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How To Get The Most Out Of Therapy

How To Get The Most Out Of Therapy

Written by: Andrew da Roza

Deciding to see a therapist is a big step – and staying in therapy requires a commitment to effect real change.   

It is not surprising that many hesitate before starting therapy. 

Some may be wondering how talking to a stranger can change their lives for the better. 

They may not know which therapist they ought to approach – and what they should be looking for in a therapist.

Others may hesitate because they are anxiously thinking ahead: “what happens if I don’t like the therapist?”; “what if the therapist doesn’t understand my struggle?”; “what if I don’t think that enough progress is being made?”.

They may also be wondering if they can change their therapist and if they can have more than one therapist. 

If you are struggling with these questions, thankfully, there may be some answers that put your mind at rest and give you the confidence to seek a therapist and engage in the healing process. 

 

Choosing the Therapist – The Qualifications 

Most clients can articulate why they wish to seek therapy – and have clear ideas about what is causing them distress or difficulty.

Clients with clinically diagnosable mental illnesses may have already sought help from a family member, friend, doctor, psychiatrist or religious leader. They may have even “Googled” their symptoms.  

If specialist help is needed, choosing a therapist with the relevant qualifications and experience will be the first step. 

In addition, you may wish to choose a therapist you are more likely to be comfortable with based on the therapist’s language ability, gender, culture and so on. 

 

What should I look for in a Therapist?

Research has shown that the positive connection a client makes with their therapist accounts for 36%-50% of the changes clients experience as a result of treatment. (1)(2) 

Sometimes called the “therapeutic alliance”, this is experienced by clients as liking and trusting their therapist.  

Some will bond strongly with therapists if they demonstrate empathy, warmth, unconditional regard and respect. They would like their therapist to be open, non-judgmental and curious about the clients’ struggles – to have a strong desire to “walk in the clients’ shoes”. 

Such clients make good progress in therapy when they feel understood and heard – as well as valued. 

Others may seek therapists who are good communicators and are well informed about the issues the clients are facing. They tend to bond with therapists who are able to impart and discuss information; offer practical suggestions; articulate action plans, goals and timelines; and support the clients in their motivation to take action to effect positive change. 

Many also seek insights into themselves, their emotions, the ways they react to people or situations; and their perspectives and intrusive thought patterns. 

By being more present with what arises in themselves, they seek to take more control over their own lives – to respond to people and situations instead of habitually reacting to them – and to accept and let go what they cannot control. 

These clients appreciate therapists who can assist in self-discovery. Therapists who are able to help articulate their “inner worlds,” and to reframe them. Therapists who empower them to navigate this “world” with more ease and confidence by playing to their strengths, rather than dwelling on what they perceive as their weaknesses. 

Interestingly, studies have repeatedly shown that the type of therapy used for individual therapy (such as cognitive behavioral therapy, psychoanalytic or psychodynamic therapy, dialectical behavioral therapy, person centered therapy and so on) has only a marginal effect on the outcomes of therapy (3)(4)(5).     

So, the key to choosing a therapist involves articulating what you expect from therapy and your therapist, and what kind of person you think will best meet your emotional and other needs. 

It would be helpful to articulate what you want the therapist to do (and not do); and what your end goal or “vision” for therapy is. You can do this by first asking yourself the question: “what changes am I seeking that will make a real positive difference in my life?”. 

Many benefit from putting all this in writing and bringing it to the first therapy session to discuss it with the therapist. 

 

Beginning Therapy – And then Changing the Therapist 

On the first meeting with a therapist, some clients – though this may be rare – simply do not like or trust the therapist, or that they do not have the experience or knowledge to assist them.

It also sometimes happens that a client feels that the therapist is not present or really hearing the client’s narrative. 

Worst still, they may see the therapist jumping to conclusions – or solutions. They may feel disrespected and “unheard” – and that they are being left behind, while the therapist is “racing” ahead of them. 

Other clients may feel that the therapist is judging them or telling them what to do, think or feel – and not to do, think or feel. The clients may feel anxious, disempowered, dismissed, angry or offended. 

If this happens to you, let your therapist know. If you don’t see any change in their approach, rest assured that changing therapists is likely to be helpful. 

 

Changing Therapists Along the Way 

One situation that you may wish to avoid though, is changing therapists regularly. This is because continuity in therapy is one of the keys to progress. 

Therapy is very much a journey. 

Whether the goal is self-discovery, empowerment, executing action plans to change behaviour, building confidence, or managing anxiety or depression. The journey has stages, and keeping the same guide on this journey is likely to facilitate progress.

If you are in the middle of your therapeutic journey, and you wish to change therapists, it would be helpful to articulate clearly why you want to do this. 

Is the therapeutic bond broken – and cannot be fixed? Is there little or no progress in your clearly articulated goals? Have you changed the goals and discussed them with your therapist – and it is clear that the therapist will not be able to assist? 

Some clients simply feel that therapy has become “stale”; or they feel as though they are attending therapy to “tick the box” and to show others that they are willing and able to change. 

Whatever the reasons, write them down. Discussing them openly and honestly with your therapist is likely to help. 

If you wish to make a change, ask the therapist for a referral to another therapist, and give permission to the current therapist to brief the new therapist. You may wish to join in this discussion.  

This is more likely to ensure that your therapeutic journey continues without disruption. 

One situation you may wish to be conscious of, is changing therapists solely because the therapeutic work has become difficult. “Jumping ship” may not be the answer. 

There is no doubt that therapy can be very challenging – perhaps the most challenging thing you have ever done. 

The challenge could arise because the insights are uncomfortable (or even painful); the changes in behaviour require a lot of motivation to sustain; a change in perspective seems counterintuitive; or because the anxiety, intrusive rumination or low mood seem relentless.  

Changing therapists may not be the answer – and may simply delay or disrupt the difficult therapeutic work ahead of you.

It is likely to be more helpful to articulate these challenges, write them down and discuss them with your therapist.    

 

Having more than one therapist

Some clients may need more than one therapist. 

A client may have an individual therapist who assists the client on their own personal journey. 

They may also have a couples’ therapist to address their relationship with their partner. In that event, the therapist treats the couplehood as “the client” – and provides equal support to both parties and works towards their joint goals.  

Other clients may also have a family therapist to address the relationships within the family. Again, the therapist will see the family as “the client” and assist with the family goals.

Couples and family therapists tend to provide specific modes of therapy, which have proved effective for couples and families.  

In the case of individual, couple and family therapy, in most cases, it is generally considered unethical and a conflict of interest for one therapist to play all three roles. 

The therapist cannot best serve the client’s, couples’, and family’s interests while wearing all three “hats”. 

Once a therapist tries to do this, they may (for example) feel obliged to keep secrets from one person in the couplehood or others in the family. This may reinforce the unhealthy dynamics of secrets and deceit that brought the clients to therapy in the first place.

Conflicts of interest create confusion, anxiety, anger and disappointment for clients. 

Keeping to ethical boundaries is more likely to ensure that the therapeutic journey is not sabotaged. 

Unethical conflicts of interest also arise if a client is seeing two different individual therapists.

Broadly, therapists are obliged to decline to see a client if they already have an individual therapist they are actively working with. 

Having two therapists engaged in the same work exposes clients to confusion, anxiety and conflict, and is likely to disrupt a client’s progress in their therapeutic journey. 

If you are considering seeing two therapists for individual therapy, it would be helpful to clearly articulate why you think this will assist – and to discuss this openly with the therapists.

Some clients may change therapists to “find the right answer”; the “best answer”; or the answer that fits their “view of the world”. That “view” may be the same “view” that has been causing them the trouble – and motivated them to seek therapy in the first place. 

All this is worthy of open and honest discussion and exploration. 

Another situation in which other therapists may be involved occurs when a client has an individual therapist and also attends group therapy. Group therapy can be a very effective way to continue the therapeutic journey, once progress has been made in individual therapy. 

Again, therapists commonly use specific modes of therapy for groups. 

 

Working with Multiple Therapists 

If you are working with multiple therapists, it is helpful to let them know who else you are working with, and what goals you (e.g. as an individual, couple or a family member) have agreed to pursue with the other therapists.

From time to time, it will assist to share with your therapists what you took away from the other therapy sessions, how the sessions are progressing and what plans you have agreed with the therapists.

It is always open to you to ask the therapists to communicate with each other and to coordinate treatment. 

It is also your right to maintain confidentiality and not to coordinate treatment – but “dovetailing” these different therapy sessions is more likely to help optimize your outcomes.

The Promises Healthcare website provides assistance to clients to identify their issues and provides photographs, names, languages, qualifications and experience of the specialists who can assist: https://promises.com.sg/about-us/our-team/

We hope that you will be able to find the right help from us.

 


  1. Horvath, A.O., Del Re, A.C., Fluckiger, C., and Symonds, D. (2011). Alliance in individual psychotherapy. Psychotherapy, 48, 9-16. Doi:10.1037/a0022186
  2. Duncan, B. (2014). On becoming a better therapist – evidence-based practice one client at a time. (2nd Ed.) Chapter 1, pp.23-24. The American Psychological Association, Washington DC. 
  3. Stiles, W.B., Barkham, M., Mellor-Clark, J., & Connel, J. (2008). Effectiveness of cognative-behavuoural, person-centred and psychodynamic therapies in the UK primary-care routine practice. Psychological Medicine, 38, pp 677-688. Doi:10.1017/S0033291707001511
  4. Benish, S.G., Imel, Z.E., & Wampold, B.E. (2008). The relative efficacy of bona fide psychotherapies for treating post-traumatic stress disorder: A meta-analysis of direct comparisons. Clinical Psychological Review, 28, 746-758. Doi:10.1016/j.cpr.2007.10.005. 
  5. Duncan, B. (2014). On becoming a better therapist – evidence-based practice one client at a time. (2nd Ed.) Chapter 1, pp.9-12. The American Psychological Association, Washington DC. 
Family Therapy 101 in the context of the pandemic.

Family Therapy 101 in the context of the pandemic.

The year 2020 saw a rise in uncertainties. Many have experienced anxiety, job loss, a strain on finances and family relationships due to the impact of the pandemic. By default, couples need to adjust to working from homes, with blurred boundaries between work and family, lesser personal space and challenges in new routines. They may not have readily communicated effectively about their roles, given the constant changes in adjusting to tightening and lifting measures.  Coupled with the labour crunch, families may find it increasingly formidable or costly to hire a helper to care for children, who are required to stay home for home-based learning or the care of elderly parents who may be weak and frail.  This may inevitably lead to unresolved conflicts between the couple due to the stress and demands of constant transition and change. In 2020, a survey for mums showed that 60% of the participants rated their stress level at a 7 out of 10. In addition, 3 out of 10 of the participants felt sad most of the time.   

Children and young people are not spared from the raging wave of anxiety. According to a survey conducted by Focus on the Family, kids are more anxious about exams than Covid 19 (The Straits Times, 18 Sep 2020). However, in an international study of 72 countries (including Singapore), only 6% of teens share their problems with their families (Impact of the Pandemic on Family Life Across Cultures 2020, Namad Bin Kalifa University). No wonder the CEO of the Institute of Mental Health says that “Gen Z faces different forms of stress, maybe more anxious, depressed than others before them (Today, updated on 1 Mar 2021).” President Halimah also urged Singapore to step up efforts to protect children’s mental health early (The Straits Times, 2 Dec 2020).    

Given the tremendous stress that kids and adults are facing, families are stretched very thinly. Therefore, they ought to rise above their concern of seeking a mental health facility to deal with their issues early, so that family members can get the professional help they need.   

It is timely for the family to consider attending family therapy to address and deal with the mental well-being issues, be it stress or anxiety collectively.   

You may have some questions about family therapy, and here are some FAQs that seek to answer your questions. 

 

Why Family Therapy? 

Having to deal with unhealthy family dynamics constantly puts a toll on one’s mental wellness. Family therapy focuses on improving family communication; it deals with family conflicts, seeks and creates better functioning and environment. It provides family members with an opportunity to talk about how they think and feel, being affected by the issue they face. It enhances skills to facilitate healing. Therefore marriage and family therapy are essential. 

Family therapy shifts the focus from blame, diagnostical lens, linear causality, and looks at circular causality in an issue. For example, a teen who exhibits school refusal may be staying home because of his worry and caregiving role to his mum, who is in chronic health and has a strained marital relationship with her spouse. It helps the family understand the issue confronting them in the family context and the larger contexts, i.e. the pandemic. 

Family Therapy is often used to help treat an individual’s problem that has dire effects on the entire family, i.e. depression, anxiety and behavioural issues. This type of psychotherapy is also helpful in addressing family-centric problems, i.e. conflicts between spouses, siblings, parents and children. 

 

What is Family Therapy? 

Family therapy is psychotherapy designed to identify family patterns that may have contributed to behavioural or mental well-being concerns. The idea is to help family members break those habits as the family therapist involves the family in discussion and problem-solving. 

 

What can I expect when my family and I attend a Family Therapy session? 

During family systems therapy, the family therapist works individually and collaboratively to resolve their issue, which directly affects one or more family members. Each family member has the space to say what they think and how they feel as the issue affects them. For example, when a teen has anxiety issues, a family member gets to talk about how this issue impacts them.  

 

How long is each session and how long is the therapy period? 

1.5 hours per session over a period of 4-8 sessions, subject to review with your family therapist. Family therapy is a specialised counselling process. No one is a miracle worker. It takes time and commitment for the family to work through their issues. 

 

Are family therapists trained? 

Yes, systemic family therapists are trained with a Masters in Family and Systemic Psychotherapy, a specialised skills competency in systemic couple and family work. It draws on systems thinking and views the family as a unit. It evaluates the parts of the system (individual) in relation to the whole (family) and examines how an issue of one or more members of the family affects the whole family. It suggests that a family member’s behaviour or issue may be embedded in the family dynamics and influenced by the family of origin issues. 

Family Therapists would have undergone at least 560 hours of academic instruction and supervised clinical practice, accompanied by years of experience. 

 

When should my family and I attend Family Therapy?

It is always helpful to seek family therapy early before the issue snowballs and becomes more difficult or complicated to manage at the later stage. 

 

Who should attend Family Therapy? 

Immediate Family members in a family nucleus should attend Family Therapy, i.e. couples, parents, children (includes teens and adult children) siblings.

 

Does my whole family need to attend? What happens if I am unable to get all my family members to attend Family Therapy? 

It will be helpful if your family can attend therapy together. However, it is okay if not all family members can turn up for therapy. The family therapist will collaborate with the members who come for therapy sessions. 

 

How do I prepare for Family Therapy? 

Discuss with your family members about attending therapy together. Think and write down what you want to discuss before each session. Then, ask your family therapist how you want to improve the communication in the family. 

 

Is there confidentiality? 

Yes, the session is confidential under the Singapore Data Protection Act 2012 (“Act”). 

 

Where can I attend Family Therapy? 

Promises Healthcare provides family therapy service, so feel free to visit our website or contact us at Tel: 6397 7309 to make an appointment. 

Motivational Interviewing

Motivational Interviewing

Motivational Interviewing (MI) is a widely used evidence-based technique to encourage behaviour change. According to clinical psychologists William R. Miller and Stephen Rollnick, “MI is a collaborative, goal-oriented style of communication with particular attention to the language of change. It is designed to strengthen personal motivation for and commitment to a specific goal by eliciting and exploring the person’s own reasons for change within an atmosphere of acceptance and compassion.” In the clinical setting, it has been proven effective in tackling certain issues such as smoking, substance abuse, or other compulsive behaviour disorders including problem gambling, hypersexuality, or compulsive spending. In a way, MI serves as a decision aid and to guide clients towards making the necessary lifestyle changes. It assists clients in weighing the pros and cons of their respective situations, and encourages them to assess the benefits they can reap if they were to change their behaviour. 

 

MI works best for individuals who fall within any one of these categories below. Of course, this is not to suggest that MI doesn’t work for conversations and discussions outside of these categories.

 

  • High ambivalence: These people are still experiencing mixed feelings about their situation. They sit on the fence, contemplating if they should make any changes.
  • Low confidence: These individuals are doubtful of their abilities to make the necessary lifestyle changes in order to overcome difficulties.
  • Low desire: These people are uncertain as to whether they really want to make a change.
  • Low importance: The line between the costs of the current situation and benefits of change is blurred, leaving the situation unclear.

 

In general, there are 4 fundamental processes to MI: 

 

  1. Engaging

As with all other therapeutic methods, establishing a solid and productive therapist-client relationship is extremely important. This involves asking open-ended questions, affirming clients’ strengths, reflecting to clients what they may wish to express but have not yet spoken aloud and summarizing what has occurred in the therapeutic interaction. Having respect for the client’s autonomy is also a key aspect.

 

  1. Focusing

At the beginning, not all clients will have a clear goal in mind, and may lack direction and insight. This process gives the interviewer and the client the opportunity to narrow down on a shared goal or purpose that they can work towards. With that, the clinician is better able to steer the client into a directional conversation about change.

 

  1. Evoking

Essentially, the interviewer needs to be able to pick up on hints or cues which may suggest the client’s willingness to change. Oftentimes, clients may express their desire to change and their fear of the potential consequences if they do not. Interviewers will then employ more open-ended questions to guide the client, giving him a chance to elaborate on his attitudes, thoughts and motivations. Normalising ambivalence and ensuring that sensitive information is explored without judgement is also important.

 

  1. Planning

Planning should come from the clients themselves based on their insights, self-knowledge, values and motivation. Typically, interviewers do not attempt to take full control and to force a commitment plan onto the client. Doing so will not only disempower the client, but also strips the client of his autonomy. However, they can step in when clients are stuck or unsure as to what they can do to make the necessary changes, as long as their advice is wanted.  

 

In a MI, a decisional matrix is often used. This involves an open discussion of the situation at hand, allowing the client to assess the costs and benefits involved. What are the benefits of staying the same, versus the benefits that come with change? What costs are involved if they chose to stay where they are, than if they made changes? MI isn’t about having psychologists force their views on the client and having them follow their orders. By having an open discussion in a safe, non-judgemental space, clients are able to reflect on their behaviour and come to a decision based on a “fair” hearing. By getting clients to think about the costs of staying the same, this also allows for greater cognitive dissonance, making changes more likely. 

 

Another common aspect of MI involves the Columbo approach, which can be characterised as deploying discrepancies. This technique was inspired by 1970s television series Columbo, in which TV detective Columbo would apply it to rationalise discrepancies and to seek additional supporting information. When contradictory information surfaces, the interviewer will then present a question in a way that makes the client reflect on their mindset. For example, a question could be phrased as, “How does your (risky behaviour) fit in with your goals?” 

 

Motivational interviewing is sometimes used on its own or may be combined with other treatment approaches. In short, MI is a method of communication rather than an intervention, and it  serves to help you attain greater confidence in self-improvement and to make crucial behavioural changes for the better. MI doesn’t force you to commit to a plan, nor involve scare tactics to pressure you into making decisions that you feel uncomfortable with. It does, however, motivate you and aims to help you achieve greater clarity on the importance of making a change. If you or a loved one needs to seek professional mental health support, do reach out to our team!

 

References:

  1. https://www.mentalhealthacademy.co.uk/dashboard/catalogue/motivational-interviewing-the-basics (Accessed 13/06/2021)
  2. https://motivationalinterviewing.org/understanding-motivational-interviewing (Accessed 13/06/2021)
  3. https://psychcentral.com/pro/the-four-processes-of-motivational-interviewing#2 (Accessed 14/06/2021)
  4. Miller, W.R.  & Rollnick, S. (2013) Motivational Interviewing: Helping people to change (3rd Edition). Guilford Press. 
Treating Trauma With Eye Movement Desensitisation and Reprocessing (EMDR)

Treating Trauma With Eye Movement Desensitisation and Reprocessing (EMDR)

Fear resulting from psychological trauma can be extremely deep-seated. The distress, feelings of helplessness and constant flashback of traumatic events can turn one’s world upside down, causing major problems with daily activities and quality of life. It may be easy for someone to say, “Well, why can’t you just get over it?” But in reality, we need to recognise that it is much easier said than done. In order to help people move past their traumatic experiences, researchers and psychologists have worked tirelessly, creating various therapeutic methods and tweaking them to achieve the optimal recovery outcome. In regards to the treatment of post-traumatic stress disorder (PTSD), you may be familiar with an approach known as Dialectical Behavioural Therapy. In this article, we’ll be introducing you to an alternative psychotherapy technique, also known as Eye Movement Desensitisation and Reprocessing (EMDR).

Developed by Francine Shapiro in 1987, EMDR therapy is an empirically validated treatment for trauma and other negative life experiences. While it is also increasingly applied for the treatment of other mental health conditions such as depression, anxiety or panic attacks, researchers have not found EMDR to be as effective as with trauma-related conditions. As its name suggests, EMDR isn’t all about talk therapy or medications. In a different vein from cognitive behavioural therapy, EMDR doesn’t focus on altering a client’s thought patterns or behaviours. Instead, it relies on one’s own rapid, rhythmic eye movements, allowing the brain to process memories and resume its natural healing process. 

What is the Basis of EMDR Therapy?

EMDR is fundamentally based on the Adaptive Information Processing (AIP) Model. A key tenet of this model is that the symptoms of PTSD are manifested due to memories that are dysfunctionally stored or not fully processed. Memories of disturbing experiences often string along negative emotions, thoughts, beliefs and even physical sensations that were associated with them at the time of occurrence. This can bring about a multitude of unpleasant symptoms that can be exceptionally detrimental to one’s mental health. 

When one is exposed to stress or trauma, the body’s automatic response would be to activate its Sympathetic Nervous System (SNS). As an adaptive system, it controls our natural fight, flight or freeze instincts, which is critical in ensuring our survival. When the SNS is activated, the individual will undergo physical alterations such as increased heart and breathing rates, decreased blood flow to the digestive system and constricted blood vessels. In addition, hormone levels including those of adrenaline and cortisol will increase dramatically, causing hypervigilance. However, for someone who is under constant stress from traumatic flashbacks, the over-stimulation of the SNS will be greatly damaging to this person’s physical health. As such, EMDR therapy aims to process memories such that the experience is remembered, but the fight, flight or freeze response is eased. 

At this juncture, you may be wondering how clinician-directed eye movements could possibly alleviate trauma-induced stress. EMDR therapy involves guiding the client towards reliving triggering experiences in short phases while the clinician directs his eye movements. During the process, the client will be tasked to focus on trauma-related imagery and the relevant sensations. The clinician will then simultaneously move their finger across the client’s field of view, with each phase lasting approximately 20 to 30 seconds. This will then be repeated a couple of times. At some point, other forms of rhythmic left-right stimulation (for example, listening to tones that go back and forth between the left and right sides of your head) will also be incorporated into the therapeutic process. As distressing as it sounds, the process in fact allows for the vividness and emotional triggers of the memory to be reduced over time. When the client’s attention is diverted as they recall the traumatic event, this makes the exposure to negative thoughts and memories less upsetting, hence limiting a strong psychological response. After attending several EMDR therapy sessions (depending on the individual), the impact of the traumatic event is believed to be significantly reduced. 

How is EMDR Structured? 

Generally speaking, EMDR takes on an eight-phase approach. 

Stage 1: History Taking and Treatment Planning

For a start, the clinician will work hand-in-hand with the client to identify the traumatic experiences which require attention. Should the client have a problematic childhood, the initial stage of EMDR may focus on resolving childhood traumas before moving on to resolve adult onset stressors. Identifying targets for EMDR treatment is also crucial – this means looking further into the client’s past memories, their current emotional triggers, as well as what they hope to achieve by the end of the treatment phase.

Stage 2: Preparation

In this phase, the clinician introduces the client to a few emotion-coping strategies to ensure that the client is well able to manage their emotional distress whenever a trigger is brought up. It is important that the client is able to deal with overwhelming emotions even between EMDR sessions in daily life. The clinician may also familiarise the client with the eye movements or bilateral stimulations. 

Stage 3: Assessment

The clinician will then identify and assess the specific traumatic memories that need to be tackled. This also involves analysing the associated emotions and sensations triggered by the memories. 

Stages 4 to 7: Treatment Process

These intermediate stages focus on the process of desensitisation, installation, a body scan, and seeking closure. The client is asked to concentrate on the trauma-related imagery and memory while engaged in the directed eye movements or other bilateral stimulation. After each set of stimulation, the client will be asked to clear their mind and report what they feel, think, and the sensations they experience. Depending on the individual, the clinician may have the client refocus on the same memory, or move on to another. This process is repeated until the client reports no distress. 

Installation is where the clinician works with the client to increase the strength of positive cognition. This means focusing on the preferred positive beliefs, rather than negative ones. For example, an individual dealing with trauma arising from childhood domestic abuse may start off with a negative belief of “I am weak and powerless”. Installation aims to change that belief into one of “I am now in control.” Of course, EMDR does not force one to believe in something that is inappropriate or unsuitable for the situation. In the example brought up, allowing the client to realise that positive belief could mean encouraging them to take on self-defence training, or other skills that can provide them with a greater sense of security and control. 

A body scan is used in order to check for any residual somatic response that is linked to event-related tension or stress. Should any undesirable bodily sensations be present, the clinician will then target them specifically in subsequent sets. 

Stage 8: Evaluation

The next EMDR session begins with this phase. This stage is mainly for the re-evaluation of the client’s plight. More importantly, this step is to ensure that the necessary progress is made and to review the client’s psychological state. Further review will be carried out, and the relevant changes will be made to provide the optimal treatment effect. 

Although EMDR may be a relatively new technique as compared to other forms of therapy, it is nonetheless an extensively researched method proven to alleviate the stress symptoms of trauma survivors and other individuals who have had distressing life experiences. If you think that EMDR therapy is right for you, do seek help from a mental health professional.


References:

  1. https://www.apa.org/ptsd-guideline/treatments/eye-movement-reprocessing (Accessed 18/03/2021)
  2. https://www.emdr.com/what-is-emdr/ (Accessed 18/03/2021)
  3. https://www.emdria.org/about-emdr-therapy/ (Accessed 19/03/2021)
  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4467776/ (Accessed 20/03/2021)
  5. https://anxietyreleaseapp.com/what-is-bilateral-stimulation/ (Accessed 20/03/2021)
  6. https://hornsveldpsychologenpraktijk.files.wordpress.com/2019/01/full-8-phase-explanation.pdf (Accessed 20/03/2021)
What Does Journeying with a Psychologist for My Mental Health Issue Look Like?

What Does Journeying with a Psychologist for My Mental Health Issue Look Like?

So you are going to see a psychologist for the first time – now what should we expect? The thought of having to step into a psychologist’s room for the first time can be nerve-racking, and understandably so. Oftentimes, individuals may be apprehensive and would wonder if talking to a complete stranger is really going to help, or if opening up your innermost thoughts to a stranger was too much of a risk to take. However, rest be assured that these mental health professionals are well-versed in psychotherapy methods to help you manage your issues as best as possible, and will work closely with you at a comfortable pace. Just like in the treatment of physical illnesses by physicians, patient privacy and confidentiality are also primary obligations for psychologists. In this article, we hope to give you a clearer idea of what you can expect from your visit to a psychologist, especially if it is your first session.  

 

First things first, it is important to understand that psychotherapy isn’t merely a one-off session. While the duration of treatment may vary from one person to another, the American Psychological Association (APA) reports that “recent research indicates that on average 15 to 20 sessions are required for 50 percent of patients to recover as indicated by self-reported symptom measures.” The type and duration of treatment also heavily depend on the nature and severity of each client’s conditions, and it would simply be unfair to make an overgeneralised statement. Regardless, it would be beneficial to go in with an open mind, and to have an honest conversation with your psychologist. It really helps to trust that the process works, while acknowledging that it takes time. 

 

Meeting the psychologist

At the beginning, the first few sessions would aim to help one identify the most pertinent issue that needs to be dealt with. The psychologist will talk through with you gathering some information on your life history, your family’s mental health history, the problems you are dealing with, and analyse those details – no matter how insignificant they may seem at first – that could have possibly led to emotional distress or coping difficulties. For the psychologist, being able to get a good grasp of the situation and seeing the big picture is vital for formulating the treatment plan and treatment process, as it will help to determine the type of psychotherapy that is best suited for you. The psychologist is trained to listen and analyse your conditions in order to help you with your recovery. As such, it is equally important that you don’t hold yourself back from being fully honest with your psychologist. To a large extent, the patient’s participation in the therapy is an important determinant of the success of the outcome. 

 

Goal-setting

While we fully understand that it can be unnerving, these mental health professionals are trained to help you work through the challenges you face, and the therapy room is very much a safe, non-judgemental space. Goal-setting is one of the key aspects of psychotherapy, and it is exceptionally important to set goals from the start that you can use to track your progress. You may start by identifying personally meaningful broad motives, hopes and dreams – having a clear direction in mind will better steer future sessions towards alleviating symptoms of distress and tackling the root cause of one’s concerns. Don’t worry if you feel the need to change your goals or take a different approach halfway through the treatment process. Psychotherapy is a dynamic process after all, and increased self-discovery along the way can certainly give you a better sense of what needs to be changed.

 

Different approaches to psychotherapy

There are several approaches to psychotherapy that can be implemented in the following sessions. Not strictly limited to one or the other, psychologists may make use of psychoanalysis and psychodynamic therapies, cognitive-behavioural, interpersonal, and other types of talk therapy. They can help you focus on changing problematic behaviours, feelings, and thoughts to build on healthy habits, or teach you emotion-coping strategies to cope with your symptoms. Forms of treatment like cognitive-behavioural therapy also aim to help individuals recognise negative thought and behaviour patterns, thereby working towards a positive change. Each session is essentially a problem-solving session. By allowing yourself to talk to your psychologist about your most difficult moments, your feelings and the change you want to observe, the psychologist is then able to make use of his/her expertise to assist you.  Many mental health professionals don’t limit their treatment to any one approach. Instead, they blend elements from different approaches and tailor their treatment according to each patient’s needs.

 

‘Homework’

To make the most of the treatment process, “homework” may sometimes be assigned as between-session tasks to clients as part of your treatment. A variety of homework assignments exist – sometimes in the form of practising new skills, habits, and other coping mechanisms, or someone who is dealing with complicated emotions could be asked to record your negative thoughts in nightly journal entries. When you return for your next session, the psychologist would then check in on your progress, and address any issues that may have arisen while you were completing your tasks. For some clients the benefits of therapy can be achieved in a few sessions, while for other clients they might need more to improve. Empirical evidence supports the benefits of homework in promoting positive symptom change and increasing patient functioning, that is, the quality of a client’s participation in therapy through active application of what they learn will lead to improvements in their conditions.  

 

Was the psychologist right for you?

Often during the conversation with the psychotherapist, or after the session, you may feel a sense of relief, elation, or anxiety and exhaustion. However you feel, it is important to take note of those feelings. Did the psychologist put you at ease? Did he/she listen to you carefully and demonstrate compassion? Did he/she develop a plan to guide you with your goals and show expertise and confidence in working with issues that you have? For the treatment to be effective, you need to be able to ‘click’ with the psychologist, that is you are able to  build trust and a strong connection with your psychologist.

 

To end off, the first session with a psychologist is understandably a bit intimidating and overwhelming, but the first step in the journey to recovery is a critical step to regain your mental wellbeing.

 


 

References:

  1. https://www.apa.org/ptsd-guideline/patients-and-families/length-treatment (Accessed 24/04/2021)
  2. https://www.apa.org/topics/psychotherapy/understanding Accessed 25/04/2021)
  3. https://www.self.com/story/how-to-tell-if-therapy-is-working (Accessed 25/04/2021)
  4. https://www.researchgate.net/publication/281642213_Homework_in_Psychotherapy

(Accessed 26/04/2021)