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Does going to therapy mean you're "crazy" or something is wrong with you?
No, not at all. Even therapists often see the benefits of going to therapy themselves. We see it as a healthy tool for maintaining mental health care and coping with emotional wounds as needed. People go to doctors for check-ups, injuries, etc. for their physical health, so it makes sense to do the same for your mental and emotional health when you need to as well. So, no, it doesn't mean you are "crazy," but instead you are likely having a normal reaction to something abnormally stressful or challenging and you are proactively seeking help to cope with it from someone who has the appropriate knowledge and skills to help you, and that's a good thing! Everyone has problems and rough patches in life, but not everyone is willing to put forth the effort to try to change themselves and/or their lives to make things better. If you are, that's a major strength, and if you need assistance in doing that, that is perfectly okay!
What do people actually do in therapy? Are they just going to ask me how I feel about everything?
There is a lot more to therapy than asking people, "How does that make you feel?" like in the movies!
Generally, we will give you assessments to help determine what kind of symptoms you are having and gather your history to help us make an accurate diagnosis. Then, we (the therapist and you) will create treatment goals to help guide us through the process, but this plan will be reviewed periodically, it is flexible, and it is okay to deviate from it as needed, based on whatever is going on in your life or whatever you need to talk about that week.
Beyond that, what we do depends on your situation, your needs, and our clinical judgment about what would be most helpful for you. We are all trained in many different treatment modalities and techniques, so we tend to use a combination of them, and may even change it up if we feel like something is not working well for you. Everything you do is voluntary and if you feel like something is not helpful or you don't want to do it, you don't have to, and you are encouraged to let your therapist know if there is something else you would rather talk about or work on. It's actually very helpful for us when people are willing to give feedback, as therapy should be a collaborative process where we are helping you achieve what you want to achieve with yourself, your relationships, and your life.
I feel embarrassed about all my problems. Will my therapist judge me about everything going on in my life?
That would be like a doctor judging you for having the flu. We do not judge people for anything they say, and more than likely, what you are dealing with is more common than you think. We have also dealt with our own personal struggles as well, so we understand what it's like to go through difficult things and to allow ourselves to be vulnerable enough to ask for help with the most sensitive areas of our lives. It takes great trust and strength to do that, and we are honored to be the person to offer you that help. If you ever feel judged, please tell your therapist that. It is very important that we know if we are doing something unhelpful, not just for your sake, but for all of our clients' sake. We are very open to feedback and growth, so please share with us if you felt bad about something we did or said so that we are aware of it and can make improvements. I promise, it's okay!
Can I cuss in therapy?
Yes, you can cuss. We have all heard plenty of cuss words, we are not so delicate or easily offended by language, and we understand that sometimes when you are discussing emotionally charged topics, you will let it out however it comes out, which can be pretty raw sometimes. We are human, we get it! Many clients feel like they have to hold back with us because we are "professionals," and we would prefer you are comfortable and don't hold back on however you want to talk about your own life. We will work on expressing yourself effectively in other contexts as needed, but how you express yourself to us is up to you as long as you are not disrespecting us personally in some way. For example, you can call your roommate a b**** in your therapy session, but don't call us a b****.
Do therapists cuss in therapy?
Some therapists may disagree about this, but at Courageous Counseling, we value being "real" with people because there is great value in authenticity, and it often helps people to feel more comfortable talking about their lives. Our therapists are permitted to do so if they know you would be comfortable and prefer them to converse with you on a more casual level. Many clients prefer that we talk like "real people," but there's certainly an appropriate balance to be found. They shouldn't do it first or if you haven't yet established a comfortable enough relationship with them to do so.
What if I don't like my therapist, don't feel like it's helpful, or don't like something they are doing?
1) First, reflect upon why you don't like them and identify the reason. There could be several different reasons:
Is it something they did that offended you?
Is it because they facilitated an uncomfortable feeling or discussion that you didn't particularly enjoy? It's really easy to misdirect negative feelings towards a therapist who is helping you go through something that is emotionally difficult.
Is it just that you don't feel you are connecting well with them?
2) If it is something they did wrong, the first preference is to discuss it with them. We are a big fan of being assertive about what you want and need, not just with us, but in all your relationships.
3) If it is something that you don't feel can be reconciled with your therapist, please contact Courageous Counseling and let us know and we can address it and assign you to a new therapist if we have one who is able to accept new clients.
4) If you just didn't connect well with them, that's totally okay and we can assign you to a new therapist if we have one with availability or give you referrals for counselors elsewhere. Your therapist will not be offended, as we all understand that sometimes it's just not a good match. If you have preferences that will help us determine what kind of therapist would be a good match for you, please let us know.
Can I ask my therapist questions about themselves?
You can. They may or may not give you thorough answers, but that will depend on whether they think it would be beneficial for you to know. Therapists will voluntarily self-disclose information about themselves and their experiences when they determine it might help you feel more comfortable or otherwise benefit you. For example, if you are a new parent struggling with postpartum depression, your therapist may have had that experience as well and may share that with you. But keep in mind that therapy is about you and even if your therapist has not been through the same experiences, we have many years of education and experience with a wide variety of diagnoses, acuities, issues, and subject matter. So, if for example you are suffering from an addiction, your therapist need not have suffered an addiction themselves to have valuable knowledge and experience in the area of helping people through addictions. Also, therapists do not practice outside their scope of practice, which means that if they don't feel they are qualified to help you with a certain problem, they will either take measures to correct that, such as by consulting with another therapist who is experienced in that area to gain the skills and knowledge needed to help you, or they will refer you to someone else.
Do therapists have mental health struggles?
Therapists are people just like anyone else and have likely gone through their own mental health struggles and life challenges, which may have contributed to their ability to relate so well to others who are going through such things. However, even if they have not gone through the same mental health struggles or challenges that you have, therapists are required to have many years of education and likely already have many years of experience in the field to help them understand your problems and the most effective ways of navigating those problems successfully.
How long does therapy take?
That depends on a lot of factors: the severity of whatever you are facing, your motivation to change the situation(s) you are struggling with, your willingness to follow recommendations and try to apply what you are learning between sessions, your consistency in showing up to sessions, and whatever may come up in your life while you are going through counseling, and many other factors. There are no guarantees on how long it will take because too many factors are outside of our control, but we do our best to help you resolve past issues that may be barriers, build supports in your life that you need going forward and develop the skills you need to navigate challenges on your own in the future. Some people can get to a point where they feel confident moving on after a few months, but others may take a year or more to feel comfortable, in more complex cases it could take longer than that before you feel ready. Regardless, it does not have to be an abrupt process. When you start to feel like you have nothing to talk about in therapy or the therapist feels you are ready, we can review your treatment plan to see where you are at with all your goals and reduce counseling to a lesser frequency, and if that goes well, we can reduce it to a follow up every month or so for a while before ending counseling. That is not required and you can end counseling whenever you like, but sometimes a gradual process can help people build the confidence they need to resume their lives without therapy. And if you later need it again, you can always come back later as well.
Why is therapy so expensive?
It is a common misconception that therapists' rates are their "hourly" rate, but they actually don't usually do therapy the whole day for a couple of reasons: 1) therapy requires a high level of cognitive and emotional functioning and attention, so they shouldn't do that for several hours straight without a break or else the quality of therapy may suffer; 2) there are a lot of other tasks that have to be done, such as treatment plans, phone calls, emails, billing, therapy notes, researching resources for clients, training, meetings, consultations with other providers, and other tasks that may come up; 3) for providers who have to have a Master's degree and maintain a license to practice, the average income of therapists is actually pretty low in comparison to other such practitioners, for a few reasons--one is that large groups and facilities collect the fees from insurance and clients, but only give therapists providing those services half or less of those fees; 4) because some insurance companies refuse to reimburse services at respectable rates, medical providers of any kind are forced to offset this loss in their regular rates, or by just not accept those insurances at all. Some providers are now choosing not to accept any insurance because of the loss and expenses involved in doing so.
Can I friend or follow my therapist on social media?
We do understand the temptation to be "friends" with your therapist outside of therapy, but therapists are not allowed to be friends with our clients on social media or in any context outside of therapy. Sometimes you could end up in each other's networks by accident, such as when you have a large network of people you may not know in person, people's names are not the same as their legal name, or some other accidental reason, but we do not intentionally accept any requests to connect on social media. If your therapist has a blog or some other publicly shared professional profile, you are allowed to follow them in a professional capacity, but it is strongly discouraged to follow them or cross any boundaries into personal social media, even if it is publicly available. Not only is it unethical for us to engage with clients in that capacity, but it is also a much-appreciated courtesy to us to respect our personal lives as well and it could tarnish the quality of your therapeutic relationship to know too much about their personal life.
What if I feel attracted to my therapist? Can I date my therapist after therapy has ended?
It's not uncommon for people to feel attracted to their therapist because a therapeutic relationship requires vulnerability and trust, however, it is against our Code of Ethics to date clients during or after termination of services. It is unethical and exploitative on the part of the therapist to cross such boundaries. There are certain power dynamics that could end up being emotionally harmful to clients if they were to engage in a romantic relationship with their therapist, or even a friendship. For example, if your therapist knows things about you that you shared in a confidential setting, those things may go far beyond what you would have told them had you met them in a dating or friendship context. Hence, if later the protection of that confidential setting is removed (it is never technically removed - you always have that protection - but theoretically, if it is removed by a crossing of those boundaries), this would be an unfair advantage to them. You can sue a therapist for engaging in a romantic relationship with you as a client and/or make a complaint against their license if a therapist attempts to cross the boundary into any romantic or sexual relationship with you or reciprocate any attempts on your part to do so, as they should understand the potential for such dynamics and address that appropriately and sensitively if that happens.
What will happen if I see my therapist in public?
If you live in the same town and feel this is a concern, feel free to discuss with your therapist how you would like them to handle it. Generally, we will not acknowledge you in public. This is for your protection. If you choose to acknowledge us, we will talk to you, but we will not disclose how we know you. If you choose to disclose that to anyone, that is completely up to you. Your status as a therapy client is protected by HIPAA laws and we are required to keep your protected health information private, just like any medical practitioner.
Can I invite my therapist to my graduation, wedding, etc.?
You can, and your therapist can attend, but you will need to discuss how you would like them to handle any questions about how they know you, as they are not allowed to disclose that to anyone. Some therapists may prefer not to attend such events and that is at their discretion, based on whether they believe it would be beneficial (or harmful) to you for them to do so. We understand that a therapeutic relationship can be a long and meaningful relationship and if such attendance is important to a client, we are allowed to consider attending important events as a caring and supportive professional, not as a friend or any other kind of relationship, as that would be crossing boundaries into a dual-relationship, which we are not allowed to do.
Am I allowed to give my therapist a gift?
First, you are never expected to do so for any reason. But if you want to, you are allowed to do so within reason, and it will be the therapist's responsibility to decide if it should be accepted or not.
The American Counseling Association addresses gifts directly in their Code of Ethics. Section A.10.f. States, “Receiving Gifts: Counselors understand the challenges of accepting gifts from clients and recognize that in some cultures, small gifts are a token of respect and gratitude. When determining whether to accept a gift from clients, counselors take into account the therapeutic relationship, the monetary value of the gift, the client’s motivation for giving the gift, and the counselor’s motivation for wanting to accept or decline the gift.”
Can I keep in contact with my therapist after therapy has ended?
Your therapist may potentially follow up with you if there is reason to do so, and you are allowed to contact them in a professional context for various reasons, such as to ask a question, ask for a resource or recommendation, resolve billing inquiries, provide follow-up surveys, or contact them for therapy again, but you may not continue regular casual communication with them after therapy has ended, as that would be considered a friendship or relationship that is no longer able to be defined as a client-therapist relationship. It should be understood that they are no longer providing therapy or treatment of any kind once the therapeutic relationship has been terminated, unless it has been agreed that you wish to resume therapy with them.
Can my therapist patronize my business or services?
Your therapist may patronize a business if it's something that would not be personal to you, such as if you own a store and they happen to shop at that store, but if you are a professional who offers services personally, such as a lawyer or accountant, your therapist cannot hire you to provide those services. Your therapist should never offer you other services either, for example, if they are also a realtor, they cannot sell you a house or list your house for you. If they are a researcher, they cannot recruit you as a research participant. The reason for this is because a client would likely feel pressure to agree, even if they didn't want to, which is an unfair advantage and not appropriate. They can help you find community resources you need, but they cannot provide you with such services themselves.
Still have questions on your mind that we didn't answer here?
If you have any other burning questions on your mind that you would like to know, please feel free to ask. You can contact us directly in our inbox at info@courageousaf.org, or you can ask your therapist whatever you want to know. If you have a good question we didn't think of, we may even add it to this list if we think it will be helpful for others!
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