What happens in therapy

After you get in touch I send you a form to complete. We can then arrange an initial consultation. This consultation will give you a chance to share your issue in more depth and ask any questions. I will decide if it is something I can help you with, and if it is an issue that is suitable for addressing in online therapy. If we both feel we could work together we will complete a therapy agreement so that it is clear what we can expect from each other and to create a safe and supportive framework for you.  

We then start to meet on a regular basis using the chosen medium at planned times, usually once per week. The emphasis at the beginning will be to understand the issues you are struggling with as clearly as possible. We call this the 'assessment' stage, which simply means gathering enough information to have an accurate picture of the issues you want to address. I will ask questions, and might ask you go complete some questionnaires. We may at times look back into your early experience as that can help us understand what is happening in the present moment, but the emphasis will be more on how understanding how your issues are affecting you now.  

 

An important part of this will be to look at what you are currently doing (or not doing) in your life in response to the difficulties you are facing. If there are things that are working, we want to encourage and reinforce those. But if things are not working, we want to know why. It will be helpful to see if we can discover any 'vicious cycles' - any behaviours you do in response to difficult thoughts and feelings that inadvertently keeps your problems going, rather than make them better. With this information we can hypothesise what is keeping you stuck in certain difficulties, and we can then identify where we might break the vicious cycles and try something new. This is called the 'formulation' stage and it informs what we do in our subsequent sessions. 

Once we have a working hypothesis, sessions will focus on trying to change what can be changed, and accept what can't be changed. It will be helpful to think of some therapy goals to guide our sessions and to evaluate if we are heading in the right direction. This stage might involve a fair bit of learning and practicing relevant skills, depending on your need, such as identifying and connecting to your values, practicing mindful awareness, cultivating compassion, taking helpful perspectives, and regulating emotions. We might choose to focus on impulse control, problem solving, sleep hygiene, assertiveness and other communication skills. (We don't need to do all of these things! Only what is needed and helpful.) A key part of this process is thinking about what you can be doing in your day to day life that can help develop new learning, and putting any new learning into practice. 

It is recommended to make a commitment to a few sessions to allow a bit of time to see how the process works. It might take a few sessions to get a feel for how they are working and to see if any changes are beginning to happen. We will have periodic reviews of the process, and I welcome honest feedback about what is and is not helping. This way we can tailor the process to meet your needs best.    

At the end of therapy we complete a final review, and then plan a discharge, which might include a follow up session in a few weeks or months, depending on your needs. 

 

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