What really happens in psychotherapy?


After looking at the overwhelming amount of information about the benefits of psychotherapy and how to find the right psychologist (therapist), now you want to understand what happens once therapy begins.


What exactly is going to happen?


To begin, let’s review what psychotherapy is and what it is not.


Psychotherapy with a psychologist is:

  • Applying science-supported interventions and techniques to help you (the client) develop effective habits

  • A supportive place that allows you to talk openly with someone who is objective, neutral and nonjudgmental

  • A collaborative relationship between a client and a psychologist (therapist) where you are expected to actively participate

Psychotherapy is not:

  • A conversation with a friend who you will spend time with outside of session

  • An existing relationship with a family member or friend who is a licensed or unlicensed therapist

  • A place where you don’t feel comfortable or safe to share feelings and problems

  • A place where the therapist tells you what to do and exactly how to do it with no consideration for your thoughts or feelings


Psychotherapy is often referred to as talk therapy, and that’s what you’ll be doing during each session. You will engage in talking about your problems and finding solutions and new ways to view the challenges. As psychotherapy goes on, you’ll continue the process of building a therapeutic relationship with your psychologist and will be an active agent in resolving the difficulties that led to seeking therapy in the first place. There is no right or wrong way to be a client! 


The first and second times of meeting, the psychologist will want to learn more about your life and help clarify what’s troubling you. Once you have established what the difficulties are and the goals you want to reach, the two of you will talk about each of those challenges. As you progress, there will be a focus on problem-solving and working together to find different ways to think, changing behavior patterns, and understanding your feelings.


For some difficulties, involving other people in the psychotherapy may be beneficial (with your permission). If there are relationship challenges, the psychologist may suggest your partner or spouse attend a session or two to support you. Perhaps the goals you’re working on involve medical needs, and your psychologist feels it would be helpful to have a conversation about your health. She/he may ask for your permission to speak with your physician, fitness trainer, dietician, or others who are providing care to you.


Your psychologist will likely ask you to practice the skills or new behaviors discussed in therapy. Research has shown that taking action is an important reason therapy is successful! It can be hard to change old patterns of thought and behavior, so practice is necessary. The psychologist will expect to hear what you learned and help you keep those gains and working toward resolving your problems.


Lastly, there is no clear number of sessions to “cure what ails you.” How long psychotherapy takes depends on many factors like the type of problem(s), your goals, what's going on in your life outside of therapy and how fast you can make progress.


Ask your psychologist for progress updates often!


Dr. Erika McElroy

Smooth Rock Psychological Services, LLC



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