What You Should Know Before Starting Therapy, from a Trauma Therapist in Sacramento - Part Two
Welcome back! I’m a trauma therapist in Sacramento and in my last blog post, Part One of this three-part series, I began to clear up some common misconceptions about psychotherapy. I shared examples of how different therapists have different styles of working, and explained how healing occurs, and the three main factors that make therapy a success. If you missed it, you can read it here.
Today I’m continuing this insider look behind the scenes of therapy with info on how often I meet with clients for therapy and for how long, as well as a big picture overview of what happens in therapy from start to finish.
If you’ve never been in therapy before, or if you have and are curious to see how my way of working may be different from your previous therapist, then this post is for you.
Let’s dive in!
Frequency of Sessions and Length of Treatment
I meet with new clients on a weekly basis to start.
This is the session frequency I’ve found works best for getting clients the results they’re looking for. In my experience, clients who come to therapy weekly almost always make more progress than those who come in every other week.
Don’t just take my word for it! Check out this study which compares the effectiveness of lower frequency vs. higher frequency of sessions in outpatient mental health care.
I understand that therapy is an investment and that you may have a limited budget for services. This is often what drives folks to ask for every-other-week or less frequent sessions.
If financial limitations are a concern, I encourage you to think in the long term and determine what your total budget is for therapy, and then put that towards weekly sessions for as long as you’re able to, or until you reach your goals.
For example, I believe it’s more beneficial to come to therapy weekly for 6 months than it is to come in every other week for a year.
My position on this may sound firm, but it isn’t arbitrary. I’ve seen the way clients lose momentum with every-other-week or less frequent sessions. And sometimes they conclude that therapy isn’t that helpful, when it’s just that they aren’t taking the most effective dose.
What ends up happening with less-frequent sessions is that most of our time gets spent on updates (i.e., what has happened in your life since I last saw you) and there isn’t sufficient time remaining to do the deeper work addressing the root causes of the issues that brought you to therapy.
I do use every-other-week sessions towards the end of a client’s journey in therapy as a way to solidify the progress they’ve made. Think of it as maintenance mode.
As I see it, a client is ready to move to every-other-week sessions when they’ve made most of the progress they want to make and there’s just a little bit more they want to work on before completing therapy.
As for monthly sessions, I find that if you can comfortably go a month without a session, you’re probably functioning well enough that you don’t need therapy right now, and it’s ok for you to do the healing work on your own.
One of my highest values as a therapist is to honor clients’ autonomy and support their sense of agency and empowerment. I don’t foster dependence.
Often it’s me, rather than the client, who initiates the conversation about moving to every other week. (Although, if you feel ready, there’s no need to wait for me. Please speak up!)
I’m happy to tell clients when I think they’re ready to graduate from therapy. After doing this work over the past 15 years, I’ve come to recognize the signs.
Therapy is not a quick fix.
In my initial consultation with a potential new client, I always ask the person if they have an idea of how long they expect therapy to go or how much therapy they think they need. Most people aren’t sure and that’s ok. I ask to see if we’re on the same page in terms of timeframe.
I don’t want you to be in therapy forever. But I want you to stay in treatment long enough to get the results you’re looking for, so that you can say therapy was truly a success.
I’m not a short-term therapist and a large part of the reason for that is that my specialty is trauma and more specifically, childhood trauma.
The more severe the trauma, the longer healing is going to take.
If a problem has been with you for decades—for the entire duration of your life—and it’s baked into your nervous system and your whole way of being in the world, we’re not going to be able to resolve that in a few sessions.
I say this not to be discouraging, but to set realistic expectations.
Sometimes, especially if someone hasn’t been in therapy before, they might think that they can come in for a few sessions or even a few months and have their issues resolved, but it doesn’t really work like that, at least not for me and the way that I work.
I want to get down to the deepest core of the issues and help you heal the root causes, rather than just putting on a Band-Aid to relieve symptoms at a surface level.
The length of treatment really varies from person to person. It’ll depend on your history, your goals, how much work you’re putting in outside of session, how much support you have, and more.
Some people want to be done with therapy as soon as they’re feeling a little bit better, and others like to stick around for a while to really solidify the progress they’ve made and move from a place of surviving to thriving. The choice is yours.
I hesitate to put out a number because the ideal length of treatment varies so much from person to person and couple to couple, but I’d say that on average one year is a good initial commitment to make for individual therapy (or 6 months for couples therapy) and enough time for most folks to make significant progress.
If you’d like to do individual therapy with me, I ask that you be willing to commit to at least 6 months. For couples, I ask for a minimum commitment of 3 months.
The Episodic Nature of Treatment
As I said, I don’t want you to be in therapy forever, and I don’t foster dependence. I don’t want you to feel like you can’t cope without me. That’s disempowering.
I see therapy as something that’s episodic. Meaning, you come in when you’re going through a difficult chapter of your life and you could use some support.
We work together until your reach your goal and then you graduate or take a break from therapy. We know you’re ready to go when you’re no longer needing as much support. When you feel capable to continue the healing work on your own.
Ending therapy scares some people. It’s like taking the training wheels off a bicycle.
I reassure clients that they’re always welcome to come back to therapy, and doing so is not a sign of failure or regression.
Life is always life-ing. You will hit another bump in the road.
Life challenges will make it harder to maintain your progress at times and you may find it harder to cope or maintain your healthy habits, or you may see a resurgence of unhealthy behaviors that you thought you were “over.” This is all normal!
Let me say it louder for the people in the back—You have not failed! You’re human and life is challenging for us all.
This bump in the road can happen weeks, months, or years after you were last in therapy. You may be able to get through these periods of challenge on your own, or you may want my support again.
If you come back to therapy, it can be for a one-off “tune up” session, or we can meet on an ongoing basis again, depending on your needs. Just know that support is available whenever you need it.
The Process of Therapy
Now I’d like to give you a big picture overview of what happens in therapy from start to finish.
First we have a free consultation to get to know each other a little bit and see if it feels like a good fit. If we decide to work together, I’ll have you complete some intake paperwork online for me to review before we meet.
The first couple of sessions are assessment. That’s me getting to know you, getting background information, and getting more information about the problems going on.
After the assessment, we’ll come up with a treatment plan together, which will say really specifically what our goal for therapy is going to be and how we’re going to work towards that goal.
You should have a clear goal for therapy.
My clients love having a clear goal for therapy. I write up the goal we decide on into a treatment plan, and you’ll get a copy of the plan to refer to and keep for your records.
It helps folks feel more settled to know what to expect.
It continually surprises me when clients who’ve been in previous treatment with another provider come to me and tell me that they didn’t have a treatment plan with their previous therapist. (At least not one they were aware of, or that they collaborated on.)
This is not good, y’all!
Every therapist needs to have a treatment plan for every client, to meet the standard of care for our profession. It can be general or specific. It can be written up into a document or just agreed upon verbally. But there needs to be a goal for therapy.
I prefer to have a specific goal that’s written out because I think it’s empowering to have my client be an active and informed participant in the process of treatment. I try to demystify therapy so that you understand how it works and why I’m doing what I’m doing.
It’s important to me to have a treatment plan because it helps us judge whether or not what we’re doing in therapy is successful. I tell clients, the plan helps me know which direction to steer the ship.
The treatment plan is a working document and it can change over time if it needs to. We’ll make adjustments over the course of our work together to meet your ever-changing needs.
Progress Check-Ins
I check in with clients regularly about progress and I encourage folks to share any feedback they have, whether it’s positive or negative, as it comes up. This helps me tailor therapy to each client, so that it can be as effective as possible.
Therapy is not one size fits all!
If there’s anything we do in session that you find particularly helpful, that’s important for me to know so that we can do more of that, or other similar practices. And in the same vein, if there’s anything that doesn’t resonate or doesn’t work well for you, I need to know so that we don’t repeat it. I promise, I won’t be offended.
I find progress check-ins especially important as a designated time for my clients to recognize their strengths and efforts and give themselves credit for the changes they’ve made, which can be easy to overlook (especially for the folks I work with, who are often perfectionistic and struggle to recognize their accomplishments).
Ending Therapy
We’ll decide together when to reduce frequency of sessions, and when to graduate or take a break from therapy.
As I discussed earlier, you’ll be ready to end therapy when you’ve met your treatment goal and you feel confident continue the healing work on your own.
If a client wants to end therapy with me for any reason, I ask that they talk with me about it. If I think they would benefit from continued treatment, I’ll be honest about that. But ultimately, the decision is the client’s, and I’ll always respect their autonomy.
A client may choose to end treatment early for a variety of reasons. They may not be getting the results they wanted. They might be feeling overwhelmed by the emotions that therapy has brought up. Or maybe something has come up in their life where they just don’t have the time or energy to put into healing right now.
But let’s talk about it. We can troubleshoot most problems.
If you’re not getting the results you want, maybe there’s something we can change in our approach. If you’re getting overwhelmed, we can slow it down and give you more resources and coping skills to make the tough emotions more digestible.
If you’ve got too much on your plate right now, we can agree to take a break from therapy and make plans for you to return when you have the bandwidth. If I’m not the best fit for you, I can help you find the provider who is.
Please don’t ghost therapy.
Not often but occasionally, a client will just disappear from therapy and I’ll wonder, even years later, what happened to them.
If I wasn’t meeting their needs in some way, I would really like to know. I appreciate constructive criticism.
I can’t say for sure why people ghost, but I have some guesses.
Maybe they’re afraid of confrontation. Or maybe this is what ending relationships has been like in their history and they don’t have experience with goodbyes or closure. Maybe they didn’t want to feel the emotions that saying goodbye would bring up.
But you have an opportunity in therapy to do things differently.
As I said, therapy is a place to practice being in relationship. So let’s practice having hard conversations. Practice speaking your truth, even if you’re worried the other person will be disappointed.
Grow your distress tolerance. Get comfortable being uncomfortable.
Therapy is one of the safest places to practice having challenging conversations, setting boundaries, and so many other relational skills. And you get to take those skills with you.
If you want to end therapy, I promise, I’ll respect your decision. But please, let’s communicate.
A Tailored Approach from a Seasoned Trauma Therapist in Sacramento
Hopefully this post has given you a better idea of what to expect from therapy. If you think you could benefit from therapy, I’d love to connect with you!
Maybe you’re in a particularly challenging season of your life and could use some support. Or maybe you’re just ready for your past to stop negatively influencing your present quite so much.
I provide therapy in the most effective, efficient, and empowering way I can, addressing the root causes of your problems and creating customized goals so that therapy is truly a success.
The best way to figure out whether you could benefit from therapy and whether I’m the right therapist for you is to have a free 15-minute consultation. We can get to know each other with no pressure or obligation for you to sign up for therapy. I’m very transparent and direct, and I’ll be straightforward about what you can realistically expect from therapy.
If you’re interested, click here to book your free consultation for trauma therapy in Sacramento today.
Stay tuned for the third and final installment of What You Should Know Before Starting Trauma Therapy in Sacramento where I’ll share how I collaborate with clients on every aspect of treatment, as well as what a typical trauma therapy session with me looks like.
