Self determination and goodness of fit are key components for effective psychotherapy.

The biggest factor in a persons success in therapy is whether or not they personally want to be there. If someone else is forcing or pressuring them to seek counseling they are less likely to reap the many positive benefits. Educating someone who is struggling about the positive aspects of therapy can be beneficial, but it is important to remember that ultimately each person has the right to decide if they want to go to therapy, and to engage in it on their own terms.

Some people may avoid therapy due to fear of talking through shameful or painful memories. Others may feel too overwhelmed already with incredibly busy lives, and not feel able to make time for therapy, or not be educated about the many potential benefits. Still other people may have had a bad past experience with a therapist and may be hesitant to want to commit their time and money to therapy.

While avoiding therapy due to fear of discussing painful or shameful memories is very understandable, people considering therapy should remember that they control the content of therapy discussions. They can verbalize to their therapist the pace at which they want to move, and if addressing a particularly painful topic, begin and end the session with mental and physical relaxation exercises to avoid feeling overwhelmed. It’s also important to remember that a good therapist is not there to pass judgement or criticize. They want to help, and move at a pace that is supportive to each specific client.

In order to motivate yourself to get engaged in therapy, it might be helpful to think of therapy like exercise. It is important to not just get you well, but to keep you well. If you are going through a busy or stressful time in your life, it may significantly benefit you to have a 45 min session per week (or every few weeks) to vent your frustrations, organize your thoughts and possibly even discuss how to be more productive or better manage your stress. This will work especially well if you are able to find a therapist with flexible scheduling.

And finally, it’s important to remember that one of the most significant aspects of therapy is the goodness of fit between therapist and patient. Some people have a bad experience with a therapist and then never return to counseling again. It’s completely understandable that someone would not want to participate in therapy if in the past they found it to be an unhelpful waste of time, or worse, dealt with a rude, overly critical or judgmental therapist who gave them bad advice. Why would someone want to waste money and time for no benefit or to leave feeling worse than they did when they arrived? That wouldn’t make sense!

For this reason it is important to keep in mind that each therapist is different. An analogy I often make is to hair dressers or barbers. If you got a bad hair cut in the past, that would most likely not mean you would never get your hair cut again, right? You might try to explain what you wanted differently to your hair dresser the next time you visit or try a different salon.

This is the fallacy that people sometimes fall into after having a bad experience in therapy. They may state “therapy doesn’t work for me.” However, what they likely mean, is that they met with someone who was not a good fit for them. They had a bad experience in therapy.

The truth is that all therapists can not be lumped into one category. No therapist is perfect, but finding one that is helpful can truly make a huge difference. Each therapist brings their unique background and style, personal and professional experiences together to create their version of therapy. Your job as the client is to find one that works for you. Your comfort level is of primary importance.

Prior to or during your first appointment you may want to ask your therapist:

• What type of therapy do you practice?
• How many years of experience do you have?
• What issues do you treat? Do you have experience with what I am dealing with?
• How long can I expect to be in treatment?
• What are payment options?
• Do you offer phone sessions or flexible scheduling?

To make it easier to test the waters of therapy I offer flexible hours, phone sessions, Skype/ FaceTime sessions and in home counseling. I also offer discounts for the first session with a client to help them decide if the counseling relationship will be a good fit. If a client decides not to continue with therapy, I offer referrals and suggestions for other colleagues/ types of therapy that may be useful to them.

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