About Therapy

Sooner or late r, hard times and unexpected difficulties strike everyone. They are part of life.

Most of us find ways to weather these challenges and work through the issues on our own, until they pass or improve.

But sometimes the challenge is so overwhelming that we feel powerless to cope. Or past experiences have not prepared us for what we must face. Sometimes we don't know what to do, so we do nothing.

Other times we turn to unhealthy choices, such as over-indulging in food, alcohol or drugs; burying ourselves in work; or running away from the problem, either literally or figuratively, merely pushing the problem aside, rather than resolving it. And for a while, it may seem "out of sight, out of mind," but it hasn't really gone away and can later sprout into more serious problems, such as depression, anxiety, marital impasse, or ongoing hurt feelings.

Therapy c an make a dramatic difference in the effect adversity has on our lives. It does not "magically" make everything all right. It can't change the difficult incident or event that happened. But it can help us understand the situation better and learn how to respond in a healthier way. It can also help us turn challenges into learning experiences, from which to draw strength and wisdom in the future.

What exactly is therapy? It is not simply a technique. There are countless approaches to therapy - cognitive, Gestalt, psychodynamic, behavioral, systems, to name a few. Regardless of the approach used, the essence of therapy is about relationship - the relationship between the client and the therapist. In this relationship the client feels safe enough to share thoughts and feelings, and to feel heard - maybe for the first time in one's life. In this relationship the client develops a new understanding of self and learns new ways of dealing with issues.

It is important to note that this relationship does not consist of the therapist telling the client what he or she should do. Rather, it is a mutual endeavor, through which the client and therapist work together to solve the issue. First they try to understand the exact nature of the concerns or problems, with a focus on how the client would like to see things change. Then they jointly develop a plan to bring about the desired change. We believe that establishing goals - often in writing - enhances the therapy process and increases the likelihood of change actually occurring. While the therapist is expected to provide guidance and to offer different possible courses of action or options, the goals and plan will be determined by the client's wishes, not those of the therapist.

Some of the goals commonly addressed in therapy may include: improving communications skills with a partner or other family member; learning to be more assertive; conquering addictions; resolving painful feelings stemming from a rape or other trauma; dealing with an alcoholic or drug-addicted family member; overcoming pervasive feelings of shame; improving depression or anxiety.

Therapy is hard work. The most important part of the therapeutic process takes place during the days and hours in between sessions, as clients attempt to apply new ideas and behaviors in their day-to-day life. In between sessions, clients are often asked to do "homework" to enhance the process, consisting of such assignments as writing in a journal, scheduling regular times to talk with a spouse, reading an article or book, attending a support group in the community or practicing relaxation exercises. The amount of effort put forth by the client will greatly determine the effectiveness of therapy.

For many clients, therapy can have a profound effect on their lives. After a few or perhaps many sessions, countless clients have found and learned to speak their own voices. One client described his experience as a truly "life-changing" process, that had completely altered his view of the world and the way he reacted to it.

Therapy with couples. The focus of work with couples (married or not) is not on individual issues, but rather, on the relationship between both partners. The therapist maintains a neutral position, endeavoring to understand factors contributing to their distress and suggesting ways to make things better. This may include learning new communication skills, granting forgiveness, understanding how to negotiate, or practicing fair fighting.

It is important to note that most of the principles involved in improving relationships apply to both married and unmarried couples, and we work with many styles of couples, including gay and lesbian couples.

Therapy with families. While everyone is influenced by their families, past and present, these influences are frequently only discussed by the client in the course of individual therapy. But many issues, particularly those involving children, are best addressed by including multiple family members.

As with couples, family therapy focuses on the relationship of family members to each other, as well as the way the family functions. Changing the way family members relate to each other can have a profound effect on everyone in the family, even those not participating in therapy.

Problems involving children and adolescents almost always benefit from family therapy with key family members. Other times when family therapy is particularly helpful is during transitional periods, such as death or serious illness in the family, divorce, unemployment, retirement, or the departure of young adult children from the home.

Family therapy may include all or some members of a nuclear family; grandparents; step-parents; adult siblings, or anyone else considered part of the family. Who is to be included depends on the specific issues, as well as availability of family members.

Confidentiality . Confidentiality is a cornerstone of the therapeutic process, contributing to one's sense of safety in the therapeutic relationship. Confidentiality means that the therapist will keep private whatever is said in the session, with some exceptions. Thus, the information will not be shared with employer, family, friends or neighbors without the client's written permission.

The exceptions to this policy almost always involve the element of safety and harm. If the client is in danger of hurting self or others, the therapist is legally bound to tell someone in order to keep the client safe. If child or elder abuse is suspected, the therapist is legally mandated to involve child or elder protection authorities to investigate. Confidentiality and its limits are discussed in detail early in therapy.

Length of therapy. How long therapy will last is determined by the issues to be resolved, by the agreed-upon goals, and by the client's motivation and commitment to the process. Some clients are vastly improved after one or two sessions. Others may be in therapy for many sessions stretching over a period of months or even years.

Most therapy sessions last for 45-50 minutes, but some may last nearly 90 minutes. Sessions are usually scheduled weekly, especially in the first month as the client and therapist are getting to know each other and to define the issues to be addressed. Sessions may then be scheduled every other week, or even monthly, with homework assigned in between to continue the process. The frequency is determined jointly by therapist and client, while considering issues, the degree of distress, safety, goals, finances, and available time.

It is impossible to predict the number of sessions needed until after you have met with a therapist and discussed the nature of your concerns. After the initial 1-2 sessions, your therapist can better estimate the length of therapy.

Appointments. If you are interested in scheduling an appointment, please call (314) 863-8734 and a therapist will return your call as soon as possible. Daytime, evening and weekend appointments are available.

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