best predictor of success in therapy is “therapeutic alliance”, or the genuinely collaborative relationship that forms between client and therapist. For this reason, I encourage you to speak with multiple therapists until you find someone that you feel comfortable talking to and that is able to help with your specific needs.

Your Initial Appointment

If after your phone consultation we decide to initiate therapy, we will schedule an initial appointment. Our first meeting together will take place either via telehealth or in person. In either case, we will discuss ways to ensure that you are in a comfortable and private environment so that we can concentrate on our time together with minimal distractions.

We will begin with a conversation about what to expect, and will focus on the challenge that is bringing you in for therapy. The first visit is longer than other sessions, 60 minutes, and can be referred to as an “intake.” This will give us the time necessary to discuss your history and to understand what might be contributing to your current troubles. I will ask more questions during this visit than in later sessions, to be sure that I have a clear understanding of your situation.

Regular Sessions

Therapy sessions take place on a weekly basis and appointments typically last 50 minutes. Some forms of therapy require longer sessions, and we would discuss that in advance. Talk therapy is only effective with regularly scheduled sessions. It may help to think of your sessions as the equivalent of a dose of a prescribed medication. The “talking” is the treatment and missing “doses” can slow or stop progress.

Our broad goal is to create change in your life outside of the therapy room using the work done during your sessions. Depending on the approach that we are using, there may be written assignments aimed at applying and reviewing techniques to address your specific goals.

Endings

Therapy is designed to come to an end. When this end arrives often depends on what brought you in for therapy in the first place. Some problems are clearly defined and can be approached using targeted and time-limited treatments. In this case, you and I will discuss the number of sessions that we will plan to meet early on. More self-reflective or exploratory approaches go into greater depth integrating experiences from throughout your life, and therefore take longer. In either case, we will periodically check in about how things are progressing, what is working well, and what we should continue to focus on.

In all cases, the aim of therapy is for you to be able to bring the learning and growth from our work together into your day-to-day life, and to ultimately part ways.

Below is more information about my specialties, approaches and some useful descriptions of common problems to help guide you in your search.