When a therapist starts with a new patient, they don’t know what to expect.  Generally, therapists have little information on new patients.  The therapist may know the patient’s age, whether they have insurance, and other basic information, but they often don’t know issues related to why the patient came to treatment.  They don’t know what sparked the call they made to schedule an appointment.  They don’t know what their home looks like, who lives with the patient, if the patient is working, and what they hope to gain.  A good therapist can answer most of those questions in the first session, but only if the patient shares the information. Therapists can’t read your mind.  They are not psychics.  You have to share information with them and be honest if you want help with your concerns.

After the initial paperwork, I often ask patients “How do I help you best”.  I’m often surprised by how many people respond with “I don’t know”. Making a decision to schedule a session with a therapist is a big step.  It’s okay not to have a good idea of what kind of help you need initially, but you need to trust the therapist so they can help you figure it out. 

As a therapist begins to develop a treatment plan with you , they may ask about your current situation.  They may want to know what is going well and what areas you would like to be different.  They will want to know about your history, including medical and mental health information.  They may ask about family history, including your childhood and your parents.  Previous counseling and therapy will be important to share, and things that you already do to help manage stress will be important.  They need as much information as they can gather to help them help you quickly and efficiently. 

As therapy progresses, the hope is that they can help you develop goals.  Those goals may be in one area or many areas.   I rarely worked with someone who only had one goal.  Most of my patients had  multiple, from finding a new job to developing new relationships.  If they were trying to manage trauma, everything changed.  There was more to address.  If the goal was just being unhappy with life, the goal became to define what happiness might look like. Once goals were established, objectives could be defined and weekly tasks could begin.

Goals and objectives are different, and should be different, for each patient. No two people have the same history, experience, relationships, or goals for the future.  Different types of therapy work for different people, and there is a place for evidence-based practice treatment, but there is also a place for solution-focused and many other different approaches.  The more you share with your therapist, the more options they will have to offer related to treatment.

You don’t have to know your goals, or even why you came to treatment to start a path toward positive changes in your life.  As a therapist, I can tell you that I don’t need to know why you came, I’m just glad that you did.  I can offer support, ideas related to skill development, trauma processing, and hope for the future.  You bring the motivation and I will do my best to help you improve your future.  It’s all part of being happy, for life.