Going into therapy as a first time experience poses important questions. What can I expect to get out of the therapy? Should I work with a male or a female therapist? How long does therapy take to produce effective change? Does therapy work? How much does it cost? These represent just a small smattering of questions most ask as they contemplate the initial step of contacting a therapist. They are considerations that deserve answers; and since I have been doing therapy for more than 30 years I am well positoned to address your concerns.
First let's examine the question of counseling effectiveness. Here we have good data which shows that "talk" therapy, Clinical Behavioural Therapy, Relational therapy and Rational therapy produce excellent outcomes. Both individual and couples therapy demonstrate excellent long term results particularly when certain skills can be acquired such as learning how to use soft-start-ups and how to repair relationships after conflict. When working with issues like depression, statistics reveal that while only 25% of those who are depressed come for counseling, of that 25%, 80% get better!
Drugs and "talk" therapy. All the studies indicate that "talk" therapy on its own without the use of drugs is as effective as drug therapy on a short term basis; more so on a long term basis; and even more so when used with drugs in certain instances such as bi-polar and schizophrenia.
But what happens inside the clinical hour? You will be asked to begin with a simple verbal word statement termed a "therapeutic contract." This gets established between you and the therapist based upon what you want, what you want to change, address or improve in your life. This verbal/statement contract will only be a sentence or two in length and the very best ones are in 4th grade english or less. The simpler they are they are the better they are. A sample would be, "I want to learn how to control my anger." This is clear and to the point. Both you and the therapist know exactly what you want to accomplish and this verbal contract becomes the measuring rod for knowing where you are in the process and when you are done.
Should I work with a male or female therapist? It will depend on your circumstances and what you want to achieve. But generally speaking most males will feel more comfortable talking to a male therapist about matters such as their sexuality and the same can be said for women. Since so many households find themselves led by a working single Mom and if they have teen-agers where no father/male role model is on the scene, then, a male therapist may be preferable.
Lastly, I received my early training at the bastion of Freudian psychoanalytic psychology, the Menninger Foundation, Div. of Religion and Psychiatry, Topeka, Ks. But I have long since moved on from the psychoanalytic model simply because it takes too long and costs too much. I now use Cognitive Behaviour techniques and in doing so I give my clients tons of homework in the service to teaching fundamental basic skills. I spend almost no time going into the past as my goal is to assist people to move forward.
I hope this answers some of your questions regarding what to expect from therapy. Dr. Peter Salerno, D.Min.
