While this may not be an exhaustive list, here are a few reasons to explore and get you started:
- Something NEEDS to change or be addressed: If there is one thing I have learned from years of working with people it is that human beings are extremely resilient. The body, mind, and spirit can endure and cope with large amounts of stress. Whether it is the physical stress of not addressing a medical need or the emotional stress of staying with a harmful relationship. People are able to cope themselves into corners and dark places. Taking time to reflect on life and truly look at how long a relationship, job, or physical condition has been going on can provide clarity into what truly needs to change. It never ceases to surprise me how many years people will endure things (especially jobs and relationships) that are literally destroying other areas of their life.
- Change Requires New Narratives: It doesn’t matter how far someone moves or how great the new job or relationship is, the old story will still replay from time to time. Be prepared to remind your wandering thoughts that life is changing and to give it time before feelings of satisfaction or peace come with that change. Keep track of successes and milestones that mark your way to the life you do want. Proactively choose the narrative or story that you replay in your mind. I ran into this problem when I went from a grueling internship to private practice. I had days I would catch myself dreading going to work or feeling anxious about my practice. I finally realized, I was addicted to that way of thinking because I had endured and coped with a harsh environment for so long. It may sound silly but I had to literally remind myself that I was not doing that kind of work any more. I had to create a new story to tell myself about my career. I would reflect on how lucky I am to spend my time helping people and if there is something I can change it.
- Gratitude is a practice first and a feeling second: A practice of gratitude is truly life changing. When clients discover the ability to be grateful for the change that is occurring in their lives or focus on the parts of life that are going well feelings of happiness and satisfaction abound. The ability to not let work stress or one relationship bleed into other areas of life is important. Just because there is a couple difficult people at work doesn’t mean a person has to hate the whole job. Practicing gratitude helps keep life in focus and can offer clarity about what needs to change. I see this commonly with the most intimate and important relationships in client’s lives. When there is marriage or family stress, it appears to affect all areas of life. Staying grateful for what is going well in life keeps people focused and offers an honest reflection of your present context or environment.
Important Reminder: You are in charge of your mental and emotional health. No one should tell you what your experience is and mental health concerns are not a reason to feel disempowered and/or helpless. Your therapist/doctor/counselor/psychologist/psychiatrist should be able to clearly articulate risks and benefits of the treatment they are suggesting. It is my opinion, after 7 years of training and practice in this field that medication should always be approach as an absolute last resort and never a first response to mental health concerns. In addition, a diagnosis (such as bi-polar or depression) is not a treatment plan.
When looking for a therapist, it is important to know a few important but simple questions to ask to ensure you get the best therapist for your situation.
- Where & when did you attend school? If the school doesn’t sound relatively familiar, look it up. Make sure that live supervision and an internship were part of the program, especially if you are working with an intern. If the clinician is fully licensed, you know they have had three years of supervision in Oregon.
- How long have you been practicing and what is your license in? It doesn’t matter whether the therapist has been in practice for 9 months or 29 years, neither guarantees a good therapeutic fit. What you are looking for in this question is for a confident response. If you get a shaking, “only a few months” or a cocky, “too long!” it’s a red flag. You want a clinician who is hungry to learn but confident in their skills. It’s a delicate balance!
- How do you believe change occurs? Some clinicians believe change occurs when brain chemicals are altered, others believe it happens over a period of time when you gain more coping skills, others believe change happens in the moment in therapy. It is important to know how your therapist believes change happens. For example, I believe that change occurs when the habits/patterns change whether it is emotional, behavioral, or interactional (between two people) patterns. Therefore it would not be a good fit for me to work with a therapist who believed that my emotional state would improve by changing chemicals in my brain.
- What is the average amount of sessions you work with clients? The answer to this comes down to preference and what you believe change looks like. I typically work with clients for 12 session. I believe clients should pay me only for the sessions they need and as they begin to experience change and healing we should start spacing out sessions. Clients can always come back if they need more support and I never want to foster dependence or send a message that a client needs me. Other therapists have a more long term approach, I can’t speak to that because I wasn’t trained in it, so it comes down to what you believe.
- What is your treatment plan? Of course you may have to attend a couple sessions to get the answer to this question, but a good therapist can always articulate how they are seeing the problem and how they seek to help you with it.