How Therapy Works and What You Can Expect

Therapy (or counselling) is often a structured conversation with a trained mental health professional who helps you understand and change thoughts, emotions, and behaviors that cause distress or get in the way of living the life you want. Other times, therapy is an experience, where a mental health professional facilitates a here-and-now process to help you access new thoughts, feelings and perspectives, right in the counselling session.

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Therapy works through the following key processes:
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1. Building a relationship (the therapeutic alliance)
   The foundation of therapy is trust and collaboration between you and your therapist. A safe, nonjudgmental space helps you open up honestly and explore difficult issues.
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2. Increasing awareness
   Therapy works to help you notice patterns in how you think, feel, and act and how these patterns connect to your past or present life situations. With increased awareness, comes a greater capacity to make changes that support your therapy goals.
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3. Developing insight and new skills
   Depending on the type of therapy, you might learn coping skills (e.g., breathing, grounding or communication techniques), challenge unhelpful thoughts, process trauma, or practice new behaviors (e.g., mindfulness skills training).
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4. Making and maintaining change
   Over time, you apply what you’ve learned to your daily life to improve relationships, manage stress, and increase emotional resilience. The application is an ongoing effort, even once therapy session conclude, to ensure lasting change in the long-term.

Your therapist will ask about your background, what is bringing you in, and what you hope to get out of therapy. You might also discuss questions you have, or gather information about treatment modalities. Together, you’ll set goals and agree on how often you will meet (typically weekly or biweekly).‍

Sessions usually last 50 minutes, though trauma processing sessions may be 90 minutes. You’ll talk about your recent successes and challenges related to your concerns, and how you've managed them, including use of any skills taught. Your therapist may use different therapeutic approaches such as:‍
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1. CBT (Cognitive Behavioural Therapy) - Focuses on changing your thought patterns and behaviours to generate improvements to your mood.
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2. Motivational interviewing - Addresses ambivalence toward change and fosters internal motivation to change a behaviour.
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3. Humanistic or person-centered therapy - Emphasizes self-understanding, non-judgement and unconditional positive regard to foster growth.
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4. Trauma therapies (EMDR, SE, PE, CPT) - Helps you process stressful past experiences to resolve distress stored in your nervous system.

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‍‍Many therapists assign small activities between sessions such as journaling, noticing patterns, or trying new behaviors to promote and reinforce progress. If homework is assigned, most therapists will explore your experience of the homework at follow-up as a means of supporting your goals for treatment.

Therapy is a gradual process. You may feel better quickly, or it might take time as you work through deeper issues. Occasional discomfort is normal and expected; it is an important part of the growth process. It is also possible to feel worse before you feel better. Open communication with your therapist about what is working (and what isn’t) is key to support collaboration!

You will discuss with your therapist when it is time to stop or reduce sessions. It's typical as you recover, or if progress plateaus and you need something else. Effective therapists plan collaboratively and may suggest occasional check-ins post discharge to maintain progress or mitigate any setbacks early.

Greater self-awareness and awareness of others, better emotional and behavioural regulation, improved relationships and communication (including with yourself), healthier coping strategies to best manage your symptoms, a stronger sense of control, fulfillment and purpose in your life.

Would you like to know more? Reach out for a free 15-min consultation to see if therapy is something that may be useful for you.