If this is your first time seeing a psychologist it isn’t quite like they show in the movies. So if you expect the old man sitting in the corner of the office with a pipe letting you mentally meander through your childhood you may be disappointed. It is also very unlikely you will hear me say it is your mother’s entire fault & you are doomed because of that.
What will the first session be like?
It is a little different from some of our regular meetings. The first session I often allow one hour and fifteen minutes. After the initial visit a typical session is fifty minutes. However, on occasion we may decide to book longer sessions, which is more common for couples or family therapy.
There will be a little bit of paperwork to make sure I have contact info for you etc. We will spend a few minutes reviewing a little info about our professional relationship e.g. how to handle rescheduling, privacy, and payments etc.
After some of the housekeeping things are taken care of we will get to know each other by discussing your history. It is helpful as we start talking about plans of how to change the things you want to work on that we consider all the moving parts in your life. Some info about your health, family life, work, education etc. helps put things in context so we can develop a practical plan together about how best to move forward.
What’s involved in a typical session?
Every psychologist offers a different approach and there are two aspects to consider when choosing to undertake therapy: the style of therapy and the theoretical approaches used.
My approach and therapy style
The personal style part is easy to explain. Basically I am very open, relaxed, interactive and approachable which sets the tone for our sessions. We may even be able to add a bit of humour to lighten up the discussions at times. Overall, the goal is to put me out of work. We will aim towards getting the things accomplished that you want to change as soon as practical. Once things are in a better place for you we can discuss whether we move towards a maintenance schedule to make sure you don’t drift back into old ways or if we decide to part ways.
My theoretical approach
The topic of theoretical approaches takes a bit more of an explanation. With all the theories within psychology there are some practitioners who are devout followers of one particular theory. There are others who may not be loyal to just one theory but two or three. For some of these professionals that is a reflection of their training. For example if your only training has been in the use of Cognitive Behavioural Therapy you would be limited to only using techniques that are apart of that system. So you may find some professionals out there that advocate for the use of their technique exclusively. That is great if you happen to have one of the issues that lend themselves to that type of treatment. However, all theories do not work equally well for all issues or for all people.
For me I draw from a few different theories. I adjust my approach to what best suits the client’s needs, strengths and preferences. For folks that need some straightforward skill building to help them better address something the go to approach is going to include primarily Cognitive Behavioural Therapy (CBT). This approach is one of preferred ways to address depression and anxiety for example. It aims to help you change your thinking and behaving. It views this as a two way street so some of the assignments or tasks may focus more on helping you adjust your negative thinking for example while others may emphasise the need to change your actions which will nudge your thinking back in line.
For clients who prefer to also have a bit more context of why this issue / theme repeats in their life a bit of work from an Interpersonal Therapy (IPT) or even Systemic Families approach is useful. IPT helps to uncover how the person’s personality and their interactions in relationships impact on their emotional well being.
When working with families I use a Family Systems Model & have been blending in more Attachment Theory references over the last few years. Family Systems Theory as the name implies focuses on how the entire system functions. In doing this the aim is to help each individual in the system, each subsystem e.g. Parents, siblings, as well as how they interact as a whole. Attachment Theory involves flushing out more about what your needs are from others & how others meet those needs. The origin of this model was focused on small children & the attachment style they had with their parents. Research over the last few decades has found that there is a grown up version of some of these concepts that plays out in our romantic and social relationships as adults.
With couples therapy there would be influence from the Systems, Attachment and some Interpersonal models though I find a big part of helping couples boils down to really working on effective communication and rebuilding intimacy for many of them. Once that is restored some of the other issues for the couple become more manageable. I have completed Level 2 training in Gottman Couples therapy. I have also been trained in Emotion Focused Couples therapy and Imago therapy.
For the substance abuse crowd my default mode is to go with a 12-step model since that is what many of the treatment programs I have worked in used. This approach aims towards abstinence from the problematic substance. This approach is the modern version of what began with the development of Alcoholics Anonymous back in the 1930s. Though especially for those more on the earlier stages of addiction I may work with clients on switching back to responsible use with a Moderation Management or Harm Reduction approach. With these models the goal is to reduce chemical use to a responsible level & use in a safe manner to eliminate the negative consequences that develop by chemical abuse. I am a Certified Addictions Informed Mental Health Professional (CAIMHP).
Beyond our sessions
Overall, when you come for sessions we will aim to improve your understanding of your issue as well as add in some new tools to help you address it. As we progress you will likely be doing more homework between sessions. The idea being you will be improving in your ability to address more of these things at home instead of at the counseling office. This may be readings, discussions, or tasks depending on the specific place you are with your changes. Homework also helps with keeping momentum between sessions so that you are making it a habit to do the things that are becoming helpful for you.