Why People Use Therapy
Therapy is a positive experience. Because of therapy, you will feel better, learn how
to find solutions to your living problems, and become more comfortable with other people.
And anything therapy cannot change, it can certainly help you to accept.
Therapy works so well because a professional therapist is trained to help you explore
and understand your feelings. When you know where your feelings come from, and what
they mean, you can achieve practical solutions to your living problems. Because therapy
takes place in a safe and supportive atmosphere, it helps you increase your trust in your
own decisions and beliefs, and you also learn to trust other people more. As a result
of that trust, you will experience greater self-esteem and confidence.
This increased self-esteem will result in more satisfaction everywhere, including your
work life, and with your family and friends. You will have the freedom of living more
fully as a result of therapy. By talking things out with a therapist, you locate the
solutions that are hidden within you. People often know what they need to do, about
many situations, but they have troubling trusting their own judgment. With
compassionate, professional help, clients can look within to explore their own
answers and then be reassured that their increasing trust in themselves is deserved.
We will look at different kinds of therapy and how they are helpful. But therapy also works well when combined with appropriate self-help programs.
SYMPTOMS
You can make good use of therapy if you have any of the following symptoms or problems:
Emotional Problems:
You are anxious or restless.
You are lonely or depressed.
Your moods change without any warning.
You feel life is not worth the effort.
You are dissatisfied much of the time.
You cannot control your anger.
You worry about the future.
You don't value your accomplishments.
You feel guilty about something you did or felt.
Relationships:
You hold on to angry feelings about others.
You haven't recovered from a death or the breakup of a relationship.
You can't get along with your parents, your spouse, your children, or your friends.
You are afraid to let other people get close to you.
You have trouble allowing yourself to depend on anyone else.
You have questions or problems regarding sex.
You repeatedly take care of others and ignore your own needs.
You are overly dependent on someone else.
You often feel other people are not listening to you.
You don't know how to leave relationships that are not good for you.
Work Problems:
You feel overwhelmed at work.
You have problems with coworkers or supervisors.
You have excessive tardiness or absenteeism at work.
You have been terminated from several jobs.
You would like a promotion, or a raise, or more training, but you're afraid to apply.
You are dissatisfied with your career, but you don't know what else to do.
Thought Difficulties:
You have trouble making decisions or prioritizing your time.
You think about your childhood a lot.
You are too preoccupied about your problems to function.
You cannot remember the events of the recent past, or events from a long time ago.
You have poor judgment in some living situations.
You frequently do not understand what is being said to you by others.
Obsessive Behaviors:
You are unable to control your drinking, drug use, compulsive spending,
compulsive overeating, or other obsessive behavior.
Or, perhaps, someone in your life is abusing alcohol or drugs; a compulsive
overeater, a compulsive gambler or a compulsive spender; or displaying
other obsessive behaviors which affect you negatively.
Phobic Disorders:
You are frightened in elevators and other closed spaces.
You have a fear of heights, or traveling, or flying, or being near water.
All of the above-mentioned issues can be treated successfully in therapy. The frequency
of your sessions, and the length of the treatment, will depend upon your particular issues.
But you do not have to have a high IQ or an advanced education, or even know exactly what
your problem is, to participate fully in therapy.
WHAT A THERAPIST DOES
Your therapist will be a partner and helper. Together, you are going on a journey through
the past, the present, and to some extent the future. This journey begins with your
history. A little bit at a time, you are going to tell the story of your life and your
therapist is going to "play it back' to you, in simple language, and make suggestions
that will help you to grow and to change.
For example, when you go to a therapist, you may have emotions that are interfering with
your ability to feel comfortable in some area of your life. Whatever you are feeling,
you have a good reason. Often, these feelings are the ghosts of unresolved past hurts,
and you've never told anyone about them. As you tell your story, your therapist will help
you understand your history, so that it no longer intrudes on your life. Once you are able
to see the original problem that caused the hurt, these ghosts from the past will cease
to haunt you.
Therapy Will be a Safe Place for You
A therapist has a calm, soothing way of relating to you, from the beginning. The office
is quiet and private. There are no interruptions. And, in individual therapy, there is
no one in the room but you and your therapist. No one is going to argue with you about
how you feel, or criticize you for anything you say. Your therapist is not going to repeat
what you say to anyone else, so you can feel safe confiding anything.
You are also free, in therapy, to say nothing if that is how you are feeling in the
beginning. Some people find this comforting if they have always felt pressure to "fill
the silences" or if they are shy. You will warm up to the process as you get to know your
therapist better, but if you can say "Hello," you can begin therapy work.
As therapy progresses, your trust in your therapist is sure to grow. This safe place
becomes one in which you can examine intimate details about your life that you were never
able to tell anyone else. Your therapist will not judge or condemn you for anything you
did or said or felt. In fact, he or she will most likely remind you that you are only
human. You may have confusion or guilt over issues surrounding sex, for example, because
you lack basic information which your therapist will easily provide.
Your Therapist Will Help You Understand Painful Feelings
Growing pains are necessary for everyone, but sometimes it's just more comforting to feel
bad with someone than it is to isolate. Also, the therapist's years of experience enable
observation of your feelings without being threatened by them. Your anger won't be taken
as a personal attack because your therapist knows that you have to express it somewhere,
in order to get rid of it.
Many times, we have gone through life pushing these old, intense feelings down, which has
caused us to feel anxious or depressed. A therapist is a stronger person than you are,
emotionally, who is able to act as a temporary reservoir for your feelings. The therapist
can be objective while you vent these feelings, and can then help you to understand them
when you are calmer.
None of your powerful feelings will surprise your therapist, whose experience includes
encounters with people's deepest emotions. Delving into the past, in order to change,
sometimes feels uncomfortable but, because of years of experience, your therapist knows
there is really nothing to fear. Your therapist can honestly reassure you that feelings
have much less power over you once they are out in the open.
Your Therapist Will Help You Solve Your Living Problems
As you talk about your week's activities, your feelings, your insights, your dreams, and
your interactions with other people, your therapist interprets all these details. For
instance, your therapist will be able to tell you, in language that you will understand,
why you may feel helpless to alter some situation in your life.
This understanding does not always solve your problem, but you will feel reassured, and
even stronger, while you and your therapist sort through the problem together and arrive
at a solution. This may include changing your point of view; or taking an action you
hadn't thought of, that will alter the situation; or simply coming to accept the situation
as it is.
Your Therapist Will Reinforce Your Best Qualities
Therapists are persons with consistency, personal integrity, and the other traits that
comprise responsible, fulfilled adults. As you meet with your therapist every week, you
will begin to recognize these same positive traits within yourself Soon, you recognize
these valuable qualities within yourself even when you are not with your therapist. This
strengthens your self-esteem by letting you know you are capable of dealing with situations
on your own, or that you know how and where to get assistance.
Your Therapist is There for You in Emergencies
Into every human life, there is bound to come some crisis, such as the illness or death
of a loved one, for example. Your therapist will be a source of comfort to you in these
times. While remaining detached enough to help you, your therapist is able to share your
pain with you, so that you do not have to bear it alone. Sharing this vulnerability also
allows you to feel stronger, to be more effective in your daily life during a crisis, and
to help others through the situation.
Besides comforting you, your therapist is, at the same time, assessing what actions you
need to take during a crisis. These actions will be explained to you; this way, you can
allow yourself to feel the pain, and to move through it, while being assisted in making
decisions you may not want to make alone.
Your Therapist Will Help You Through a Disappointment or a Loss
A therapist helps you to identify the losses in your life-small ones, large ones, anything
that you feel sad about or need to grieve over. Grieving is a natural, human response to
a loss. You may need your therapist's help to follow its course like a stream, as it
makes its way through your system. Therapists are trained to help us put these losses
into perspective, because not all losses share equal significance in our lives.
Your Therapist Will Teach You to be Easier on Yourself
Because your therapist has treated you with respect every week, for example, you won't
be so hard on yourself when something doesn't work out as you planned; or when you don't
accomplish as much as you thought you could; or when you make an error in judgment. And
this respect and kindness will transfer over to your other relationships. You'll find
yourself less judgmental and more understanding of other people.
SOME LIMITATIONS OF THERAPY
Therapy is Not a Cure-All
As helpful as therapy is, for all these issues and more, it does have some limitations.
For instance, therapy alone cannot cure alcoholism, drug addiction, gambling, overeating,
or compulsive spending, although it can help you learn to live comfortably without the
obsessive behavior. For these issues, your therapist will direct you to Alcoholics Anonymous,
or to a comparable Twelve-Step program, while you are in individual therapy. When used
concurrently with therapy, these programs offer valuable support in maintaining freedom
from addiction and in reinforcing new, life-affirming living skills.
Therapy Cannot Change the Events of Your Past
The best we can all do about the past is to make peace with it. But therapy can change
the effects of the past, if they are giving you trouble. In therapy you will look back,
see why life was the way it was, make changes based on your therapist's experience with
similar problems, and then move on to enjoy your present life.
Therapy Cannot Predict the Future
Life is what happens to each of us while we make plans. But therapy can help you set
realistic goals and take appropriate measures to achieve them. A therapist cannot know
what is going to happen to you, but a therapist is trained to help you prepare for whatever
happens to you. This is done by first understanding, and then helping you change or
eliminate, those behaviors, emotions, and beliefs that prevent you from coping effectively
with your life. Your therapist will also teach you behaviors that strengthen your positive
traits, thus giving you more confidence and less fear about whatever the future holds.
Therapy Cannot Change Your Entire Personality
You wouldn't want it to, anyway; if it did, then you wouldn't be you. But in therapy you
will learn what traits can't be changed and how to adapt to them, as well as what traits
can be changed and how to make those changes. For instance, you may be particularly sensitive
to arguments or yelling but, in the past, you sat and suffered in silence. With the
encouragement of a therapist, you can learn how to confront the problem, or how to walk away
from the argument. Maybe you'd rather read a good book than attend a crowded party, but
don't know how to say "no" to an invitation. In therapy, you will learn to do what you
want to do, rather than submitting to social pressure.
WHERE THERAPY IS USEFUL
Here are some sample case studies (with names and details changed) to illustrate how therapy
helps some common problems:
Growing Up in a Dysfunctional Family
Amanda was referred to therapy by her physician for her emotional problems surrounding
family alcoholism. For Amanda, alcoholism on both sides of her family goes back at least
four generations. Many of her relatives died of alcohol-related auto accidents, suicide,
liver disease, heart disease, strokes, and mental breakdowns. As a child, she experienced
sexual, physical and verbal abuse in an alcoholic home. In therapy, she was able to
release appropriate feelings of anger and sadness for her damaged childhood.
Therapy was the first time Amanda had ever told anyone about the details of this painful
childhood. Her therapist became her witness to the past, which is a vital ingredient for
anyone from a dysfunctional family. Adults who were abused children often perceive the
world as a fearful place because they have had no one with whom to compare their views
and, in their experience, no one would listen anyway. The fear of living can be
substantially reduced or eliminated when you share the details of a painful childhood
with someone you trust. For this reason, there is much freedom in store in selecting
a therapist as the person to hear your story. This relief is then followed up with
professional treatment for the damaged childhood.
Amanda's therapist was consistent in all his behavior with her, which strengthened Amanda's
trust in him, and made her feel she was worth caring about. Through her therapist's
thorough history-taking, his model of consistency, his encouragement, and his
reinforcement of Amanda's own abilities, much old damage was repaired and Amanda's life
was reconstructed in a way that would have been impossible without therapy.
Amanda could not have done this work alone, because she needed someone to listen to her
story; and then she needed someone to encourage her to take the actions that change
requires. For anyone from an alcoholic or dysfunctional family, therapy is the vital
link to healing and emotional freedom.
Phobic Disorders Such As the Fear of Leaving Your Home
Before therapy, if Cora went as far as the mailbox in her front yard, she hyperventilated
and fainted. She was unable to hold a job, to drive a car, or to travel any distance.
When she described her symptoms to her family physician, he encouraged her to participate
in therapy for the treatment of this problem.
Her early therapy consisted of one weekly appointment, and taking short walks alone every
day, at a distance she and her therapist predetermined. She was encouraged by her therapist
to go only as far from home as she felt she could comfortably manage. Farther along in her
therapy, Cora felt confident enough to extend her emotional comfort zone by walking a
little farther, and by learning to drive. She was eventually able to hold a job, keep
social engagements, and take vacations.
Cora's therapist worked at Cora's pace, and he didn't push her too quickly, because he
was experienced in the use of behavior modification therapy. But he firmly encouraged
her to stretch her comfort zone while they explored, together, possible causes for her
anxiety. With therapy, her agoraphobia was greatly improved, and she has been given
tools to deal with it, should it recur.
When Couples Disagree
A problem regarding their upcoming wedding brought Lois and Tim to counseling. By
hemselves, they had been able to resolve all the major issues confronting most engaged
couples except one: where to live. They had met and become engaged in Seattle, where
Lois and her family lived and where she intended to remain. Tim had recently been
offered a better career position in Dallas, where he wanted to relocate. They entered
therapy together, determined to resolve the issue or break the engagement.
Their therapist suggested that Lois make a list of the reasons she did not wish to move
from Seattle, and that Tim make a list of the reasons he felt he had to take the job in
Dallas. Then she asked Lois and Tim to trade lists and each defend the opposite position.
They were both able to see the other's point of view; in this way, their therapist
demonstrated how rigidly both of them had clung to the need to "win." She suggested that
this need had become more important, in the anxiety of the wedding, than their original
commitment to one another. It became clear to Lois and Tim, rather rapidly, that they
could happily live and work in either location. They decided to move to Dallas, in the
interest of Tim's career, on a one-year trial basis, to be reevaluated at the end of
that year. During their stay in Dallas, Lois has visited her family in Seattle one week a
month.
Because of their therapy together before their marriage, Lois and Tim were able to be
more vigilant about their need to "be right" when it surfaced later on, and to deal with
it immediately. They are both active people, committed to a variety of interests, so
much effective "list trading' still goes on in their home.
Recovering From a Loss
Robert began seeing a therapist following a tragic auto accident that claimed the life of
his 27-year-old wife. Left alone with two small children to raise, Robert felt angry,
bereft and bewildered. He had only short-term help from his retired parents and in-laws
during this time, and Robert felt overwhelmed. He became temporarily unable to think
clearly, to set daily priorities, or to look at his two small children without crying.
Robert's therapist provided essential support in the early stages of his readjustment.
She referred Robert to a grief workshop where he was able to share his feelings with
understanding people who had also lost someone. And she helped Robert redefine his
hildren's immediate and long-term needs, as well as his own. Robert's therapist
recommended that both children be seen by a child psychologist, in order to work through
their grief for their lost mother. Although not fully recovered from this loss, Robert
is back at work and his children are back in school. Supportive therapy has enabled
this family to get on with the business of living.
Evaluating Your Achievements and Giving Up Illusions
Thomas, a widower, entered therapy due to depression following his sixtieth birthday.
In therapy, he learned how to make peace with his past achievements, and how to say
good-bye to his boyhood dreams. Over the course of his treatment he was able to accept
that, although he was not going to become an airline pilot, he had enjoyed a fulfilling
career as an aeronautical engineer.
When Thomas' sons were young, he had not spent as much time with them as he would have
liked, because of his work. He told his therapist he was concerned that he had not been
a good parent. But, as his therapist encouraged him to speak of his sons, Thomas
realized that he had been there for both boys, as young adults, when they had needed
financial assistance and career guidance. With his therapist's encouragement, Thomas
also became more actively involved with his beloved grandchildren, an activity which he
enjoyed and which strengthened his bond to his sons.
For Thomas, therapy provided an effective look over his shoulder at his past, with more
satisfaction than sadness, regarding both his professional life and his role as a parent.
With his therapist, Thomas also discussed and rejected many of the myths of aging, so he
awakens to each new day with more enthusiasm than depression.
Treating the Entire Family Together
Roberta and Clark pursued family therapy because they felt their teenage son, Richie,
was withdrawing from them. They could both see the gradual disintegration of Richie's
values and his increased lack of interest in life. But they felt unable to talk to him
or to help him.
In family therapy, Roberta and Clark were able to confront Richie with their feelings of
disappointment and confusion concerning his behavior. Richie was able to respond at first
with only silence and sullen stares. He felt he was there "so you can all pick on me.'
The therapist gained Richie's confidence, however, by consistently acknowledging Richie's
words and feelings, whatever they were. She did not criticize what Richie said, or
discount his presence in any way.
Soon, Richie sensed the therapist was willing to work patiently, as long as it took, to
help him solve his problems. As the therapist drew him out, and as he continued to meet
with his parents and the therapist weekly, Richie began to reveal the feelings of fear
and inadequacy that lay beneath his initial hostility. Richie felt considerable pressure
to abuse drugs and alcohol, as many of his peers were doing, but he had been unable to
confide this to his parents in the past.
Now, although Richie's feelings were emerging, family communication problems remained to
be solved. For this, the family therapist introduced them all to helpful skills they
could use at home, when talking about intense, emotional issues. As the family therapy
progressed still further, Richie regained his enthusiasm for life. He had the support
of both the therapist and his parents in remaining drug free; and he formed new,
appropriate friendships. He developed inner self-confidence; and he took many suggestions
from his therapist, regarding his appearance and attitude, that his parents were still
learning how to communicate to him.
Although their home is not one hundred percent peaceful, the daily battles of this family
have ceased, and the battleground has been moved, when necessary, from their living room
to the therapist's office.
Temporary Substitute for a Spouse or Partner
Isobel sought grief counseling when her husband of forty years died, after a lingering
illness. When her grieving was completed, however, she experienced some reluctance to
terminate her therapy sessions. This confused her; she had grieved and gotten on with
the business of living, so why stay? Together, she and her therapist made a list of
possible reasons why Isobel felt she needed to remain in weekly therapy at this time in
her life.
What they discovered, together, was that for forty years Isobel had been used to sharing
the details of her day, across the dinner table, with a partner who was now deceased.
Her three grown children were attentive, when they could make the time, but they seemed
ambivalent to meeting Isobel's need for regular companionship. Although she had resumed
a full life, Isobel's need for a partner remained unmet.
In her therapist, Isobel found a valuable and comforting listener until she could form
new ties. She says her therapy sessions gave her a feeling of independence, and someone
in whom to confide. She is enthusiastic about her life and, with her therapist's
encouragement, she has made new friends since her husband's death. She feels less
needy, and the time she spends with her grown children is more rewarding to her than
ever.
Using a therapist proved to be beneficial in providing these clients with a safe
place to examine their feelings; to practice new ways of communicating with family
members; to make difficult decisions; to lean temporarily on a stronger person until
a crisis had passed; and to surrender old illusions in order to confront the facts of
life.
YOUR FIRST APPOINTMENT
You don't have to pull yourself together for your first therapy appointment. Just go
as you are, whether that's depressed, anxious, confused, angry, tearful, uncertain, or
feeling nothing at all. Believe me, the therapist has seen it before. And an important
part of you wants to be there as you are, or you would not have made the appointment.
The first session can be a little awkward for your new therapist, too. Why wouldn't it
be? You're strangers. The fact that the therapist sees new people on a regular basis
does not mean that the process is completely comfortable. You'll both get through it,
and you won't be judged or criticized in any way.
Don't be disappointed if the first session isn't very exciting. Maybe it will be, but
often the preliminary questions your therapist has to ask you can seem routine. However,
a thorough documenting of your history is vital if you are to be helped. Your therapist
must learn more about what your problems are, how your life is going, and what you are
feeling.
If you underwent a mental health evaluation, your therapist will weave the evaluation
results together with the history notes from your first appointment, to form a
psychological portrait of who you are when you meet. This brings your therapist up to
date so you can begin to move forward together in dealing with your current issues.
When you get home from your first appointment, write down your impressions of the
initial session. Include anything you felt especially positive about, and anything you
felt apprehensive about. Allow yourself to explore your initial impressions of everything
about that first session; your first impressions often reflect your deepest feelings.
In addition, they may be a clue, for both of you, as to what underlying problems were
"mirrored" by your therapist, and his surroundings, in this first meeting. This
mirroring just means what you saw, heard, and felt, reflected an important part of you,
that you'll deal with together.
WHAT YOU PROVIDE TO YOUR THERAPIST
Your therapy session is not a weekly performance in which you have to impress your
therapist with something memorable. Bringing yourself to your appointment is sufficient.
Usually, in the beginning, you and your therapist will be on a 'get acquainted" mission.
Although techniques vary among therapists, one way you'll work with your therapist is
to describe, in your own words, what you did and how you felt during the week. It
can include items such as the following:
Who you spent time with and the nature of your activities;
How you felt at work; at home; and with your family and friends; especially
Any time or situation when you were uncomfortable;
Any recurring thoughts that bothered you;
Any unusual behavior, something you did that you don't usually do;
Any dreams you can remember and,
The results of any between-session assignments your therapist has asked you to do.
What you discuss with your therapist is certainly not limited to the issues just
described. You will have plenty to talk about, from week to week, that is unique
to you and your situation. And if you don't seem to have anything to say, your therapist
will help you along and make it easy for you to discuss your feelings and problems.
WHAT YOUR THERAPIST PROVIDES
Your therapist will listen carefully to what you say about your thoughts, feelings,
and actions during the week. Years of training and experience enable your therapist
to trace the origin of your feelings and present possible reasons for any anxiety or
depression you have. A therapist will help to interpret what your thoughts and dreams
are trying to tell you about yourself, and suggest alternative ways to deal with other
people. And whatever else is provided in therapy, you may be assured that your therapist
will be there next week to help you, no matter what you say or how much pain you are in.
Your therapist won't grow tired of you or your problems.
HOW THE PROCESS DEVELOPS
Together, you and your therapist establish a relationship based upon trust. Now you have
a person with whom you are free to speak openly about all the issues in your life, and you
have that person's undivided attention. For this reason, you may soon feel a sense of
relief because you have begun to do something about your problems: you have found a good
listener with whom to share them.
You develop more trust in your therapist from week to week, so you reveal yourself at
increasingly deeper levels. And the more you reveal, the more insight and understanding
your therapist brings to your life and to your issues. As a result of this exchange,
you begin to feel better and to respond with more interest and responsibility to the world
around you. You also trust yourself and your own judgment at a deeper level. And you
notice that you are more relaxed and trusting around other people.
Realistically, there are bumps in the road. But, once you're in therapy, at least you're
on the road. There may be times you will want to quit but, if you maintain your commitment
to be helped, this frustration passes and you recover in spite of it. Therapy is worth
some occasional discomfort because it works so well most of the time.
THE ESSENTIALS
Don't expect a therapist to read your mind. Your therapist is well-trained to interpret
what you say, to help you solve your problems. But a therapist is not able to "read" your
thoughts and magically interpret your needs. A certain amount of "speaking up" will be
required, and your therapist will help you learn to express what you need, as you work
together.
Talk about everything that is giving you trouble, even when you would rather not admit
it to yourself, or even if you think it's unimportant. Let your therapist decide, with
you, what material is helpful to you.
Periodically, ask what you could be doing to help your therapy along. And share any
writing you have done. Remember, if your therapist suggests things for you to do or think
about between sessions, try to carry them out. This will help you achieve your goals in
therapy faster. If you have problems with some of the between-session tasks, contact your
therapist for further help or instructions.
Don't expect your therapist to become your friend or to share a social life with you.
Because your therapist wants to be as effective as possible in treating you, any other
kind of relationship with you would not be desirable or useful to you.
CONFIDENTIALITY AND INFORMED CONSENT
In therapy, you have the same rights to client confidentiality that you have with your
medical doctor. A therapist who violates that rule of confidentiality should be reported
to your State Board of Medical Quality Assurance, and should be fired by you.
If your therapist suggests that any kind of mental health testing be administered to you,
your informed consent must be obtained. You have a responsibility to yourself to understand
the purpose of the testing, what the test results will be used for, and who will see the
results. If anything about the testing procedure makes you uncomfortable, discuss it
with your therapist.
TAKING MEDICATION
If you are taking any medication when you begin therapy, including medication for high
blood pressure or low blood pressure, symptoms of menopause, anxiety, depression, or
sleep disorders, be sure to inform your new therapist. These medications are known to
cause changes in your consciousness, your emotional state, your thinking, your memory,
your concentration, and your judgment - so of course they will affect your therapy
process.
If your therapist recommends medication for you, find out when and how you are to take
it, what the medication is intended to accomplish, and what side effects you may expect.
Remember that only a medical doctor can prescribe medication so, unless your therapist
is a psychiatrist, you will need a referral to a doctor for a medication evaluation and/or
a prescription. If the idea of taking an antidepressant or antianxiety medication upsets
you, by all means say so. Your therapist is not a mind reader, and your reassurance about
medication is essential to your well being. If you won't take the medication, it can't
help you.
Psychotropic medications (drugs which affect mental activity) do not solve your problems,
or take the place of having to feel your emotions, or become a substitute for your therapy.
They enable you to proceed with therapy and to cope with life while you and your
therapist work together. And your dosage should never be reduced, increased, or
discontinued by anyone but the practitioner who prescribed them.
CONSIDERATE THERAPY MANNERS
If you are a smoker, ask your therapist's permission before you smoke anywhere in the
office. You are on your therapist's turf and common courtesy is appropriate. Don't
open up a three-course meal in the office, even if you are on your lunch hour. Arrange
your meals to occur outside of therapy. And don't expect your therapist to return your
phone calls on your timetable. Most therapists are on a fixed appointment schedule with
little time between clients.
If you have a genuine reason to phone your therapist, by
all means do so. However, you should not make this a habit. Early in your therapy, you
and your therapist should discuss any occasions when it would be necessary or appropriate
for you to telephone. The therapist's waiting room is not the place for children and
friends to gather. Make baby-sitting arrangements in advance, and meet companions
elsewhere, since this is usually a much smaller waiting room than the one in your doctor's
office.
CANCELING APPOINTMENTS
It is important to remember that your therapist makes his or her living providing you
with services. If you are on a fee for service payment arrangement, your therapist
expects to collect a fee for all scheduled appointments made for you. If you cancel
an appointment, this generally mean lost revenue for the therapist as yours was an
appointment time that he was reserving for you and could not fill by seeing someone
else.
If an emergency arises, your therapist will understand but be aware that your
therapist might expect payment for the session nonetheless. Some therapists charge
a bundled rate for the therapy regardless of the number of sessions, so payment issues
are less of a problem. Remember, if you make an appointment you are expected to keep
it. You should not communicate any ambivalence about continuing in therapy by canceling
appointments. Speak directly to your therapist about these concerns. He or she will
appreciate your directness.