13 Things Your Therapist Wants You to Know

Doctor William C Lloyd Healthgrades Medical Reviewer
Medically Reviewed By William C. Lloyd III, MD, FACS
Written By Healthgrades Editorial Staff on August 10, 2021

Psychiatrists, psychologists, and other mental health professionals are renowned for listening. But there’s actually a lot they’d like to tell you about how therapy works—including the fact that the old lying-on-a-couch stereotype is so out-of-date. Here’s what we found out when we asked them about their feelings.

  • counselor-speaking-with-patient-and-taking notes
    1. "Coming to us doesn't mean you’re weak or crazy."
    Cast off the stigma of mental illness. "The truth is that current psychological research and intervention takes aim at building a better brain, rather than labeling it with a psychopathological name," says psychologist Jeffrey L. Brown, PsyD, ABPP. "Today, therapy offices are filled with intellectually sharp individuals who are trying to harness the power of their brains."
  • woman on laptop
    2. "Google me first."
    You comparison shop for cars and TVs; do the same for your therapist. Most have an online presence that offers helpful clues as to whether you’ll click. "Through my website, blogs, and articles, you’ll get to see what I look like, what my style is, and my types of clients," explains Paulette Janus, LCSW, a social worker who provides psychotherapy services.
  • Women on phone
    3. "Don't hire me if we’re not a good fit."
    Most therapists offer a free consultation, or will at least answer initial questions by phone or email. "Ask about my typical sessions, treatment approaches, areas of expertise, and ways of monitoring progress," Janus says. "And don’t be afraid to say that we’re not a good fit. I won’t take it personally."
  • Pills
    4. "Drugs aren’t the only way to treat psychological conditions."
    Yes, medications are effective against depression, anxiety, and similar conditions. But studies show they work best in combination with therapy, and sometimes therapy alone proves superior. “Medication can be a Band-Aid that’s helpful while you are in psychotherapy to get to the root of your problems,” says psychiatrist Carole Lieberman, MD.
  • Male doctor consulting with female doctor
    5. "However, serious illnesses usually need drug treatment."
    "Many times, individuals will think a therapist can help them get sober or stabilized by seeing them once a week," says Lisa Bahar, LMFT, LPCC, a licensed marriage and family therapist and professional clinical counselor. But serious cases need medical stabilization. That typically means treatment by a psychiatrist, a medical doctor with an additional three to four years of combined internship and residency.
  • using-smart-phone
    6. "Turn off your cell phone."
    Your session is yours, and you’re free to spend it updating your Facebook status. But often, patients use technology to avoid issues they don’t want to face. You’ll probably get more out of your time by turning your ringer off and keeping your phone in your pocket.
  • Woman counseling a man in her office
    7. "I can’t wave a wand and make it better."
    "We live in a culture where we've been conditioned to believe we can have whatever we want when we want it. This simply isn’t the case with therapy," Dr. Brown says. "Therapy is a collaboration, not a magic show. It’s a process of change and life improvement."
  • Living With Cancer
    8. "You can talk to us about anything -- including sex."
    Check your shame at the door. "Patients are most embarrassed describing sexual issues, but they needn’t be since mental health professionals are trained in sexuality -- and engage in sex, too," Dr. Lieberman says. If you want help changing your behaviors, your therapist needs to know the whole truth.
  • Piggy Bank Wearing Glasses With Calculator
    9. "It’s harder to help you if you don’t pay me."
    Arrive with an understanding of your copayments, the office policies on payment—and your checkbook, if needed. Many times, payment is required at each session. "Therapists may become resentful if they are not paid, and that only hurts the client," Bahar says.
  • Sadness
    10. "You might feel worse before you feel better."
    "Therapy is about dealing with difficulties," Janus says. "You have to delve into the tough emotions and situations in order to process them and change." Understand that there will be ups and downs along the way, but also speak up to your therapist if you’re frustrated by your progress.
  • serious conversation with doctor
    11. "I won’t tell you what to do."
    Don’t expect your therapist to make decisions for you. "That’s simply not our job," Dr. Brown says. But do expect honest feedback about your emotions and behavior. "We may point out your blind spots in order to help you, but a good psychotherapist never judges or criticizes," Dr. Lieberman says.
  • Tired woman
    12. "You might get mad at me—and I’m OK with that."
    Some styles of therapy result in a phenomenon called transference. Angry or hurt feelings toward others may be shifted to your therapist as you work to address them. Professionals are trained not to take this personally, and also to manage it so you continue to make progress, Bahar says.
  • Working on computer
    13. "I'm mandated to report certain things."
    Your session is confidential. But there are certain issues that must be shared with local authorities, including abuse and homicide. Before you begin your first session, your therapist should have you sign an agreement that clearly spells out these exceptions and circumstances.
13 Things Your Therapist Wants You to Know
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Last Review Date: 2021 Aug 10
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.