Often times when people first enter into therapy, they see it as a mysterious and/or intimidating prospect. Sometimes their only frame of reference for therapy is what they have seen in TV shows or movies. It can be important to understand what therapy involves and why it works, in order to de-mystify the process and help people feel more comfortable in seeking help.

First, it should be noted that therapy does indeed work! With an effective therapist, research has clearly shown that psychotherapy leads to improved outcomes for clients. In fact, therapy can work better in the long-term than medication; for example, studies show that therapy leads to fewer relapses of anxiety and mild to moderate depression (two of the most common concerns that bring people into therapy) than medication use alone.

The most common model of psychotherapy involves weekly meetings with the therapist that last 45 to 50 minutes. These meeting can be individual, or can involve couples, parents and their children, whole families, or groups of unrelated individuals. Psychotherapy can be short-term (a few months), dealing with more immediate challenges, or long-term (several months to a few years), dealing with longstanding and complex issues. The goals, duration and frequency of treatment should be discussed by the patient and therapist together, at the outset of therapy.

An effective therapist is first and foremost someone who can connect interpersonally with his or her clients. Studies have suggested that good therapists have strong interpersonal skills, can form a positive alliance with their clients, and correspondingly are able to build a sense of trust and understanding as therapy unfolds. If you are looking for a therapist, it is important that you feel a sense of connection and of being understood. It is perfectly okay – and in fact, a good idea – to let a new therapist know if you aren’t comfortable (e.g. don’t feel that you can be honest or “be yourself”) within the first 2 or 3 meetings. If you can’t get to a place that involves feelings of trust and safety, you may need to switch therapists.  

Research suggests that a strong therapeutic alliance is the best indicator for a good outcome from therapy. In addition, therapy works in part because the therapist can provide an explanation for a given client’s struggles that may be different from the ones that they have developed themselves. This therapeutic explanation typically corresponds to a set of changes that clients can make in order to lead healthier and more satisfying lives. Thus, therapy with a trusted clinician works because clients are able to feel heard and understood, can begin to understand themselves in a different way, and can gain a sense of what steps they can take to improve their situation.