Context:
I have so many issues to address. I have a history of sexual abuse, I’m a breast cancer survivor and I am a lifetime insomniac.    I have a long history of depression and I’m beginning to have anxiety. I have low self esteem but I’ve been happily married for almost 35 years.
   I’ve never had counseling about any of this. Do I have too many issues to address in counseling?

Response: You absolutely do not have "too many issues" for counseling. Your reaching out to ask this question shows you have a resilient spirit. Also, your happy marriage can be a support and strength to you as you embark on a counseling journey. I would recommend that you find a counselor who specializes in trauma, sexual trauma and/or EMDR (a type of therapy that is proven to have a strong impact on healing from trauma). Good luck!


Context:
I have so many issues to address. I have a history of sexual abuse, I’m a breast cancer survivor and I am a lifetime insomniac.    I have a long history of depression and I’m beginning to have anxiety. I have low self esteem but I’ve been happily married for almost 35 years.
   I’ve never had counseling about any of this. Do I have too many issues to address in counseling?

Response: I don't think you have too many issues for counseling.  If a client came to me for help with the same issues that you have listed here I would first want them to meet with their doctor to get a physical to rule out any biological causes to your depression, anxiety, and insomnia.  I would work with you on deciding which of these issues to tackle first.  I usually suggest starting with the issue that is easiest.  Reading through your symptoms I might choose anxiety to start with since you are in the early stages of it.  I like to give my client skills they can use right away, so I would focus on teaching you breathing exercises to manage the anxiety as well as cognitive restructuring so that when an anxious thought pops up you can talk yourself through it.  Once you felt that you had some control over the anxiety I'd start to work on some of your other concerns, but I would seek your input on what you felt like might be good to work on next.  My gut is that some of these issues would be resolved as you worked on others.  For example as you worked on your anxiety and began to process your trauma and as you began to work on self care and getting more sleep - your self esteem would probably improve.  I encourage you to meet with a therapist and ask them how they might be able to help you.  These are just some thoughts that came up for me on how I might help someone with the same or similar symptoms.


Context:
I have so many issues to address. I have a history of sexual abuse, I’m a breast cancer survivor and I am a lifetime insomniac.    I have a long history of depression and I’m beginning to have anxiety. I have low self esteem but I’ve been happily married for almost 35 years.
   I’ve never had counseling about any of this. Do I have too many issues to address in counseling?

Response: The way it goes is that all your issues are connected. Once you work on one issue it will have a positive effect on all areas. Slowly each issue is addressed and actually less issues will need to be addressed directly since resolving one helps your overall wellness. So no, you do not have too many issues. Don’t give up. Get help now and see how your life can change for the better.


Context:
I have so many issues to address. I have a history of sexual abuse, I’m a breast cancer survivor and I am a lifetime insomniac.    I have a long history of depression and I’m beginning to have anxiety. I have low self esteem but I’ve been happily married for almost 35 years.
   I’ve never had counseling about any of this. Do I have too many issues to address in counseling?

Response: I think this is a very common question that people who have never been to counseling before have.  There is a lot of anxiety in going to counseling for the first time.  This is normal.  In answer to your  question, the answer is an absolute NO!  An important thing to remember about getting counseling is that it is a courageous first step towards hope and healing.  Getting help is like training to run a marathon, it is not a sprint.  You have shared a lot of issues that you are dealing with from your past, that are now negatively impacting your present, but I believe that in getting the right kind of help and support, none of them are impossible to overcome.  Part of the therapeutic process is defining and prioritizing therapy goals.  In collaboration with you, as a client, a therapist is there to help you with this process in determining what you would like to work on first.  Not getting counseling, based on the history you have shared, has the potential to put you more at risk for mental and physical health issues.  You are already seeing this happen as you begin to experience new symptoms, namely your anxiety.  In therapy, you will gain understanding and insight, as well as learn skills and strategies to manage the symptoms you are experiencing.In conclusion, I would encourage you to reach out to a licensed counselor who has experience in treating trauma, grief/loss and will address shame.  These are three areas that I have found that gets to  the core issues that are contributing to your depression and anxiety.   I believe you can get the help you need to find hope and healing.  Best of luck to you!


Context:
I have so many issues to address. I have a history of sexual abuse, I’m a breast cancer survivor and I am a lifetime insomniac.    I have a long history of depression and I’m beginning to have anxiety. I have low self esteem but I’ve been happily married for almost 35 years.
   I’ve never had counseling about any of this. Do I have too many issues to address in counseling?

Response: Hello, I'm so glad you decided to take the first step in opening a conversation first. Deciding to go to therapy can sometimes be difficult for some, but with the right therapist, healing is possible and obtainable, even with what you've described. To answer your question, no you do not have too many issues to go to counseling.  You've been through a lot and have been strong and at times it's helpful to have someone else to help you through it. What I would say is to be sure and find a therapist who is experienced in sexual abuse and trauma overall. But you absolutely do not have too many issues for counseling. Please feel free to ask any other questions you may have regarding your situation and I hope you find the therapist you're looking for, there are many great ones out there. Many of the issues you're experiencing may be tied together from the trauma. Best Wishes. Laura Cassity, LMSW, LMAC


Context:
I have so many issues to address. I have a history of sexual abuse, I’m a breast cancer survivor and I am a lifetime insomniac.    I have a long history of depression and I’m beginning to have anxiety. I have low self esteem but I’ve been happily married for almost 35 years.
   I’ve never had counseling about any of this. Do I have too many issues to address in counseling?

Response: Not at all my dear. Human beings are complex creatures, and in my opinion, our issues interconnect in a very nuanced web between our levels of being (for example, mind, body, and spirit). Everything you bring up affects all three. The truly beautiful thing about the human body is that when you begin to work on one, the others improve as well!I would encourage you to seek out a counselor who's style and approach speaks to you and start with whichever issue feels most pressing to you. A skilled therapist will flow with you at your own pace and make recommendations to other professionals (e.g., physicians, holistic practitioners, EMDR specialists for trauma etc) as needed to complement the psychotherapy work you're doing with him or her to help you find the total healing you seek. I wish you well on your journey!


Context:
I have so many issues to address. I have a history of sexual abuse, I’m a breast cancer survivor and I am a lifetime insomniac.    I have a long history of depression and I’m beginning to have anxiety. I have low self esteem but I’ve been happily married for almost 35 years.
   I’ve never had counseling about any of this. Do I have too many issues to address in counseling?

Response: Everyone has topics to discuss when they start therapy.   There is no correct number of topics.youSometimes people go to therapy for one specific area of their life.   Not everyone has the time or interest to utilize therapy just when a significant topic arises in their life.Since you are one person, no matter how many or few topics you would like to address in therapy, all the topics relate to you.Possibly the result of your therapy will be more transformational than if you talked only on one topic.  Lucky you, to be on the cusp of clearing and resolving many vulnerabilities at once.   You will feel brand new by the time you finish your therapy work!


Context: What are the basic skills a good counselor needs to have?

Response: 1) An awareness of their own incompetence and inexperience with events in your life;2) An awareness of how the body, mind, emotions, spirit, and others all intertwine and activate one another;3) How to work to use these connections to have you improve your experience...Oh yeah, and there's some listening in there, as well :)


Context: What are the basic skills a good counselor needs to have?

Response: Here is a list of skills I use every session, and a short explanation of what they are:Reflecting: Paraphrasing what clients have said so that they know you understand themValidating: Helping clients to know that their point of view is valuable and rationalClient-centered talk: Maintaining focus on the client in therapy sessions, rather than a therapist talking about themselvesAttending: Nonverbal or verbal cues that indicate I am listening to a client (i.e., nodding, leaning in, affirmations)Reframing: Helping a client to see a problematic behavior or situation in a different way (usually only works well after they feel heard and understood)


Context: What are the basic skills a good counselor needs to have?

Response: I think that the most important skill a good counselor has is the ability to empathize (whether that be natural empathy, or trained, empathy is essential.) A good counselor also knows the difference between identifying with their client, and empathizing with their client. An ability to not bring in our own baggage (we all have baggage and most are "wounded healers") into our work, as it's not about us. If it is brought in, it should be in only a way that can help a client.And to listen...specifically to what the client is needing.


Context: What are the basic skills a good counselor needs to have?

Response: To be non-judgemental, know who they themselves are, be able to step forward and ask questions with ease and grace into painful emotional areas.Also to respect human difference in accomplishing basic life tasks and everyday living.


Context: How does a counselor decide when to end counseling sessions or to terminate working with a client?

Response: There are typically three reasons why therapy is terminated:1) Client has met therapy goals2) Client is not progressing 3) Therapist is not a good fit for clientIn order to properly assess whether therapy is helping and what progress is being made, the therapist needs to have ways of consistently checking in with clients sessions-by-session to determine what is helping, what isn't, and where the client is at in relation to their original therapy goals. When a client has met their goals, that is a good time to end counselling sessions unless the client has new goals or simply wants to check-in periodically to make sure that they are still on track (sometimes referred to as relapse prevention). When a client is not progressing, and feedback has been taken and attempts have been made to make the therapy more helpful for the client but to no avail, than it is considered unethical to continue to work with the client. In these circumstances, referring out to another therapist who may be a better fit is a good idea.


Context: How does a counselor decide when to end counseling sessions or to terminate working with a client?

Response: Hello. The end of the counselor/client relationship is one of mutual respect and engagement. Counseling sessions can end for any number of reasons. Among them are the client's inability to make forward progress in therapy; the clinician's inability to help the client (for a variety of reasons); a mutually agreed upon time frame for a number of sessions to be provided; or the financial challenges of the client who decides that they need to put their resources elsewhere. In this last case, a counselor should never cancel sessions with a client simply on the basis of the client's inability to pay. That is traditionally seen as an unethical practice. Other arrangements can be made to provide care to the client, which in itself should be paramount.When the client and therapist decide that services are done, it is best if there is at least one or two more sessions to allow a case file review to occur, and to bring an appropriate psychological sense of closure to the client (and vicariously to the clinician as well, those this is perhaps not as important). This transition gives both a sense of having reached the end of a journey...rather than some abrupt departure from it. (An abrupt ending in therapy can have a varying level of impact both emotionally and psychologically on the client and therapist). Sometimes the closure of therapy is the result of a program of therapy being formally completed, in which there is a mutually known (albeit perhaps approximate) date of when that program will be finished. In this case, the client is likely feeling that impending closure and has time to prepare mentally and emotionally from a place of being the client in therapy, to a place of healing, growth and situational resolution.I have always worked in therapy with the following slogan (if you will), that I learned years ago during graduate school: "Not every therapist is good for every client, and not every client is good for every therapist." It is perhaps one of the most important guiding views I hold in working with clients. The therapeutic relationship is driven by mutuality - the desire of the client to get better at living life, and the therapist's desire to truly see the client heal and grow. When there is a block in this process from either side that prevents that synergy from occurring, the relationship that should be established may not be able to form. Or, if already formed, may at some point be unable to move forward. In these instances, referring the client to another type of service or clinician is appropriate. Usually, this can be seen pretty quickly by either party, though sometimes it is not always clear.Ultimately, the client and counselor need to work together to discover if the needs of the client (which is paramount) are being met in the therapeutic engagement with their current counselor, or if other arrangements need to be made to go elsewhere. If both are observant in this process, they can work together to maintain that sacred space and continue to reach the goals that have been set. Eventually, therapy will end, but hopefully based on the client's successful journey to the place where they wanted to go, and thus opening the next chapters of their life to a space that is more whole and brighter.


Context: How does a counselor decide when to end counseling sessions or to terminate working with a client?

Response: Hopefully both the client and counselor would together decide when to terminate counseling sessions. It's really helpful for the client to leave counseling with a solid sense of what he or she has accomplished in counseling, so it can be a good idea to spend some time acknowledging that in the last session or sessions. Sometimes, however, a client has needs beyond the scope of the counselor's expertise. That's a good time for a conversation about those needs and ideas of  how best to meet them, whether by adding in care with an additional mental health professional or transferring care entirely to a new mental health provider.


Context: How does a counselor decide when to end counseling sessions or to terminate working with a client?

Response: There are different reasons why a counselor may seek to terminate with a client and these will each have different processes by which the counselor will come to that decision. Here are a few examples. The counselor may determine that the client's needs are outside what the counselor is competent to be able to work with. A person may have come to the counselor talking about a particular issue but either when they first met or as counseling progressed, it may become clear that the issue is in fact something different or that there is an additional related issue. If that issue is outside the competence of the counselor, the counselor should look for alternatives, the most common of which would be to terminate and refer. Beyond clinical issues, this could also come up around particular other related facts, such as the culture of the client or linguistic issues. This could also be the choice of the counselor if they know someone that they feel would be a better match for the client's issues. Another reason for discharge (and possible referral) would be if the relationship does not seem to be a good fit. No counselor is the right person to work with everyone. If the right level of connection is not happening, the counselor will often look first at what they are doing, might talk about it with the client and ultimately will admit that things don't seem to be working to allow the desired therapeutic process to work. A similar process would be followed if the counselor determined that the client might not yet be ready for counseling as evidenced by lack of engagement such as frequent cancellations, not doing any agreed on work between sessions, showing up late or being really guarded in session. The easiest situation to decide on is when a person has met their counseling goals and have nothing new that they are working on. While this is the easiest one to determine, it is also probably the hardest one for the counselor as they may be like the client in not wanting the relationship to come to an end. However, counselors know that this is part of the process. They will also determine this by regularly reviewing the treatment plan or by sending in the sessions that the work has come to an end. This type of termination maybe final or may be with the intent that the client will return later to address other things that have been identified but for which they are not ready to move into. All of these (and other) situations involves the counselor being open to the relationship ending, to monitoring how things are going, then engaging in self reflection, possibly talking with the client and then coming to a conclusion on which the counselor  follows through.


Context: How does a counselor decide when to end counseling sessions or to terminate working with a client?

Response: From the very beginning of counseling sessions I emphasize that the work will and must end at some point.In counseling there is an arc to the process. A beginning, middle and end. I am always digging, searching and exploring. There comes a point where things come to there natural ending.I always leave an opening for continuing counseling in the future. At least as a check in.


Context: How does a counselor decide when to end counseling sessions or to terminate working with a client?

Response: For most:  When the money/insurance runs out.When best:  When the job is done... and you're feeling much better.


Context: How does a counselor decide when to end counseling sessions or to terminate working with a client?

Response:
To be able to identify a clear ending to a counseling relationship, we must have a clear understanding of the goals and limitations of treatment.  Usually, during the initial evaluation, I identify my client’s short term and long term therapy goals.  As therapy progress, we verify goals on a monthly to a quarterly basis, depending on the frequency of the appointments.  Once the therapy goals have been met, there is a closing session, the counseling relationship is ended, and the client can stop attending sessions.  In some cases, the client can also establish new goals and determine if I am a good fit for their therapy needs or if they need a new provider, in which case I provide multiple referrals.The counseling relationship could also end due to other factors like noncompliance= when a client is not committed to the agreed treatment process, or when the client’s or a counselor violates the counseling relationship.  Either the counselor or the client is able to end counseling.  Although, as mental health providers we need to provide a reason for terminating our therapeutic relationship and referral options, as a client no explanation is needed, a closing session is highly recommended.  ¿Cómo termina la terapia?¿Cómo un consejero decide cuando terminar las sesiones de consejería o terminar de trabajar con un paciente?Para poder determinar el final de la relación del consejero, debemos comprender las metas y parámetros de la terapia.  Usualmente durante la evaluación inicial se identifican metas a corto y largo plazo con el cliente, y se discute con el cliente como esas metas serán alcanzadas.  Durante el proceso de terapia el consejero revisa las metas mensual o trimestralmente dependiendo de la frecuencia de las citas.  Ya que las metas de terapia son alcanzadas, hay una sesión de cierre y el cliente puede terminar la terapia.   En algunos casos el cliente puede identificar nuevas metas para la terapia y determinar si el mismo consejero u otro consejero le pueden asistir.
La relación de consejería también puede terminar por no conformar o violentar los parámetros  establecidos para la terapia.   Tanto el consejero como el cliente pueden terminar la relación de terapia.  Como proveedores de salud mental los consejeros estamos obligados a proveer un razón para la conclusión del tratamiento y proveer referidos según aplique, los clientes no necesitan proveer una explicación, aunque es recomendable discutirlo en una sesión de cierre.


Context: How does a counselor decide when to end counseling sessions or to terminate working with a client?

Response: It is usually time to end counseling sessions when it is clear to both the client and the counselor that therapeutic goals have been reached and enough improvement has been made that the client can continue without that support. There are exceptions to this rule, but for the most part this is when counselors begin termination. For some clients, this is an easy process that marks the achievements they have made in working through their emotions and difficulties. For some other clients, however, this is a difficult process in which they are losing a valuable support and are understandably anxious about what life will be like without the frequent meetings. Ultimately, termination is different for everyone, and there are many ways that termination can be healthy and helpful.


Context: How does a counselor decide when to end counseling sessions or to terminate working with a client?

Response: As a therapist who believes in client self-determination above most other elements of the process, I want to as much as possible leave it up to the client to determine when they are finished. In the case of a termination because a client's distress has resolved, I might periodically check in with the client about how therapy has been going, and if we want to re-evaluate where we are.The more unfortunate situation would come about if I felt that I wasn't the best fit for the client. I would offer that in words, and ideas of therapists (with names) of who I thought might be a better fit and why. It still is up to the client whether to continue, however should they want to keep seeing me, a part of the work would be about that want (to see someone who professionally doesn't believe they can help as much as someone else.)I also find it perplexing when I hear a client (or on a personal level) tell me that their therapist said they "didn't need therapy." I don't know that I buy into that scenario all that much, because I do believe that yes, not everyone NEEDS therapy, but that everyone CAN benefit from therapy and I don't believe it is the therapist's job to deter someone from ever seeking out help of any kind.


Context: How does a counselor decide when to end counseling sessions or to terminate working with a client?

Response: Ideally, termination should be a mutual process. It's not that the therapist kicks the client out at some point and says, "Okay, you're done." Rather, over time the client will decrease the frequency with which he/she comes to session so that it may start off as weekly, then decrease to biweekly, then perhaps once every three weeks, then once/month and so on. Throughout this process, the therapist and client should have had regular check ins about progress toward goals. If the client feels good about where he/she is in life, he/she might decide to suspend therapy for now. That being said, the therapist should make it very clear that if the client ever decided to return for "maintenance" therapy or a check in, he/she would always be welcome. There is no hard and fast rule to ending or a particular time period in which it must end. What matters most is that the client feels good about it and knows that the therapist will always be there should he/she wish to return.


Context: How does a counselor decide when to end counseling sessions or to terminate working with a client?

Response: For a therapist, deciding to end counseling sessions or terminate working with a client is a thoughtful and intentional decision. One that is not entered into lightly. While there are many considerations counselors take into account, to help answer this question, I'll offer an example of two areas that counselor's take into consideration when ending counseling sessions:Does the client need different or more specialized care than the current counselor can provide? This requires the counselor to determine whether referring the client to another therapist or health care provider is needed.And, has the therapeutic relationship reached treatment goal(s)? While this question is specific to the counselor, I'd like to also add that a client, at any time, can end counseling.


Context: How does a counselor decide when to end counseling sessions or to terminate working with a client?

Response: In general, I usually let the client decide when this should occur, sometimes with some clients it will be a joint agreement, but even in that case it should weigh mostly on what the client feels. In short, therapy ends when you feel your done.C


Context: How does a counselor decide when to end counseling sessions or to terminate working with a client?

Response: I will work with clients and continually review progress with them and determine if counseling is helping.  If a client appears to have less to talk about in sessions, appears more stable for a period of time and has reached therapeutic goals I will talk about termination.  Some clients however I may continue with on a monthly or bi monthly process to allow for check-ins to see how they are doing and if they need more help at that time.


Context: How does a counselor decide when to end counseling sessions or to terminate working with a client?

Response: There are several reasons for a counselor to decide to end counseling.  A major reason to end counseling is if the counselor feels that he or she does not have the skills or experience to work with the client.  This may happen during the intake process or after working with the client for some time.  If the clinician feels that the client is not benefitting from the therapy, it is ethical to suggest that the client terminate the therapy.  The process of termination must not injure the client and, if necessary, the clinician may need to refer the client to other treatment modalities.  Another reason to terminate working with a client is if the client needs a higher level of care.  If the client has a crisis or is at risk of hurting himself or someone else, he or she may need a higher level of care.  In this circumstance, the clinician may need to involve outside services such as a crisis unit.  A third reason to terminate with a client is if the clinician feels that he or she cannot remain professional with the client relationship.  For example, if the issues that the client is working on bring up something significant for the clinician and the clinician feels that he is unable to separate that from the professional relationship.  In this instance, the clinician should refer the client to another therapist.  Finally, if the client has reached her goals for therapy and no longer needs treatment, the clinician and client should terminate treatment.


Context: How does a counselor decide when to end counseling sessions or to terminate working with a client?

Response: Counseling ends when the client has received the maximum benefit from the therapist. Even if the therapist believes the client is not making progress, the client may feel they are improving and receiving a benefit. And the therapist may see a benefit and the client does not. It is best to have ongoing dialogue with the client to determine when termination is appropriate.


Context: How does a counselor decide when to end counseling sessions or to terminate working with a client?

Response:
Goodbyes can be hard.
Chances are most of the goodbyes you have experienced in your life have been
difficult. Saying goodbye to a therapist can be different. It can be an
opportunity to create a healthy ending in a positive relationship in your life.
If you work with a therapist who is skilled, then saying goodbye can be just as
transformative as the therapy itself. Ending therapy is also known
as “termination.” I know, “termination” doesn’t have a great ring to it!
However, it is what it is. It is an ending of the relationship as it existed.
It is reality cold and stark. Of course, when I talk to clients I don’t use the
word “termination,” I usually say “our goodbye.”  Under what circumstances does therapy usually
end? Therapy should end when a client does not need further assistance, is not
receiving any benefit from therapy, or might be harmed by continuing to work
with a particular therapist.In the best case scenario
the decision to move on from therapy and “say our goodbyes” happens when both
the therapist and the client feel like the client is ready to move on and move
up!  Ending the therapeutic relationship
should actually be worked on from the very first session. What I mean by that
is, there should be an understanding that the work we do together will have an
ending and that is a good thing because it means the client has gained the
skills to continue working on themselves independently. So the first session I
have with clients usually outlines a plan where the end goal is discussed and
we both have an understanding of the skills the client wants to learn or what
they hope to achieve. Now sometimes there are
situations where the therapist ends the relationship and the client may take
that personally, it is hard when any relationship ends and it might bring up
feelings of sadness, and fear or abandonment. Any good therapist will end the
relationship based on what is right for the client. What are some situations
where a therapist might end the relationship?If the situation the client
is dealing with is out of the therapist's scope of practice, the therapist may
end the relationship and refer the client to someone else. This is in the
client’s best interest. Another reason a therapist might end the relationship
is that the therapist is in a place in her life which prevents her from being
objective and helpful.  A therapist who
is going through a painful divorce may have difficulty working with a couple
that considering divorce. A good therapist may see that their judgement may be
clouded and want to refer the client to see someone else. This is good practice
and helps the client.If a client is actively
suicidal or actively using substances then the therapist may end the
relationship and refer out for a higher level of care. The client may need to
be hospitalized or may need an inpatient substance abuse treatment program.
Therapy may be terminated while they are being treated and may continue after
the intensive program is completed.
Ending therapy should be a
time for connection and bringing together accomplishments, or reviewing the
next important step the client needs to take. It should not be an experience of
abandonment. A skilled therapist will help a client gain a new perspective on
closure. For some clients, it may be the one time in their lives when they get
a clean ending in a healthy relationship and they get to feel a sense of
control on creating that ending. Good luck to you!


Context: How does a counselor decide when to end counseling sessions or to terminate working with a client?

Response: In the best case scenario, it's a mutual discussion and decision. If not,  I've had the discussion initiated both ways, by me, when I sense the client has gone has far as they want, by lack of interest in accepting or completing homework assignments, missing or cancelling appointments, usually at the last minute, lack of participation during sessions.  Client initiates by asking me pointed questions about why the need for homework assignments,, by forgetting their calendar, or their checkbook :) , by suggesting that we make appointments over longer intervals (once a week to once a month, for example).  I rarely have had to terminate a working relationship--that's why I don't charge for the first visit, so we know if we are a good fit before we start working together.  Then I periodically ask whether the client feels we are making progress, moving in the right direction, talking about the most relevant issues etc.


Context: How does a counselor decide when to end counseling sessions or to terminate working with a client?

Response: In my therapy practice the decision to end therapy is mutually made together with the patient.Otherwise, the person can end up with a sense of tremendous rejection and abandonment.The way you'll both know therapy is coming to a close is that the discussion will feel lighter and move easily.The person's mood will be better, they will smile more, sit in their seat in a more relaxed way, look more at ease, take better care of their appearance.One of the ways to end therapy is to gradually decrease the frequency of the sessions.Sometimes people who are in my practice start to come each three weeks, then monthly, then every three months.This gives a sense of security, friendliness, and casualness to the therapy, and de-medicalizes it as though the person was treated for a medical symptom and the symptom stops completely one day.Talk therapy is about life and life problems usually end gradually.I end my therapy in a way which mirrors the life process in which many interaction and situation problems show their effects gradually and show different effects over time.


Context: How does a counselor decide when to end counseling sessions or to terminate working with a client?

Response: Hi there, There are a number of reasons why a therapeutic relationship might end including, but not limited to the client reaching their goals, the client reaching a place of acceptance where they wish to remain or even a breach within the relationship.  The last aspect should likely be taken to supervision in order to be fully processed.  All of these things could happen, and usually happen organically (again, except for the last example). Your question, however, was about the counselor ending treatment. This is a bit more difficult and can be very nerve-wracking.  It may be beneficial to take this with you to supervision, as well.  It's important to understand why you feel the need to end or terminate with the client, as well. Do you feel that they would be better suited for another therapist, have they achieved their goals or is it something else?In regular, open-ended sessions, I try to make a point of checking in with the clients fairly frequently. In these check-ins, I use the time to ask the client how they feel about the sessions and if there is anything they wish to focus on more astutely.  I also ask if they have any immediate goals that they would like to prioritize.  In goal-oriented sessions, I check in more frequently to ensure that both the client and I remain focused and, should they wish to shift their focus, that they recognize it is part of my responsibilities to make sure we move back to the desired goal. Often, especially in longer term therapeutic relationships, we as clinicians can see that the client has reached their goal, however they are apprehensive about ending therapy.  This is actually a great place to go with them; why would they feel unable to handle issues in their external or internal environment without you? Often, having this open discussion can increase empowerment and mastery. That said, it could also highlight other issues which the client may have been apprehensive about going into within therapy and now, as the relationship seems to be ending, feels more confident in bringing these up. In the case where the relationship is a toxic one, terminating with a client may be the best option for both of you. It's a difficult conversation, but recall that part of the role of the therapist is to model that these discomforts can be managed. I hope that this brief response can assist you going forward!


Context: How does a counselor decide when to end counseling sessions or to terminate working with a client?

Response: This is a question that is very specific to each person. There are definitely some variables, but I can give you some general ideas for when counseling might end:When a client has met all of their goals, at least to a degree when they feel that they no longer need to work on them with the assistance of a counselorSometimes a decision is made that a client is no longer benefiting from counseling at a certain timeSometimes clients have to remain in counseling in order to receive medication. This depends on agency policy, but sometimes it is a requirement. If the medication is necessary and cannot be prescribed by a primary care physician, frequency of sessions is usually decreased greatlyI'm not sure why you are asking this question, but it is also something that is often discussed at the beginning of treatment. Oftentimes "discharge goals" change as treatment progresses because more is known about clients, their goals, changes in their goals, and many other things. Changes are normal, but your counselor probably has discharge goals in mind, at least generally, from the beginning. I strongly encourage you to ask about it!


Context: What are some difficulties that a counselor can encounter when dealing with a client?

Response: Dang right!  :)Heh heh, and correct me if I'm wrong... and, if we are truly professionals, we should be able to handle even the most bumptious of folks, now shouldn't we? ;)It's like a mechanic who knows his way around every inch of an engine... he'll know what to do... heh heh heh...


Context: What are some difficulties that a counselor can encounter when dealing with a client?

Response: Yes, just like some relationships outside of our work are more difficult than others. But, I would not say that the "client is more difficult," rather the dynamic between myself and the client, which constitutes a relationship, might feel more difficult. And that's okay (sometimes things that feel like the most challenging end up with profound shifts and outcomes.) It is often helpful to understand difficulties that exist, because they can illuminate for a therapist something with which a client might be struggling, and when it takes place in the therapy space, it can be experienced and then worked through.It's hard to necessarily say what some difficulties are that a counselor might encounter, but I would say that not showing up, like in any relationship, is one of the hardest things for me. And not just physically not showing up (though that is certainly frustrating), but not being open to the work is a form of not showing up. While not every client is as "motivated to change," it's helpful to my therapist-client relationships that the client try. It might be hard for them, but the effort even to say "this is tough for me" can go a long way in these kinds of relationships.


Context: What are some difficulties that a counselor can encounter when dealing with a client?

Response: Each counselor will have their own list of "difficulties" in doing therapy work with a client.  Even if clinically trained similarly, since counselors are human then their response to your question will reflect their unique differences as humans.On my list is when the emotional pain I feel for someone describing some type of injustice or unfair treatment by another, feels very deep.Sometimes I feel like avoiding the pain I feel by asking questions which will steer the conversation away from the painful areas the client talks about.What in fact is necessary to clear out their pain, is to step further into so as to realize their emotional pain isn't greater than who they are.


Context: Does counseling really do anything that can help people?

Response: Yes, Counseling provides an area for people to speak to an unbiased professional about their concerns to address their unique needs. While length of time varies, counseling is a process and can be done from as little as one session to multiple sessions. Counseling provide a safe, non-judgmental, empathetic atmosphere from a professional helper provide the service


Context: Does counseling really do anything that can help people?

Response: Hi!  Great question.  I believe counseling does help people! Of course, I am a therapist, so I would think that! :)  Seriously - I think therapy and counseling allow us to understand ourselves, our motivations and the things that bring us happiness and discontent.  Therapy can create opportunities to try new skills and enhance positive attributes that are already present in someone.  I like to think of therapy as an unbiased "aerial view" of our lives. Someone outside can often help us notice things we might otherwise miss. Hope this helps!


Context: Does counseling really do anything that can help people?

Response: Counseling provides a safe environment for people to explore the beliefs about the challenges in life. The various types(modalities/techniques) of counseling serve as guides for specific individual's personal journeys.


Context: Does counseling really do anything that can help people?

Response: Yes, counseling helps a lot of people, especially when there is a good rapport between the counselor and their client. Knowing your counselor is someone who is really on your side and wants to see you grow past your difficulties into a healthy, happy, successful life is more important than what kind of counseling method they use. If you are looking for a counselor, take your time and be sure you feel heard and respected as well as challenged to grow.


Context: Does counseling really do anything that can help people?

Response: Counseling definitely helps people!  I have seen so many positive changes from those willing to engage in the counseling process.  Having a safe place to openly share concerns with an objective listener really is therapeutic and can make a huge difference in your life.    Many times people don't feel heard or validated by people in their lives, counseling call help validate your feelings and help you become more self-aware.  You can learn new skills to better manage your life as well.  I find the people who get the most out of it are the ones most willing to make changes.


Context: Does counseling really do anything that can help people?

Response: Hi there! Thank you for your question. It's a great question and one that many people want to know the answer to. The short answer is, YES! Counseling can be very helpful to people struggling with many different things. There has been a lot of research conducted to prove that counseling is an effective way to help people with mental health concerns, life stressors, and many other issues. In addition, there are many people who would tell you that counseling made a positive, profound impact on their lives. Indeed, some would tell you that counseling saved their lives. Now, not everyone would tell you that counseling helped. But when you think about it, there are many medical treatments for a variety of healthcare issues that also do not help everyone. So, is counseling guaranteed? No. But, it is something that is worth trying if someone is suffering or is just wanting some perspective or support. Also, there is many different types of counseling. Different counselors have different styles and have different training for various issues. This means that you are likely to find someone who has a good style and expertise in an area that you want to work on. If you don't know where to go, I suggest contacting your state's counseling association. They can help. I think the real question that most people have is, how? How does it help? That question is a bit more complicated, because there are many different models of counseling/therapy that work in different ways. What I can tell you is that, regardless of the model of counseling, the relationship between counselor and client is the most important factor. I don't mean that the relationship has to be ooowy goowy... but it does have to be one where there is trust and openness. A counselor will spend time to make sure that you are working together as a team toward a common goal. If you go to counseling and you don't feel this is the case, tell your counselor. An ethical counselor will welcome your feedback. I hope this is helpful, please ask more questions! I hope some colleagues add some other thoughts, too. Be well,Robin J. Landwehr, DBH, LPCC, NCC


Context: Does counseling really do anything that can help people?

Response: Counselling offers a number of ways to help one to improve their situation.  For some, this process can take a very long, winding path of self-discovery, while, for others, they are seeking a purposeful, solution-based way to approach and manage a specific problem. It's important to remember that there are different styles of therapy, some of which will work great with some, but poorly with others, specifically to help those to decide how they wish to move forward. I often recommend speaking with a number of therapists before beginning treatment to find out more about how they practice, in order to make sure their style aligns with your goals. On a more specific note, there is myriad research out in the world that indicates both counselling and medication can have an affect on changing our moods and behaviours.  However, medication is not an effective way of treating the problem, as it treats the symptoms of that problem (increased anxiety, lowered mood, etc.) and research has shown that the most effective route for better mental health care comes from a combination of counselling and medication.


Context: Does counseling really do anything that can help people?

Response: There are multiple ways that counseling helps people. The most basic is that it gives you someone to talk to about and through what you are facing. It is better than a friend because this is a space for your stuff and you get to focus on what you need and don't have to worry about the other side. This is also a place where you do not have to worry about how else the other person is involved in the situation. Beyond this basic level, a counselor will have expertise they can bring in terms of how people, including you, can effectively deal with this kind of situation. The counselor may also be aware of connections that you would not otherwise see. A good counselor will also recognize if and when you need other help or support in the situation. Why wouldn't you benefit from having someone walk with you in your journey to peace and wholeness.


Context: Does counseling really do anything that can help people?

Response: A counselor can do a few things that can be helpful:1) Give you a space where you can explore what's in your head without worrying about being judged or punished.2) Help you better understand yourself, your choices, your motivations.3) Give you tools and information you can use to help create change in your life. Ultimately, though, it's up to the client to take action, because action is what creates change. So, a counselor can't create change ... but they can facilitate and support it.


Context: Does counseling really do anything that can help people?

Response: No, not really;And it's impossible for it to, anyway;And, this is isn't some sort of "you did it all yourself" kind of blather;Because:1) In most outcomes, if a man or woman simply does nothing and waits, most of the time, they get better... (there are reasons to that);2) In most therapy sessions, approximately 92% (give or take, per study) of all outcomes--be they positive or negative--occur due to factors SOLELY WITHIN the man or woman seeking therapy to begin with;3) The word "THERAPY" does not imply cure, but implies treatment (suppression);4) Truly, a proper "therapist" will be able to spot the problem quickly, recommended proper protocols quickly, and coach to completion.5) Even if we PRESUME generosity, the "therapist" really doesn't matter much (maybe 8%); it really all is in you...Be well, man...


Context: Does counseling really do anything that can help people?

Response: You are asking a room full of counselors, and so I am going to guess that we may be a bit biased :). My answer is this: sometimes. Many people benefit from counseling and when counseling works those benefits can show up through positive improvements in your moods, making more choices that align with your values, working through stuff, and a general improved sense of self. Sometimes, for a variety of reasons, a counselor, the approach they are using and the person do not match up and when that happens sometimes counseling does not help. It is very important to find the right counselor for you. Ideally this should be someone you feel a level of trust and connection with who is also using a style that you feel confident in. Research has shown that these aspects (what is called the 'therapeutic alliance') along with shared goals between the client and counselor give counseling the best chance at being effective


Context: Does counseling really do anything that can help people?

Response: Counseling is a collaborative process which involves the development of a confidential, unique, therapeutic, helping relationship. This relationship is unlike any other as the counselor will act as a facilitator in helping you better understand yourself, the world around you, your feelings, and your behaviors.As is the case with most things in life, there are both benefits and risks while participating in counseling. Counseling may improve your ability to relate with others, provide a clearer understanding of yourself, your values, and your goals, and it often helps relieve stress immediately.Along with these benefits, counseling will also involve discussing the unpleasant parts of your life, and you may experience uncomfortable feelings during these moments. But remember that using the awareness of one’s pain can aid the healing process and result in better relationships with yourself and others.


Context: Does counseling really do anything that can help people?

Response: Yes, counseling can help people.How this happens is bc the counselor can guide the person or couple into deeper areas of their thoughts and emotions than the person or partners would typically avoid or not even realize they are avoiding.Also, a counseling session offers emotional safety because the therapist will intervene with thoughtful questions if someone's strong emotions overwhelm them.This is different than in everyday circumstances.  When someone feels overwhelmed by their own or someone else's feelings, there is no one who asks reflective questions.Last, people get better in therapy because often therapy is the first time the person has a chance to trust someone with their confidential information and know this information will always be protected.


Context: Does counseling really do anything that can help people?

Response: Experts have defined counseling as a healing relationship that helps patients by providing a space to vent, process and receive unconditional support.  Many of my clients have expressed that they are able to find their own answers during the session, because they have the right person listening to them.  Some thought they were safe sharing their concerns with friends or relatives who are good listeners, but later they felt ashamed or guilty about what they shared.  So why people should share private issues with a Counselor (a stranger)?  Confidentiality is the key word.  A good counseling relationship should provide a space where people are able to share their deepest thoughts and feelings, allowing themselves to be vulnerable and explore those emotions that are difficult to share without implications.  Beyond the ability to provide a safe place, counselors are trained to identify symptoms and behavioral patterns, and can provide insight on how develop coping mechanisms to improve their life.I am a License Professional Counselor working on a private practice in Puerto Rico: Latitude Counseling, and also I’m licensed in Texas, where I provide theletherapy services.  If you would like to learn more about the services available, you may call 787-466-5478 or visit www.latitudecounseling.com¿Cómo la consejería ayuda a las personas?¿Realmente la consejería hace algo para ayudar a otros?Expertos definen la consejería como una relación sanadora que ayuda a los pacientes proveyéndoles un espacio para ventilar, procesar y recibir apoyo incondicional.  Algunos de mis clientes han expresado que son capaces de encontrar las respuestas a sus problemas durante la sesión de consejería, porque tiene a la persona indicada escuchándolos.   Otros cuentan que se sentian seguros compartiendo sus preocupaciones con su familia o amigos, pero esas preocupaciones afectaron sus relaciones negativamente, o los dejaron con sentimientos de culpa. Así que, ¿Por qué deben las personas compartir asuntos privados con consejero, (un extraño)?  Confidencialidad es la clave.  Una buena relación de consejería debe proveer un espacio donde las personas puedan compartir sus más íntimos pensamientos y sentimientos, permitiéndoles ser vulnerables y explorar esas emociones que son difíciles de compartir sin consecuencias. Mas allá de proveer un espacio seguro, lo consejeros profesionales estamos entrenados para identificar síntomas, patrones de conducta, y proveer perspectiva en cómo desarrollar los mecanismos de defensa necesarios para mejorar la calidad de vida.Soy Consejera Profesional Licenciada en Puerto Rico, donde practico a través de Latitdue Counseling, también estoy licenciada en Texas, donde proveo servicios de teleterapia.  Para más información llame al 787-466-5478 o visite www.latitudecounseling.com


Context: Does counseling really do anything that can help people?

Response: I love this question! Some people shy away from counseling because they think since they already talk about how they feel to their relatives or friends they shouldn't need a counselor. However, if you are having a difficult time, counseling can be beneficial in helping you move forward and get your life back on track. Counseling is not like the kind of talking we do to people we know. For one, your counselor does not have a history with you and has no expectations of how you will act and what you will do. In that way, counselors come to a session without judgement and expectation. This gives you the platform to truly explore your thoughts and feelings. A counselor can also help you understand your motivation and help you integrate your past experiences and recommend coping skills that can help you if you are feeling overwhelmed by your emotions. Over time, as you work with a counselor you will get feedback and also be able to share new insights. The work you do is based on you and where you are at. Oftentimes, when we talk to friends they bring their own agenda to a conversation, and while they mean well they may offer solutions that work for them and not you. A counselor will help you uncover the solutions that work best for you and help you find the motivation to follow through with your plan.Best of luck to you!


Context: Does counseling really do anything that can help people?

Response: Hello. Yes, counseling can be beneficial to many people. One of the effective components to effective therapy, is when the client becomes willing to participate in the counseling. I don't mean just show up and listen to the counselor for 45-50 minutes, but also that the client themselves opens up and shares with the counselor the issues that brought them to counseling in the first place. This requires you to be vulnerable, capable of moving past your protective measures of showing the best of yourself, and allowing the counselor to see the sides of you that likely are not as favorable. Therapy works when you and the counselor engage openly, honestly, and with mutual trust that both of you will work for common goals - your improvement of self. It does take time, and there are no quick fixes (usually), so be prepared to invest in yourself and explore the dark places. You'll thank yourself later, knowing that you are more connected to yourself and might even feel more whole after the process. Be well.


Context: Does counseling really do anything that can help people?

Response:
I believe that counseling (and finding a GOOD therapist)
will be of significant help when the individual seeking therapy desires change,
improvement, and overall growth. Most counseling involves homework and a level
of commitment outside of session that also contributes to resolution of
problems and an ability to cope with stresses in a productive way. Here are
some of the key ways that therapy can help.
1. Helps to define the problem and gain a clearer
understanding of where it originates. Many people seek counseling because of symptoms they are
experiencing. These can include feeling sad, increased sleeping, substance use,
panic attacks, self-harm, isolating one’s self, academic decline, etc. Often
times, people are not aware of what is causing these symptoms. Having a
therapist to help guide and explore why the symptoms are occurring and where
they come from will give individuals increased insight and awareness into their
problems.
2. Allows for a safe outlet to vent.
Not everyone likes to share their problems with close
friends or family members. Maybe they don’t want others to know of their flaws.
Maybe they don’t want to burden others with their problems. Or maybe they just
are not comfortable talking about themselves. And in some situations people do
not have the option of talking with someone they know because they have no
friends or family. While talking with those we know can help bring some relief
it is also nice to talk with someone like a therapist who is objective and
emotionally removed from given situations. Counseling gives a safe outlet in
which one can express their personal feelings and thoughts without feeling
judged.
3. Counselors can offer various problem solving solutions.

A good therapist usually will not directly point their
client in the direction they need to go. Counseling is about growth and
teaching the client to identify triggers and use effective coping strategies
that will bring about emotional and psychological relief. Counselors will help
clients to explore the various options available in given situation, based on
the client’s needs, wants, and values and will help them to choose the option
that best fits with their desired outcome.
4. Gives one the tools needed to cope with current and future
problems.
Many individuals that seek therapy have never learned
good coping strategies. Perhaps they did not have parents or caretakers to
model productive ways to cope or maybe the symptoms they are suffering from are
overbearing and take away the energy needed to cope. Different diagnoses
require different tools; however some are beneficial for any problem and any
individual. These include but are not limited to relaxation techniques,
breathing exercises, development of healthy routines, using mindfulness,
improving communication skills, and recognizing and changing maladaptive
thought patterns. A good counselor will teach clients how to use these tools,
will often practice them during session, and will assign homework for further
practice and mastery of the skills.


Context: Does counseling really do anything that can help people?

Response: Counseling allows us to have a sacred space, a space that is set apart from the outside world, it is a space of non-judgement and exploration. Being that the universe is not made for us and that the the world tends to be a fairly untamed place at times, this sacred space allows us to explore ourselves. It allows for greater reflection upon our attitudes, our behaviors and our feelings. Imagine if you will a small goldfish swimming around the usual fish tank, although I dont attest to know what a goldfish thinks, I would imagine he does not see the world outside of him, he only sees the small fishbowl, oblivious to the outside world, when one comes into the counseling room, one is trying to gain insight that was not previously there. Remember the observer affect, one cannot truly act objectively with the world, we are in a dynamic relationship with life, it reacts to us and we to it, the time in the counseling room allows us to gain an understanding that is beyond the normal limits, allowing us to see what was before hidden, often times in plain sight.


Context: Does counseling really do anything that can help people?

Response: Counseling can go a long way in improving your mental health. Counseling helps you to get new perspective on your life and problems.Talking about your problems with a counselor gives them substances and something to get a handle on. Talking about your problems gives you a chance look at your situation from a new angle to help solve your problems.The counselor is a neutral listener that can help give direction and answers to your needs.Counseling can help you solve your problems but also can set up a plan for the future. Counseling can help you to deal with things before they get out of hand.Give counseling a try.


Context: Does counseling really do anything that can help people?

Response: A lot of things affect how helpful counseling is for each person, including at least these things, but often many others:The therapeutic alliance (this refers to the bond, connection, or trust between the client and the counselor)What the person is coming in to work onHow motivated the person is to work on what it is they would like to changeSome people also ask how counseling is different from friendship. There is a similarity in the sense that hopefully both counselors and friends will listen to what you are experiencing, but that is really the end of the similarities. Some differences are:Counselors are specifically trained to phrase questions or statements in ways that help you to gain more awareness of one could be contributing to what it is that you are trying to change, both within yourself, and possibly with people around youCounselors have experience in using lots of different types of techniques (for example, focusing on finding solutions, looking at how the present situation could relate to your past, using role-plays or examples in session to help you learn new skills or ways of looking at situations, and probably hundreds of other things)Counselors are taught to look at what you are experiencing and ask questions about other related ideas that you may not have connected to what you are experiencingThere is a treatment plan in place (usually after the first, second, or third session) so both you and the counselor have an idea of where you would like to go with counseling (what you are hoping to change or learn) and a general idea of a plan for getting to your goalsIn general, I would say the following:Yes, counseling can help people who want something to be different in their livesCounseling is most helpful when the connection between the counselor and the client is strong enough that some trust forms (in other words, not every counselor or technique is helpful for every person)A lot of counselors will talk to you on the phone for a few minutes prior to you coming in for your first appointment to answer any general questions that you may haveIf you are working with a counselor and you feel as though you are not "clicking" or connecting with one another, give it three or four sessions before you change. Trust is not happening in one hour for most of peopleIf you are working with a counselor and you would like to be getting more or something different out of it, tell the counselor about that because typically modalities can be changedIf you are asking this question because you would like help with a specific issue, call a local counselor and discuss it so that you could have a more specific answer about possible options for counseling


Context: I've gone to a couple therapy sessions so far and still everytime I walk in I get nervous and shaky. Is this normal? Should I still be feeling like this?

Response: Hello. First, I am so sorry you are experiencing these feelings. They can be intense, I will do my best to offer some suggestions or thoughts that I hope will be helpful to you. There could be a number of things occurring. Therapy is a delicate, private decision and I would first like to commend you for the fact that you are not giving up, that you are working to figure this out, and make this work, it sounds like you are engaged and motivated to receive support from a professional, your continued  dedication and motivation will take you far. I would first start by asking if you have discussed this with your therapist, if you feel comfortable enough telling your therapist what is going on, maybe inform the therapist that  that you feel nervous and shaky. I am a firm believer in open communication between the client and therapist as this builds a healthy therapeutic relationship that yields positive outcomes, if this can be obtained and well received. This is YOUR time for healing and therapy should be a safe, supportive environment to not only process but to seek support and guidance from a professional who can help you move past the barriers. If you feel you are comfortable and able to speak to your therapist, that would be my first suggestion, is to tell he or she how you are feeling. If they know then they can help determine the potential cause and allow you to process and move forward. If this is left un resolved it will be hard for you to move forward. If you are not comfortable discussing this with your therapist, this may be something to take into consideration and worthy of thinking about: why you are not comfortable speaking to the therapist. I understand this is difficult. If I may offer one more suggestion, breathing exercises are very beneficial. Remind yourself what you are working to achieve, close your eyes in a safe moment and breathe in and out slowly, in slowly through your nose and out through your mouth with pursed lips. Breathe in for approximately 5-10 seconds, then let it out slowly. Be sure and do this when you are in private, and feel safe environment. When you begin, I suggest putting your hand on your stomach, over your belly button to feel yourself actually taking in those deep breaths. I know it may sound kind of silly but they really work and are incredibly helpful. We often forget to breathe, especially when we  are feeling anxious. You are supported here and try taking yourself through the above thought process and breathing and practice the breathing several times a day. I hope this shaky and uneasy feeling eases. Wishing you the very best!Laura Cassity, LMSW, LMAC


Context: I've gone to a couple therapy sessions so far and still everytime I walk in I get nervous and shaky. Is this normal? Should I still be feeling like this?

Response: It can be uncomfortable talking to someone about your life in the great detail that is normally necessary for counseling to be beneficial. Since you're already going to counseling, congratulations on taking that big, first, stress-inducing step. Hopefully by now you are starting to feel a little more comfortable with your therapist. It can be helpful to address this big "elephant in the room" and talk to your therapist about this. I do my best to help people feel comfortable when they come to counseling, but regardless of how hard we try, sometimes it is just a little hard to get accustomed to. The good news is, the more you keep at it, the more "normal" it will become.


Context: I've gone to a couple therapy sessions so far and still everytime I walk in I get nervous and shaky. Is this normal? Should I still be feeling like this?

Response: If you have only been to a couple of sessions, it makes sense that you might still feel apprehensive at first. Therapy is hard work! You may be talking about some things that you never talked to anyone about before. Opening up to stranger can be scary. After you feel comfortable with your counselor, and trust has built up and you feel understood in session, you should feel more relaxed. I would encourage you to talk to your counselor about feeling a little shaky. Sharing what the process is like for you is important in your work. If you still feel unsure about sharing after several sessions, it is important to take a look at that and try to understand where that may be coming from. For example, are you and the therapist not a good fit? But, again if you are just starting out in working together, feeling a little bit nervous makes perfect sense, and I encourage you to give it a bit more time and to talk to your therapist about how you are feeling.


Context: I've gone to a couple therapy sessions so far and still everytime I walk in I get nervous and shaky. Is this normal? Should I still be feeling like this?

Response: Hi there, Thank you for your question. It's absolutely ok to feel nervous going to therapy. I have experienced anxiety going to see my own therapist. There can be a few reasons why you might feel this way. First, it is always unnerving to see a person who is a stranger and to share intimate things with that stranger. You mentioned it has only been a couple of sessions. Your anxiety might subside as you continue to see your therapist and grow more comfortable with him/her. Another reason why you might feel particularly nervous is perhaps you are not comfortable sharing things. As children, we might have bad experiences opening up to others. Someone might bully or ridicule us, and that experience can stay with us for a long time, making it extra scary to share our intimate feelings and thoughts with others. If this the case, as you continue with your sessions and have positive interactions with your therapists, this anxiety will subside with time and you will re-learn that it is safe to share. And the last thought why you might feel the shakes is perhaps you know that you need to talk about some past experiences or memories that are uncomfortable and difficult. Regardless of the reason, it might help you to bring up your nervousness in your session and share how you feel with your therapist. Having an open dialogue about your anxiety with your therapist can help you resolve some of that anxiety and built greater trust with your therapist.


Context: I've gone to a couple therapy sessions so far and still everytime I walk in I get nervous and shaky. Is this normal? Should I still be feeling like this?

Response: Thank you for your question. It's completely normal and natural to feel nervous before a therapy session. Many people report having felt this way. I can't say enough regarding the amount of courage it takes to reach out and attend a therapy session. For many people, it can take weeks, months, or even years of contemplating whether to see a therapist or not before actually contacting one and attending the first session. It takes courage to want to work through any struggles you may be having or personal growth you aspire toward. In your question, you mentioned that you've "gone several times and are still feeling nervous and shaky." If you feel comfortable with your therapist and it's a good fit for you, I would suggest talking about this with your therapist. You don't have to struggle each time you have your appointment. Together, you and your therapist can work toward helping you have a different experience.


Context: I've gone to a couple therapy sessions so far and still everytime I walk in I get nervous and shaky. Is this normal? Should I still be feeling like this?

Response: Sure, why not!It's nerve-wracking to go to a man or woman you've never met before and who is a total stranger, that you are paying to take an interest in your life.  You're likely feeling an internal truth about the sessions, the man or woman with you, and the man or woman sitting across from you.  I'd listen to those feelings.Wouldn't it not be best to go to those around you that do provide comfort and aid, first?  Wouldn't it be better to attend to those of faith around you who have love to offer, first?  Wouldn't it be better to go to your family and loved ones, first? :)Might try that; see if your nervousness evaporates...


Context: I've gone to a couple therapy sessions so far and still everytime I walk in I get nervous and shaky. Is this normal? Should I still be feeling like this?

Response: What you are experiencing is extremely normal. Opening up to someone you don't know from a can of paint can elicit some uncomfortable feelings and make you feel shaky. With time and building trust with your therapist, you will eventually start feeling less apprehensive before sessions. Consider bringing this up to your therapist as you both can process this experience together and figure out ways of coping with this anxiety before you come into the therapy room.


Context: I've gone to a couple therapy sessions so far and still everytime I walk in I get nervous and shaky. Is this normal? Should I still be feeling like this?

Response: It’s very normal to be nervous going into therapy. You are being vulnerable and honest, which is always scary, no matter how many times you do it. The best part about therapy is that the more you go, the more confident you are in your ability to work through those difficult feelings, and while you still may sometimes get nervous, you will have confidence too!


Context: I've gone to a couple therapy sessions so far and still everytime I walk in I get nervous and shaky. Is this normal? Should I still be feeling like this?

Response: It depends on your definition of "normal"!:) I would say that the average client I see feels some level of nervous energy when they come into their sessions, and especially at the beginning. I think that with clients who I work with that have difficult times in relationships, maybe being able to trust people is tougher for them given their life experiences, the expectation would be that they have a harder time moving through those nerves and feeling more at peace in sessions.In my opinion, a competent therapist could help you explore where these nerves are actually coming from (talking about yourself, relating to another, something else?) I encourage all of my clients to bring up whatever emotions are coming up for them in the moment, as it's helpful to the client to recognize the "present moment" emotion and then being able to process, learn from, and move through to a more peaceful place, if that is what is being sought.


Context: I've gone to a couple therapy sessions so far and still everytime I walk in I get nervous and shaky. Is this normal? Should I still be feeling like this?

Response: Therapy can feel very weird to begin with - think about it, how often do we go and tell a relative stranger our deepest, darkest thoughts in the rest of our life? So I think its reasonable to expect a certain level of nerves as you get used to your therapist and to the whole process of talking about yourself and vulnerable topics. That said, its definitely worth bringing to the attention of your therapist (if you haven't already) to see if there is anything that they can do, or that the two of you can explore together, that might make the process feel less intimidating to you.


Context: I've gone to a couple therapy sessions so far and still everytime I walk in I get nervous and shaky. Is this normal? Should I still be feeling like this?

Response: It takes a lot of courage to go to therapy.  I have gone myself as a Counselor and know what that feeling is like. This is normal but hopefully you have become more comfortable with your therapist. This might be something to bring up to your Therapist and openly discuss (scary to do but its ok) this may even relieve some of your anxiety.  If it continues, you may want to consider trying another therapist as this one may not be the best fit for you.


Context: I've gone to a couple therapy sessions so far and still everytime I walk in I get nervous and shaky. Is this normal? Should I still be feeling like this?

Response: Therapy does not work overnight, oftentimes it is a lifelong struggle, the therapists job is not to "cure" you or to remove something but rather to make you strong enough to live your life with your own peculiarities and struggles, remember we are human and constantly fallible. Another important thing to note is that although you go to therapy, that is just a room, most of the magic and work takes place in your real life outside of that room.


Context: I've gone to a couple therapy sessions so far and still everytime I walk in I get nervous and shaky. Is this normal? Should I still be feeling like this?

Response: Yes, feeling nervous for the first few or several sessions of therapy, is completely normal.Therapy is an unusual way to have a conversation with someone.   The person is an expert in recognizing and understanding dynamics of human interactions.   For some people the fear is that the therapist knows more about you than you do yourself.In general terms hopefully your therapist has worked with many other people who've faced problems similar to yours.In this sense the therapist has a general idea of the basic dynamics you most likely are handling.No therapist could possibly know your particular details and your particular areas of upset or in what ways you feel unsure of yourself.Once you start to trust both your own right to tell your particular story and start to also feel that your therapist is listening attentively and cares what you tell the person, your nervousness will start to disappear all on its own.Good luck in getting the most from your therapy sessions!


Context: I've gone to a couple therapy sessions so far and still everytime I walk in I get nervous and shaky. Is this normal? Should I still be feeling like this?

Response: It is absolutely normal to be nervous about therapy.  Many people take years to make the decision to start counseling and although it is a safe place to explore feelings, it may be the first time you are facing certain issues.  It takes courage to face issues head on.  Being nervous is part of the process.  The fact that you are continuing to go to therapy sessions despite feeling nervous demonstrates your strength.  Keep it up!


Context: I've gone to a couple therapy sessions so far and still everytime I walk in I get nervous and shaky. Is this normal? Should I still be feeling like this?

Response: Yes, it is completely normal to feel anxious about therapy. Therapy often explores topics and feelings that are uncomfortable. The ultimate goal of therapy is to feel better but the process itself can be uncomfortable.


Context: I've gone to a couple therapy sessions so far and still everytime I walk in I get nervous and shaky. Is this normal? Should I still be feeling like this?

Response: For some people it's absolutely normal to feel nervous about coming to therapy.   It's sometimes hard to share our emotions and feelings with someone --- no matter how warm and caring the therapist is.     Are you comfortable with your therapist?  Is it a good relational fit?      Maybe this is a good thing to discuss with your specific therapist at the beginning of your next session --- maybe they can help you find some strategies or tools to make it easier?


Context: I've gone to a couple therapy sessions so far and still everytime I walk in I get nervous and shaky. Is this normal? Should I still be feeling like this?

Response: Well, it's generally okay to feel anxious or nervous about going into therapy, particularly in the beginning because the process of being open about what you are going through, much less to someone who you don't know well, can be anxiety-producing. It's also common to feel anxious when you are discussing something that is important, difficult to discuss, or you are making changes that are very difficult for you.The most important thing I can tell you, though, is to discuss with your therapist this idea that you feel nervous and shaky. Some anxiety can actually help to motivate or lead you toward change. There are also level of anxiety that can be counterproductive, so it's a good thing to discuss. Personally, I can tell you that I would want my clients to tell me about anxiety they feel 100% of the time. That opens the dialog to discuss whether it is the level of anxiety that they want to sit with and learn about in discovering more about themselves and their experiences and/or whether they would like to do something to lessen the feeling of anxiety.Thanks for writing here. If it caused anxiety for you to do so, I hope that feeling is diminishing for you, at least related to writing here.


Context: I've gone to a couple therapy sessions so far and still everytime I walk in I get nervous and shaky. Is this normal? Should I still be feeling like this?

Response: Certainly.


Context: I've gone to a couple therapy sessions so far and still everytime I walk in I get nervous and shaky. Is this normal? Should I still be feeling like this?

Response: of  I would love to know a little bit more about what's going on in your life but I will attempt an answer.Yes, you could still be shaky and nervous going to therapy. This therapy thing your doing is sometimes scary. First, because your opening up things that you might have never wanted to. Second, your still building a relationship with this therapist person. You may never get over that. The therapist really can't be your "friend". They are there to push the buttons that you might not want pushed and help you heal.  That in itself is scary and can make you anxious. Third, you really never know where this therapy thing will go. Yes, there are goals. But sometimes side roads need to be taken and sometimes that is scary.Know this you are in the right place. You are taking steps to change.


Context: I've gone to a couple therapy sessions so far and still everytime I walk in I get nervous and shaky. Is this normal? Should I still be feeling like this?

Response: It is absolutely a typical response.  Many of my clients are nervous the first couple of times we meet.  This is essentially a stranger with whom you are sharing your feelings.


Context: I've gone to a couple therapy sessions so far and still everytime I walk in I get nervous and shaky. Is this normal? Should I still be feeling like this?

Response: It's normal to feel a little anxiety--after all it's an important encounter for you.  My suggestion is to discuss this with your therapist, let him/her know how you're feeling, especially if you feel as though your level of anxiety is impacting the quality and benefit of your sessions.  You might try some relaxation techniques prior to starting the session, deep breathing, progressive relaxation, core muscle dis-engagement--If you're not familiar with these techniques ask your therapist or write back.


Context: I've gone to a couple therapy sessions so far and still everytime I walk in I get nervous and shaky. Is this normal? Should I still be feeling like this?

Response: Hello there.  You ask about being nervous and shaky walking in to your therapy session and want to know if its normal? ...  I realize there a few ways to look at this.  I presume you weren't anticipating feeling this way; and probably hoped to feel the opposite..  Well, my initial response is yes, sure, it can be within reason to feel this way.  Have you been in therapy before? Is this somewhat new? That could be part of the reason. But either way; new or not, I think when are entering into a meeting that holds potential evaluation of deep things about you and your heart and soul, it can cause anyone to tremble. The soul can be anticipating some things could be shaken up here, and it can feel scary to look at these things and then change.  Looking deep at our life can feel daunting and scary; so your response just might be regards to potential growth trying to happen.   OR, is there something about the therapist you don't feel confident about?  This too might be in play as a reason for your feelings...  Maybe you lack confidence in that therapist ?  Have you let your therapist know how you feel?  That would be good to explore...I would like to encourage you to look at these ideas.  Hope it helps.   Let me knowKindly,keithkeithcounseling.com


Context: I've gone to a couple therapy sessions so far and still everytime I walk in I get nervous and shaky. Is this normal? Should I still be feeling like this?

Response: "Normal" can be an insidious word to use because it can undermine your sense of worth.  It implies there's one particular way you should be behaving and can leave you feeling crappy and "abnormal" if you're not behaving according to that prescribed standard.  Instead, what I'd recommend is to pay attention to your emotional experiences when you're attending therapy.  Explore your feelings and thoughts without judgement and try to reflect and understand what's going on that's causing you anxiety.  Once you figure out the underlying meaning of the anxiety, you can figure out a way to handle it and action steps to take to diminish it.


Context: I've gone to a couple therapy sessions so far and still everytime I walk in I get nervous and shaky. Is this normal? Should I still be feeling like this?

Response: Everyone has different experiences going to therapy. Being nervous can be a typical emotion one might feel. Emotions are our body's way of telling us important information about ourselves. I would suggest talking openly in your sessions about this. That way you can process your thoughts and feelings with the guidance of your counselor. There are probably underlining emotions (fears or insecurities) that are being stirred up during your therapy sessions. Your counselor might suggest individual counseling depending on what you learn about your anxiety. In individual therapy you would have time to deal with your own stressors. As you address your issues, then you will have tools and skills that will be useful in addressing the couple relationship.


Context: I've gone to a couple therapy sessions so far and still everytime I walk in I get nervous and shaky. Is this normal? Should I still be feeling like this?

Response: I would be more concerned with how is this being addressed in therapy. Therapy can be a rewarding process, however often times we do not pay much attention to the messages being sent to our bodies. I believe in somatic therapy which deals with our mind & body connection. I would think it may not be a question of normal or abnormal however if it is impacting you then you must pay attention to that. It would be helpful to explore the feelings you're having  with your therapist. It may be something that needs addressing to help alleviate those feelings or have a better understanding of why they are showing up when it is time for therapy.


Context: I've gone to a couple therapy sessions so far and still everytime I walk in I get nervous and shaky. Is this normal? Should I still be feeling like this?

Response: It is totally normal - you have a lot riding on this and you're invested! Think about why you feel so shaky - is it something about the therapist or their style? If so, it would be a good idea to talk with them about it so you feel more at ease. In any case bringing up your feelings about therapy in therapy is totally appropriate and even necessary. Good luck!


Context: How does a person start the counseling process?

Response: Hello, There are many ways to approach a counselor and starting the process, however they all start with picking up the phone.  It's most definitely an uncomfortable feeling, but once that first step is taken it is often met with a wave of relief. My recommendation is always to call and speak with a therapist over the phone before scheduling an appointment. Listening to how they converse, use their tone and inflection, may give you a brief insight to how they will respond to you and increase your comfort right away. You may also discover, rather quickly, that this therapist is not the right match for you.Regardless of how you go about it, I like to remind all people who call, email, text or walk-in, therapists are a bit like pizzas - if you don't like the toppings, send it back! There are hundreds of therapists offering all kinds of styles of therapy - take the time to pick one that suits you.


Context: How does a person start the counseling process?

Response: Most counselors are very approachable and many offer a 15 minute chat by phone to allow you to talk about your issue, and to get a feel for the counselor.  If you like what you hear by phone, the next step is to set up a face-to-face meeting. Studies show that the most important element in effective therapy is that you feel a connection with your counselor.  Trust your instincts and if you don't feel comfortable, let him or her know that you don't think it's a good fit.  Many counselors list on websites like Psychology Today and Good Therapy.  Visit these websites to learn more about therapists in your area.


Context: How does a person start the counseling process?

Response: Hi! Great question! My suggestion would be to google therapists in your area.  One great website is called Psychology Today, which is a National site.  You can search for therapists in your zip code and search more specifically for the issue you are seeking support about.  It's a great way to find out if they therapist has a speciality, accepts insurance and whether they offer a free phone consultation. I would then make a list of the ones that may be a good fit and then give them a call!  :)  Hope this helps. Remember you get to ask anything you need to, to determine if someone is a good fit.  Don't be afraid to ask anything!  :)  Best of luck!


Context: How does a person start the counseling process?

Response: Hello. Counseling often begins way before the client ever actually calls the local therapist. There is often a tipping point in the internal struggle that the client experiences, where they can no longer deal with the issues on their own and thus giving the motivation to seek external help. That said, clients usually go seeking therapists based on what their insurance will cover, or what is likely to be more and more the case in the near future...what they are able to pay for out of pocket. That first phone call to a prospective counselor can often feel like torture, but it doesn't have to stay that way. Counselors are well trained to acknowledge the inherent goodness of all clients, and should be able to see and hear the sense of fear in the client of being judged or put down in some way. The counselor you select should be compassionate, caring, able to join with you on your journey to resolving your issues or concerns, and to do so without negative judgment of you as a person of worth.Once you have found a counselor you want to work with, you would then schedule an appointment to meet. That first session is often very low key. There might be some forms for you to complete, which will help the counselor address your concerns and learn a bit more about you. The counselor will typically provide you with what we generally call in the profession a professional disclosure or practice statement. This document (which may be several pages long) usually outlines the counselor's credentials; practice rules; forms of payment; office hours; emergency contact details; and confidentiality guidelines under state and federal law, among other details. All of this benefits you as the client, so that you are well informed and can focus your attention on why you are meeting with the counselor.In the first session, it is absolutely okay to be nervous. Here's a really big secret (which is important to keep in mind as counseling begins): Counselors are often as nervous (if not more) to meet a new client, as the client is to meet their new counselor. It's true. We as professionals are trying to put our best foot forward to impress you with our awesome counseling skills. While simultaneously hiding all the troubling unwanted issues that we ourselves have in our life too, and being worried that we might not know if we can help the client sitting in front of us. What makes it even more challenging, is that counselors are often put on a giant pedestal of perfection by clients (all while we as counselors tend to look at it like we're standing on a three legged stool). This is normal for us when seen from the eyes of the client. Counselors and clients are both human, and we both make mistakes. Coming from that place of understanding, might bring a sense of ease to both the client and the therapist as they seek to work together. Part of this perception of perfection held by clients toward counselors, is that the skills of the counselor might look like they have all the answers. We honestly do not, plain and simple. Counselors come from life experiences (where they might be farther down on life's road than you); they hold completion of various forms of training; and have advanced education. Yet we are in the end, imperfect beings struggling to help imperfect people. This makes it easier to be compassionate to new clients walking through our door with the hope that we will receive that same compassion in return. Very often, we can find ourselves reflected in our clients' lives with their struggles and can become more effective at helping if we have resolved similar issues in our own life. So as you begin to seek out a therapist, try looking for one who is aware of their own life issues and is actively working on them too. Someone who can meet you where you are at emotionally and can understand your sense of your struggle that you are facing at the present moment. That counselor may be a good example for you as you enter into therapy and build your own strength, and thus begin dealing with the issues more effectively you bring up in therapy.


Context: How does a person start the counseling process?

Response: Usually people call me by phone, they introduce themselves, we chat for a bit, then we schedule a time for their appointment


Context: How does a person start the counseling process?

Response: Honestly, don't :(Talk with your close friends, first (y'know, the ones you actually can tell sh*t to, not the more surface level ones, god-bless-their-souls...Be with your family; should you have a fine relationship with them, tell them and utilize them; they gave you life and that bond (especially between a mother and son) is unbreakable.Go with your faith; as often as various faiths have been blasted and lambasted around the world, understand that they're ultimately trying to get you closer to God :) And, ain't that a big thing.Go with those around you FIRST that actually MIGHT GIVE A CR*P about you, FIRST, before going to a total stranger you've never met before, that is just as damaged, stupid, and imperfect as we all are.


Context: How does a person start the counseling process?

Response: Great question!  You can find a counselor by doing an internet search or by asking your doctor for a referral.  Once you have the name and contact information for a therapist you want to meet with, give them a call.  Some therapists will provide a free 15-20 minute phone consultation.  This is a good chance for you to get some questions asked.  Be sure to ask about their fee, if you want to use your insurance ask them if they take your insurance.  Next you will want to ask about availability to make sure they have open times that fit in your schedule.  Once you make the appointment, in the first session you have with the therapist, the therapist will ask a lot of questions about what brought you into therapy and what you hope to accomplish in therapy.  I usually use the last 10 minutes of that first session talking with clients about how I might be able to help them with their concern and I gather feedback from them.  Here is a link to an article about how to speak with your therapist in those first couple of sessions.  http://thriveworks.com/blog/tips-open-honest-counselor/


Context: How does a person start the counseling process?

Response: Great question. Too often people search for the help they need via a phone book or a basic internet search. When looking for a new person to add to your team, whether it be a Counselor, Plumber, or Mechanic, it is important to know as much as you reasonably can about the person. I generally take the following steps: 1.) Know what is important to me in finding help. 2.) Ask for referrals from my trusted friends, family, and colleagues. 3.) Search for online reputation (Better Business Bureau, Yelp, etc). The absence of an online reputation is not necessarily a bar to consideration. However, a predominantly negative review may warrant further research. 4.) Finally call the Counselor and ask a few questions. Let the Counselor know what you are looking for. Trust your gut. For example, if you feel rushed or do not receive thorough answer, move on to the next. Taking the time to defining and conveying your requirements about what you are looking for in counseling can save you a lot of work down the road.


Context: How does a person start the counseling process?

Response: I'd recommend looking on psychologtoday.com, reading the bio's of potential therapists who you think you would relate best with, then contact them through e-mail or on the phone.