Visiting a Therapist for the First Time: Debunking Common Misconceptions of Therapy
Introduction
Ever since the COVID-19 pandemic was declared an international public health emergency by the World Health Organisation, demonstrated impacts on the mental health of people across the globe have been observed (Liu et al., 2020; Usher et al., 2020). Originally classified as a “non-essential service” during the pandemic, countries such as Singapore have since re-classified psychological and other allied health services as essential services, thanks to the push for recognition of the cardinal importance of mental health services by the community and the Singapore Psychological Society.
As the pandemic and the toll of extensive quarantine measures plague the mental health of some individuals, considerations to visit a psychologist and undergo therapy may arise. When one visits a therapist for the very first time, it can be difficult to know what to expect. Without understanding the process of therapy from a trustworthy source (e.g., a friend who has visited a therapist in the past, a clinical psychologist), we often construct misguided representations of what happens in the therapy room based on information presented in novels, television series, or movies that can misrepresent mental health conditions and the roles of therapists (Yuan et al., 2016). In an attempt to resolve common myths of therapy, this article discusses some of the predominant misconceptions held by the general public about the process of therapy.
Misconception 1: Therapy is only meant for individuals struggling with mental health conditions.
While it is common for individuals who are facing psychological distress to be referred to therapists, therapy is a universal service that one may benefit from regardless of their circumstances. For instance, students undergoing training as clinical psychologists are often required to undergo therapy and guidance sessions themselves with a qualified supervising senior therapist, providing them with an avenue to explore their own emotions, biases, and thought processes during their training sessions (Corey, 2012). Therapy can also be used as a platform for individuals to explore ways to better their lifestyles. It is for this same reason that in therapy, the person undergoing therapy is often referred to as the “client”, and not a “patient”.
Misconception 2: Therapy only involves passive talking.
Therapy is an active process which entails collaboration between the client and therapist to identify areas of concern, set time-based goals, and monitor progress towards achieving those goals. The act of listening to a client’s sharing is one of the most important components of therapy, where the role of the therapist is to establish rapport with the client through listening with unconditional positive regard (Rogers, 2012) and reflect the client’s experiences to them to understand the client’s interpretations of those experiences. Also, therapy does not only involve talking, as the client may be required to engage in active evidence-based activities such as mindfulness-based exercises (Grossman et al., 2004) or homework assignments such as reflective journaling (Miller, 2014) and reading assignments.
Misconception 3: Therapists have the legal authority to prescribe medicine.
A clear distinction must be made between psychologists (i.e., those trained in the field of psychology – the study of human behaviour and mental processes) and psychiatrists (i.e., those trained in medicine). The term “therapist” broadly includes mental health professionals who directly engage with clients to work through their concerns, such as clinical psychologists, counselling psychologists, or social workers, albeit with slight differences in their areas of specialisation. As such, only medical doctors trained in psychiatry will be involved in the prescription and monitoring of psychopharmacological medications for clients.
Misconception 4: Therapy can solve problems in a short time.
The duration that therapy can span is largely dependent on the subjective needs of the client, although some researchers estimate that the average duration a client will be seen spans an average of 18 sessions (Bachelor & Salamé, 2000). Again, the duration between each session is subjected to the client’s and therapist’s agreement – some may attend sessions once every two weeks, while others may attend sessions once per month. The duration may also be subject to the expertise and style of the therapist. For instance, therapists trained in Solution-Focused Brief Therapy aim to help clients construct solutions with added emphasis on their present and future circumstances, and this therapeutic methodology typically does not extend beyond eight sessions (Kim, 2008). On the contrary, other therapeutic techniques aim to rationalise the way clients interpret their life circumstances, and these techniques typically require repeated practices and progression checks (see Cognitive Behavioural Therapy, Cuijpers et al., 2013). In other words, it is important to note that therapy is not a speedy process and delving into the core of a problem may require extensive work and time.
Misconception 5: Therapists have ready-made solutions for everyone.
The therapist’s role is not to provide solutions, but to collaborate with clients to assist them in constructing their own solutions for their concerns. To better illustrate the role of therapists, some clinical psychologists refer to the analogy of a passenger and the driver:
Essentially, the therapist is to the client as the passenger is to the driver. In the therapeutic context, the client is in charge of ‘arriving at a destination’ [similar to how a driver wants to arrive at a predestined location] – that destination being the resolution to a certain problem or a goal set by the client. Meanwhile, the role of the therapist is to observe and provide guidance for the client in charting certain paths towards that ultimate destination [similar to how a passenger does not have access to the steering wheel and gear stick, but can provide suggestions for routes to take]. The therapist’s role is not an instructional one – the client has the final decision on their route, their own life trajectory, and the responsibility of getting to that destination still lies on the client.
What to expect from therapy?
While the misconceptions discussed above are not exhaustive, they underlie the most predominant misconceptions of therapy in the eyes of the public. When going for a therapy session, it is important to be in tune with how you feel in the therapeutic environment. Feelings of anxiety may be common during your visit, but the goal of every therapy session is to feel comfortable with the environment and the therapist. This will allow you to convey your emotions, feelings, and thoughts with limited resistances. Whenever you feel that therapy is not working out, it is important to discuss these feelings with your therapist and collaboratively propose an alternative or better treatment plan. Most importantly, as with the analogy of a passenger and the driver, the outcome yielded from therapy sessions is largely dependent not only on the quality of the therapist but also the amount of effort you bring to therapy.
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