So you've made the decision to start therapy. Its a brave choice and will likely pay off in a positive way. But now what? How do you go about finding a therapist? Maybe you ask around to your friends or family. Perhaps you get a few, "Oh, my lady is GREAAT!…here's her number, I think you'll really like her." So you wait a day or so, think about it...check out her website, and decide to make the call. You set up an appointment to meet for a first session. What should you be looking for? Many people may not realize that finding a therapist is about finding the right therapist for you. In Los Angeles, we are living in a plethora of therapists, so taking the time to figure the best fit, is well within your right and will improve your chance of benefiting from treatment.
Therapy works because of three basic concepts:
1. The therapeutic frame
2. Therapeutic alliance
3. Empathic attunement
The frame is the boundaries/limitations set by the therapist with the patient. Think of the frame like an empty picture frame. The contents of the therapy will exist within the space where the picture would go. These parameters are there for your protection and the protection of the therapy. This is everything from the day and time you meet, to how many times a week/month you meet, to how often the therapist allows contact during off hours, to how much each session costs and when you pay. As the patient, it's not your job, wholly, to know or understand all aspects of the frame. Your therapist will explain all of these boundaries along the way. Some may be more obvious than others…the most important thing is to ask.
The structure of the frame begins with the first phone call/email/text. However, the structure continues to be created from session to session. The frame involves different variables like: the theoretical orientation of the therapist, personal style, needs of a particular patient, and/or particular protocol if the therapist works at a clinic or hospital vs. private practice. Any deviation from the established frame is considered a break down of the frame. And this may happen, but it's important to remember, we are all human and therefore imperfect.
There may be times where there is a deconstruction of the frame, or the limits are tested. During these times, it's the reconstruction of the frame that can greatly benefit the therapy. The beauty about starting therapy is, the frame is not fully formed, so we don't know exactly how it will all work, we simply wait and see how the relationship unfolds (at least if we are the patient.)
As the therapist, much thought goes into creating a frame that is specific to the patient and the orientation of the therapist. So when there is a change or something unexpected (restructuring of the frame) it's extremely important for the therapist to talk the patient through the transition.
This brings me to point number two, the therapeutic alliance. This is the working relationship between patient and therapist. Essentially, how you feel working with your therapist. Do you like her style, do you feel heard, understood, do you trust her? This is important. The individual style of the therapist can come into play. The things you struggle with that you discuss in therapy are not always pleasant or easy; there may be times when you feel sadness, rage, or surprise. And working with a therapist with whom you have a strong alliance, will give you the strength and understanding to overcome difficult times.
And lastly, empathic attunement is going to be a great indicator for you to create a positive therapeutic alliance. This refers to the therapist's ability to be able to understand your emotional state and speak to it. Now, this does not mean she is a mind reader and will know what you're thinking and feeling every moment. Empathic attunement means that you and your therapist share a trusted connection where she is able to sense your underlying emotion. It can feel as powerful as magic.
Keeping all of this in mind, it's important to be honest with yourself. If you ever feel like the fit is off, the first step is to bring it up with your current therapist. Talk about your experience working with her. Be as open as you can about your expectations and goals for the work. Remember, no two therapists are exactly the same. If you decided that you're not fitting the way you'd like, you may switch therapists. Your current therapist may be able to provide referrals to others in the area, that will better fit your needs.