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People decide to start psychotherapy for all sorts of reasons.  Over the course of a typical year, more than 25 percent of the adult U.S. population meets the clinical criteria for a diagnosis of depression, anxiety or some other disorder, according to the NIMH.  Factor in stress from a crisis like losing a job, relationship problems and other concerns and it is clear that many people could benefit from psychotherapy or counseling.

The decision to seek help may come quickly if there is a crisis, or it may emerge slowly, if there is a growing sense that life isn’t working the way we want.  Some clues that it is time to seek help:  feeling hopeless, overwhelmed or stuck, trouble sleeping, unhealthy changes in eating, drinking, sexual behavior, etc.  If you’ve felt like you’ve tried to feel better but haven’t had the success you want, working with a professional is probably a good idea.

Once you’ve made the decision to start, how do you get the most out of therapy?

Set goals with your therapist.  What do you want to accomplish here?  How will you know when you get to that point – that is, what will look different in your life?

Tell your therapist what you expect.  Some clients want to focus on specific changes they want to make or areas they want to explore; for them, therapy may be relatively brief.  Others are looking to more deeply understand themselves, and therapy will be more open-ended in duration.  Therapy is a partnership.  The clearer you are about what you want, the greater the opportunity for your therapist to help you achieve your goals.

Understand that change takes effort and time.  Changing dysfunctional patterns of living isn’t easy.  If it was, you wouldn’t need a therapist!  It is understandable that someone would want immediate relief, and sometimes a person’s mood improves just from starting the effort to change.  But realize that problems that have endured for a while may take a bit of time to resolve.

You get out of therapy what you put into it.  Be yourself.  Be honest.  Let your therapist see you as you really are, without editing what you say or feel.  Many of us have grown so protective of ourselves that we may not even be fully aware of what we are genuinely experiencing.  Keep in mind that if something feels embarrassing, that’s probably a clue that it may be a rich area to explore.

Be an active partner in the therapy process.  Ask questions if something is unclear.  Remember that your therapist isn’t a mind reader.

Pay attention to what is going on inside you.  Notice how your body is feeling, how you’re breathing, as you talk about something.  Notice if you are resisting something.  Notice if something inside you may be calling out for you to pay attention to it.

If you’re worried about something, bring it up.  That could be a concern about yourself, your life, or the process of therapy itself.  Keep in mind that this is not about looking like you’ve got it all together.  This is about bringing your most real self into the consulting room, even if that’s uncomfortable.  Share what you’re feeling.

Pay attention to feelings and emotions during and after a session.  Your emotions are clues to your internal experience.  If you’re feeling emotionally raw after a session, let your therapist know.  And if, for some reason, you feel your therapist hasn’t treated you respectfully or professionally, don’t be shy about expressing your concern.