Preparing For Trauma Work in Therapy
Preparing for therapy requires more than having motivation. To get the best out of your sessions, one of the most helpful things you can do prior to starting treatment is some background reading on trauma. Also, explore your treatment options beyond talk therapy. For instance, is EMDR a good treatment option for you? Would you do better with a cognitive vs. a sensory approach? This will help you and your therapist decide upon the best overall treatment approach for you. Below are some practical suggestions and reflections on aspects of therapy that many clients overlook in their decision-making process regarding therapy. Included are some tips on how to best prepare for your first session.
At Urim Recovery, we want you to value your sessions as “prime real estate” in which you learn about and practice new strategies that you take home and implement into your everyday life. Do much of your background reading, information gathering and preparation in between your sessions!
Mind and Body May Have Different Levels of Readiness
While many treatment approaches are helpful and evidence-based (i.e. supported by clinical research), clients show up with many defense mechanisms that protect them from exploring and addressing painful experiences like trauma. If you have never had treatment or have had much therapy to no avail, part of your preparation is to invite a mindset of acceptance regarding your body’s limitations. Hopefully, this will flow to your consideration of overblown expectations.
Many of the defense mechanisms that come into play to distract you from what you need to do in treatment happen subconsciously . So while a client might be very motivated, their minds say one thing, “help me, I’m ready,” while their bodies recoil at any intervention.
“At Urim Recovery, our theoretical approach to therapy is attachment focused and trauma-informed with a systemic perspective. We are goal-driven and outcome oriented and see the client as an active participant in their healing process. We believe that your environment, spiritual outlook, culture, family and power dynamics help shape you and impact your current level of functioning. We help you figure it all out so that you can feel vibrant and empowered in your here-and-now.”
Making Progress in Therapy
Sometimes individuals find themselves frustrated by the pace of progress and not realize that they are ambivalent (e.g. of two minds) about getting better.
It is normal to want to get better, but fear change also. This is a reflection of ambivalence.
Of course, not everyone is ambivalent and oftentimes defense mechanisms don’t come into play. Many clients are open or undecided about the course of treatment and things run smoothly from the first session onwards.
Try to think about your expectations of treatment and share these in your first session to make sure you and your therapist are on the same page. Don’t be afraid to ask about your therapist’s expertise to facilitate your meeting your goals. What works? What support does your therapist have for their recommendations?
Two Important Guidelines Before Starting Therapy
In addition to the things outlined below to prepare for your session, consider the following ahead of time as these factors can impact your progress and likelihood of success:
- Make sure your therapist’s style of therapy is compatible.
- Equally competent therapists can differ considerably in their approach to therapy. Some therapists are more directed in their approach than others. By “approach” and “style,” we are often referring to the theoretical perspectives by which therapists are trained which inform ideas about what impacts functioning and change.
Most therapists will have a blended approach that integrates the client’s needs in the moment and a variety of theories. Our perspective is heavily influenced by attachment theory and is trauma informed. Some questions you might consider for your initial intake and ongoing reflection:
- Do you want to drive the sessions or do you want more guidance from your therapist?
- Are you more solution-focused wanting to resolve symptoms in the very near future with a finite time-limited goal for treatment or do you prefer a psychodynamic approach to exploring underlying core issues, family dynamics, etc.?
- Some of the more popular approaches in therapy include cognitive, behavioral, psychoanalytical, humanistic, dialectical and existential. So, for example, a cognitive approach, quite common in treating anxiety and depression, is going to focus on thinking errors and perspective taking with a view that people experience mental health challenges when their thinking is not in check with reality. A behavioral approach will also look at problematic thinking and the environment that supports that thinking. A systemic approach, highly influential for therapists with a social work background, will look at outside influences and social systems that also influence functioning.
- If you are used to talk therapy, a more embodied “bottom-up” therapy approach with imaginal work, might not feel comfortable for you. No matter the scientific support for a particular approach, it never quite works if the fit between therapist and client isn’t right or your expectations don’t jive. Sure, flexibility is key, (for client and therapist), but sometimes the gulf is just too wide.
- Equally competent therapists can differ considerably in their approach to therapy. Some therapists are more directed in their approach than others. By “approach” and “style,” we are often referring to the theoretical perspectives by which therapists are trained which inform ideas about what impacts functioning and change.
- Determine how much investment towards your therapy you want to make during and in-between sessions.
- Reflect on how you want to take responsibility for your therapy. Many say they are “ready to do the work,” but what is that “work” exactly?
- Do you want to limit your involvement in therapy to the session? How do you feel about written work or reading? How much time do you have available to practice coping strategies?
- Do you need or want in-between session support? What does in-between session support mean to you? What are your expectations regarding therapist availability?
- Cost: Are finances getting in the way? Check out our journal information on affordability to reflect on your options.
Expectations and Readiness for Counseling
Many clients show up to therapy with expectations that don’t quite jive with their body’s state of readiness. One common occurrence is when some clients feel that they must “get their story out” no matter how triggering, before they can explore and address root causes. This can become problematic if clients take on more than they can handle as they can easily plummet into overwhelm and grow disenchanted with therapy.
It’s simply not true that you need to divulge every detail of your trauma to heal from that trauma. Sometimes repeating trauma details without therapeutic guidance on how to do so is merely retraumatizing.
Losing hope so early in the process can be devastating. Many clients come to realize that the ways of healing can sometimes be counterintuitive. Allow yourself to be curious about how therapy might work in ways that are beyond what might seem to make sense. Consider whether you might want to include supports in your sessions. Certainly, ask questions about why certain things work and others don’t. Sometimes it’s the case that individuals respond differently to certain treatments and sometimes it’s the case that certain individuals have been misdiagnosed. Common symptoms can mask very different underlying causes. Diagnosing by inexperienced therapists, self diagnosing and diagnoses by multiple providers are common reasons why some clients enter treatment with diagnoses that are incorrect and unhelpful in treatment.
Before Your Therapy Appointment
How Best To Prepare For Your Session
Doing a little background reading ahead of time can save you time, money and energy prior to starting your first session and provide an opportunity for acceptance of your current capacity to heal. Our suggestions below are to help you hit the ground running in your session and devote as much time possible to actual therapy.
Here are some other practical suggestions to hit the ground running in your first and subsequent sessions:
- Complete your intake paperwork ahead of your session.
- To hold your appointment, we require that you complete your paperwork within 48 hours of your appointment confirmation.
- That’s not two days before the appointment. It’s two days after your appointment confirmation.
- Some people schedule their session weeks ahead of time because of limited availability. Our intake policy allows us to limit costs associated with no shows. More significantly, it allows us to prepare ahead of time for your session so that you hit the ground running with therapy as opposed to doing paperwork in the session. We value your time as well as ours.
- Your paperwork will be in your client portal where you logged in to set up the appointment.
- We will send you a courtesy reminder to complete your paperwork if you do not do so. After that, you will have to reschedule a new appointment if you have not completed any intake paperwork. If you have any difficulty, please text us for help.
- Journal a typical day and bring it to your first session
- Identify your daily routine.
- Note any symptoms that occur indicating times, frequency, intensity and duration
- Provide examples of triggers
- Check your connection and technology before your first session if you are using telehealth. Arrive ten minutes early to your first session and check again.
- Have a back-up device on hand.
- Set your phone or computer at the right angle for face-to-face communication that frees your hands.
- Make sure your microphone and speaker work if you are using a headset. It’s not uncommon that a headset reconfigures your microphone/speaker settings. If this happens during the session, simply log in and log out.
- Charge your devices.
- iPads don’t tend to work as well as a computer or your phone. If you would like to engage in EMDR, please use a computer.
- Bring a daily planner with a weekly view, post-its and composition book to your sessions.
- In your first session, all will be explained as to how you will use these!
- Bring a Driver’s License or some other government issued identity card to your first session if you are using telehealth.
- You don’t need to upload an ID to your client portal if doing so is complicated or tricky.
- Remember, you must be in Arizona to receive mental health services in Arizona. If you go out of state, you must let your therapist know.
- If you are using telehealth, set aside a therapeutic space for your session that is decluttered and minimizes distraction.
- As a general rule, don’t engage in therapy from your work desk especially if work stress is an element you would like to address in treatment. If you have no option, try moving your seat or clearing your desk.
- Remove triggering elements from your therapeutic space. This might include selecting a time and space where you can maintain privacy.
- Many clients like to do virtual sessions from their bedroom for comfort and privacy. If this is you, please don’t do the session lying down or half asleep. Do what you need to stay alert.
Below are some links to information to help you understand trauma on a deeper level:
You can find other soundbites related to well-being, self-compassion and healing on our coaching website that adds a big picture perspective on well-being in the context of current events. Stay in tune with issues related to your well-being and mental health right here in the Urim Recovery Journal updated 2x a week.
