What to expect from therapy for depression

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For long-term sufferers of depression, therapy is almost certain to be a considered option. Mental health professionals in charge of your case should be able to decide what type of therapy is best for you; the two most common choices are psychotherapy, which involves the client working with a professional to overcome problems, often by delving into the past and cognitive behavioural therapy (CBT), which tries to change specific thought processes through exercises. However, entering therapy can be a challenge for some clients, who don’t really know what they should expect from the treatment.

Having undergone a brief course in CBT and having experienced years of psychotherapy, the following article aims to give a newcomer an idea of what to expect from sessions. Please note that I am not a therapist myself; my comments are merely based on my own experience.

You will be expected to talk

Psychotherapy in particular involves talking. Obviously, that means you talking, not the therapist. At your first appointment, the therapist will probably introduce themselves, explaining how they expect the sessions to go and will ask you what you expect from the sessions. After that, the spotlight is on you. Usually when going to an appointment, the therapist will say hello, but then leave you to initiate the topic. He or she may interject occasionally, but generally, you will be left to talk and if you have nothing to say, there may be long silences.

Some preparation/homework is needed

With psychotherapy, the sessions tend to be driven by you, which means you can cover whatever is on your mind at the time, and often the conversation will flow from that. However, some preparation is a good idea. This ensures that, should there be any long silences, you can quickly bring up a new topic. It is also a good idea to think things through after the appointment; this way, you can hopefully build on each session, ensuring that you are covering the crux of the matter. CBT will often involve written homework; you will probably be asked to analyse a specific aspect of your behaviour and how it could/should be adapted.

Expect to be upset at times

Psychotherapy does involve delving into the past, often into things that you would really rather forget. This is bound to be upsetting at times. Don’t feel that you cannot discuss such matters because you are afraid of breaking down. Therapists are trained to deal with crying and anger; in fact they expect to see it, because it is a sign that the therapy is having some effect on you. You may feel drained after the session, so if possible, ensure that you can take it easy for an hour or so after the appointment. However, if you feel that you are unduly upset and that you are uncomfortable with your therapist and their way of dealing with you, you should consider changing them – you have every right to get the best care you need.

Don’t try to cover up your problems

There is often a period of waiting before you get to see a therapist. By that time, you may be feeling much better. Don’t use that as an excuse to pretend that everything is fine. If you are stronger, it should be easier to deal with your issues – but if you avoid talking about them in the first place, then you are wasting your own time. Your problems are still there, even if they are somewhat buried. Be confrontational, with yourself.

Don’t expect miracles

You will need to consider what it is that you expect from therapy – that will probably be one of the first things your therapist asks you. By all means, have goals. You may want to see progress in a certain relationship. You may want to get rid of the anger that you feel over a certain situation. And hopefully, the therapy will help you to talk things out and begin to come to terms with your difficulties. However, don’t expect it to work miracles. It can take a long time to recover from a bout of depression, even with therapy, so don’t expect to suddenly feel better over night.

Be prepared for the long haul

Courses of CBT will probably be fairly short – just a few weeks – although you should be able to use what you have learned in your everyday life. Psychotherapy may take much longer, obviously depending on the case and on the therapist. Usually, your progress will be reviewed after so many sessions, and your therapist should then discuss with you how much longer you should expect to be in therapy.

Expect to use what you learn

The end of therapy does not signify the end of your own work. Techniques that you have learned during therapy can be used in your everyday life. You will hopefully feel stronger and, when your thoughts begin to take over, you should be able to at least control them. And of course, if things begin to regress, you can always consider going back to therapy.

Therapy can be daunting for a first time client, but remember that you deserve it. Getting to grips with your mental health could be the most important thing you ever do.


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