In my own verbiage I would describe it as a safe place to process the whole spectrum of your thoughts and emotions with a professional who is trained to actively listen, validate your experience, work with you to find ways to navigate your circumstances and collaboratively come up with solutions that work best for you. 

Therapy is not for the “crazy,” but for anyone who is seeking to better their mental health. No one is immune to stress, grief, loss, trauma, relational difficulties, aging, medical issues, and life transitions. Since these are common to all people, irrespective of race, ethnicity, culture, religion, political preference, age and social status, all are eligible and free to receive therapy from their preferred choice of therapist. Therapy is also a tool to help you find deeper meaning and understanding of inner conflicts even if “everything looks good on the outside.” Maybe you feel like something is missing in your life and you can’t put a finger on it. Therapy is not only a modality of healing but also of prevention. 

• The information shared by you will be held completely confidential. There are two conditions under which confidentiality has to be broken. If your therapist suspects that a child or an elderly person is being abused or neglected in any way, or if your therapist believes that you are at risk of harming yourself or others in any way. Under these two conditions, a report has to be made by your therapist as it is considered mandatory by law.  

• The first session is called the “intake” which focuses on information gathering and a discussion of your treatment goals.  

• Subsequent sessions will focus on the therapy process. Your therapist will initially focus on building rapport and trust to lay a strong foundation for the therapy process which is crucial for positive treatment outcomes by reducing any defensiveness which could hinder the therapy process. Whether you are new to the therapy world or are a veteran (metaphorically speaking), both patient and therapist initially begin the journey of healing as strangers.  

• As a patient you could expect your therapist to ask many types of questions; sometimes with the aim of getting to know you in a deeper way, and sometimes to help you see things from a different perspective. You could also expect your therapist to ask questions to challenge your thinking style and beliefs.  

• Therapy is not meant to be rushed. You should expect your therapist to work with you at your pace.  

• You can expect therapy to bring up some disturbing feelings and memories. You may feel like you have now opened the “pandora’s box” so to speak or have “woken up the sleeping giant” and sometimes patients never return, not knowing that this is a necessary part of the healing. Ripping the band aid becomes crucial at some point, so the wound can eventually heal. Avoidance keeps people from going past the pain. Your persistence is critical because the therapist and patient work together as a team. It is not solo work, but a partnership where two people work together to find a new normal or a new perspective.  

• Your therapist is trained to empower you to make your own decisions rather than tell you what to do. They are there to offer guidance and to remind you that you are not alone.  

• You can expect your therapist to give you some forms to fill out to better understand your symptoms and to measure your progress as you attend sessions. This way there is a concrete method of tracking your progress.  

• You cannot expect your therapist to do all the talking. It is not one-sided process, but an exchange. Sure, there may be sessions where the patient may need to just vent. However, equally important is the patient’s ability to sit back and receive from the therapist. On the flip side, I have experienced patients who talk for the majority of time in the session, with very little room for me to provide any sort of input.  

• You can expect your therapist to give you some helpful hand-outs or homework exercises, so information learned and discussed can be easily recalled, mulled over and applied to everyday life- isn’t that the ultimate goal?
• Expect your therapist to close the session on time, even if there are things left out that have yet to be discussed by you. It is important for the therapist to close on time to avoid delaying the next patient. You can bring up your concerns to discuss in the following session.

• Decide ahead of the session what you would like to focus on that day- stick to one or two topics of highest priority that week, to maximize your experience.  

• Take time to ask yourself if therapy is actually working for you. If not, ask why. Write down your concerns and bring it up to your therapist. It is important to be honest and share what is and what isn’t working for you.  

• During the week, make note of things that are relevant to discuss- for example things that triggered you and how you handled them or perhaps those “aha moments”.   

• You are working on treatment goals outside of the session. For example you are learning to advocate for yourself by drawing boundaries. While this may feel awkward or uncomfortable in the beginning, with time and practice you learn a new and healthier way of relating to the world.  

• Take time after each session (even 5-10 minutes would suffice) to reflect on what was discussed and how it impacted you. Reflection is important for retention of information and for ultimate growth.

• A strong rapport and trust is established between you and your therapist.

• Your therapist is actively listening and reflecting your emotions.  

• You feel genuinely accepted by your therapist.  

• Your therapist periodically checks in to make sure therapy is working for you and adjusts treatment techniques and/or goals as needed.  

• Your therapist is open to your feedback and tracks your progress.  

• You don’t feel pressured to tell your therapist what you think they want to hear. 

• Your therapist practices good boundaries with you. 

• Your therapist is sensitive to your cultural and spiritual background and needs and adjusts treatment process and goals to reflect this.  

• Your therapist does not frequently compare your experience to others.

• Your therapist communicates with you in advance if they are taking time off for  vacations and such, unless there is a true emergency.  

• Your therapist makes appropriate referrals based on your needs. 

• Your therapist (when necessary) collaborates with other healthcare providers (psychiatrist, primary care doctor, physical therapist, cardiologist, pain doctor) who may be part of your treatment about any changes, concerns they may have in regards to how you are doing.   

• If you do not feel like you “click” with your therapist at all, even after you have tried your best or given it a few sessions. In this case, please communicate with the clinic manager or the front desk and we will be happy to provide you with another therapist who may be a better fit for you.  
• If your schedule changes and it no longer matches with your therapist.  
• If your feedback about their treatment style was not taken seriously by them even after you communicated your concerns. 
• If you are sexually attracted to your therapist and are finding that it is hindering you in some way. This may be a time to process your feelings and experience with the therapist and collaboratively decide if another therapist would be better for you.  
• If your therapist crosses boundaries- such as inviting, you to attend a social event together, makes sexually inappropriate comments and shares too much personal information.  
• If your therapist is often distracted for example- checking their phone often, falling asleep (which I had heard horror stories about) or consistently canceling sessions.  

This is something that you and your therapist will collaboratively decide. It begins with reducing frequency of sessions from weekly to every other week and then to once a month. Sometimes patients come in once a month for roughly six months just for “maintenance” until they eventually organically “transition out.” One of the major signs of healing is being able to talk about the difficult topics (that initially brought up very painful feelings for you) with a sense of ease. There are no intense negative feelings because these feelings were worked through and resolved. You have found effective ways to cope, are making progress in areas where you struggled in the past and are now able to look ahead into your future with a sense of confidence and a revised perspective. Even if there are residual feelings, and triggers at times, the patient feels confident to deal with them in a healthy manner instead of avoiding and withdrawing from life, relationships and responsibilities.  

Some clinics may have interns or practicum students who are in need of hours. They are supervised by licensed professionals, and the charge is much more affordable for patients with financial issues. Some clinics can also work with you on a payment plan. Another option is to reduce frequency of sessions to once a month or every other month. But this may not be advisable if your symptoms are severe. I would recommend contacting MHMR or other community based organizations as they provide mental health services free or heavily discounted to the community based on income levels.