We were talking. I was nervous. But at least we were talking. My biggest fear was that we’d be staring at each other with blank expressions. At least that wasn’t happening.
He told me his parents’ names. I made a point to remember those. He was probably going to talk about his parents a lot, right? Hadn’t I read that in a book somewhere?
I wasn’t that much older than he was. Was my age going to be a deal breaker?
We seemed to be getting along. How long had we been in session at that point? Fifteen minutes? That was good, wasn’t it? Getting along with a new client—a first client—after 15 minutes had to be a good sign.
Well, whatever the signs were pointing to, there was no doubt that it had started. He was my first client. We were working together. Our collaboration wasn’t like other working relationships. It was therapy.
Therapy can be intimidating, especially for inexperienced therapists. As nervous as we were, my first client and I ended up working well together.
I don’t remember talking with him about his parents as often as I thought we would that first session, but we did find ways of helping him manage feelings of anxiety and anger. Prior to therapy, these feelings were causing him to seclude himself from others and explode in fits of rage. After a few months of therapy, we had both acquired new skills and he experienced significant reductions in feelings of anxiety and anger and he no longer had explosive outbursts.
Therapy has a long and impressive track record of helping people overcome a wide range of mental health and relationship issues (Lamber & Ogles, 2004; Lebow, 2012; Shadish & Baldwin, 2003; Smith & Glass, 1979; Sprenkle, 2002). When a therapist is well trained and a client is open to feedback and motivated to change, the effects of therapy can be incredible. I have seen good therapy help clients overcome severe depression, crippling anxiety, staggeringly high couple conflict, and a litany of other serious mental health and relationship issues.
People often live in misery for years before seeking therapy. One study showed that distressed couples wait 6 years on average before scheduling their first session with a therapist (Notarius & Buongiorno, 1992). Statistics like this one ring true in my private practice. My clients commonly come to me after struggling with the same problems for years before asking for help. Rather than putting off treatment, I encourage people to come to therapy as soon as they notice problems. Treating mental health or relationship issues early in their development is usually quicker and easier than facing off with them after they have had years to grow and take hold of people’s lives.
Therapy is a process that requires time and significant energy. Therapy does not work like an injection or medication. Sick patients usually don’t have to do much after taking a shot or swallowing a pill in order for them to feel better. During sessions, therapists provide their clients with valuable information and teach them new skills. What happens in the therapy room is a critical part of its success. It is not everything, however. For therapy to work, clients usually have to make significant changes to their life outside of their sessions. The relationship clients have with their therapist is similar to the relationship weigh-loss patients have with their dietician. The best therapists and dieticians cannot help people unless they make significant lifestyle changes at home.
Find the Right Therapist for You
As many people have learned the hard way, not all therapists are as effective as others. It is terrible when I hear my clients talk about awful experiences they have had with what sound like bad therapists. Therapist quality is determined, in part, by a therapist’s skill level, quality of training, belief in treatment, emotional well-being, adaptability (e.g., to culture and client values), friendliness, and ability to work collaboratively with the clients (Blow et al., 2007). Because some therapists are better than others, it is important for people to have high standards when choosing their therapist.
After client factors like a readiness to change and willingness to work hard, the most important predictor of therapy effectiveness is the quality of the relationship between the therapist and client (i.e., the therapeutic alliance). Great therapy outcomes are nearly always accompanied by a strong therapeutic alliance. When therapists and clients don’t connect, therapy is rarely helpful (Sprenkle et al., 2009).
If you are looking for a therapist, the important thing to remember is that the best therapists are well trained, intelligent, and, most importantly, easy to like. Giving a therapist a call and checking out his or her website can be a good first step to making an informed decision about who to work with in therapy. When people ask me how to find a therapist, I tell them to talk with people they know who have been in therapy. Most of my clients choose to work with me on the recommendation of a trusted friend, family member, or coworker. When you do find a skilled therapist you admire, respect, and trust, feel free to get your hopes up—you will already be well on your way to a beneficial and potentially life-altering therapy experience.