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Cactus Counselling

How Therapy Works: What Happens In Therapy?

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If you haven’t had therapy before it can be unnerving. I’d like to invite you to breathe, and to come and try it anyway. We understand what it is like: counsellors and psychotherapists have to attend therapy to pass their exams, so we’ve all sat where you have at some point!

So, what can I tell you? First of all, therapy isn’t like going to the doctor. We don’t prescribe a behaviour that will make you better, like a pharmacist dispensing a pill, or perform an action that you passively receive, like a surgeon. What we do is help you develop the skills to manage the issues you talk with us about. Both you and your therapist must be active participants for therapy to work.

This is what therapy will look like from your perspective if you haven’t had therapy before:

  1. you “get it all out” and tell us what’s been going on and what’s brought you to therapy
  2. we ask more questions. This helps us get more clarity on the issue
    1. This may be where you feel unsure of what to do next. That’s okay, therapy takes some getting used to!
  3. We discuss with you what you want from therapy. For many people, it’s a change in their current circumstances (like developing their friendship network or giving up smoking). Other people want somewhere to process what’s happening in their lives (such as people with long-term pain). Some people want to reflect on an issue they cannot change (for example, clients who feel helpless about a situation happening in their family, or clients wishing to make peace with with a terminal illness) in order to finally accept it.
  4. Once we’ve agreed on a therapeutic goal, we work towards it. I will offer you whatever you need each session - so long as it’s within a therapist’s scope! This can include:
    1. listening
    2. showing you helpful pieces of theory (such as the Drama Triangle, which can help simplify many apparently complex dynamics in relationships and help you identify what, if anything, you can do to change it)
    3. exploring new thoughts and feelings as they come up
    4. reviewing your progress and celebrating your successes, and
    5. helping you plan how to maintain your progress without therapy, or with less frequent therapy.

Note that we’ll have an over-arching therapeutic goal which we’ll agree on together, but I’ll also ask you what you’d like to work on at the start of each session.


And that’s it! I’ll happily answer any other questions you might have so feel free to contact me and we can discuss your questions, thoughts, and doubts.


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