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7 Common Misconceptions About Therapy

(The following reflects my own theoretical orientation and practice principles when doing therapy. All therapists have different approaches to the therapeutic process and may have different perspectives.)

1. Therapy is a long, complex process that will take many years.

While some diagnoses and life experiences may require a longer time in therapy, the majority of patients I see benefit from brief therapy - 2 to 8 months. Psychoanalysis as portrayed in early Woody Allen movies had patients seeing a therapist 3 times a week! Most people couldn't afford the time or money to do that, nor is it clinically warranted.

2. Therapy costs a lot of money.

Most working people with health insurance benefits also have a behavioral health benefit. Many times the patient's financial obligation is a small percentage of the therapist's fee or a co-pay like that charged by a doctor's office. For folks without insurance, there are community mental health centers that operate on a sliding-fee scale. This fee is usually calculated on the patient's ability to pay.

3. If my employer pays for my insurance, they will find out if I see a therapist.

There are many safeguards in place to maintain the confidentiality of your sessions with a therapist. Most employers contract with a separate insurance company that administers the insurance benefit. In addition, all licensed therapists are under strict confidentiality guidelines. There are severe penalties for violating a patient's confidentiality.

One exception might be if an employee receives a mandatory managerial referral to counseling due to problematic behavior on the job - using alcohol/drugs or being aggressive with a co-worker, for example. Most of these kinds of referrals are through an Employee Assistance Program (EAP). In my experience with these types of referrals, the only thing I'm required to report is if the employee is compliant, i.e., if they kept their appointment, etc. I have never had to reveal any specific content of my sessions.

4. I will have to do everything my therapist tells me to do.

I probably encounter this "myth" more than any other in my work with patients. Therapists really shouldn't be dictating to patients. A good therapist will make suggestions based their experience with similar situations, on observations and cues they are picking up from the patient and what they believe may be helpful. Please tell your therapist if they are suggesting something that makes you feel very uncomfortable or isn't a good "fit" for you. If they continue to insist, it may be time for a new therapist.

5. I should share everything that happens in therapy with my spouse, friends, co-workers and/or family.

This is, of course, your choice, but I wouldn't suggest it. Therapy is for you. I find when you share your experiences often those close to you feel the need to make suggestions, offer opinions and make judgments. This can be counterproductive to making healthy and productive changes in therapy.

6. The therapist will want to know about my childhood and will only focus on that.

While some patients need to heal childhood "wounds" and this is a critical part of the therapy process, in my own practice examining childhood and developmental issues is only part of of my evaluation and focus. I believe that adults are the sum of their childhood, genetics, upbringing and life experiences to date. In the brief therapy model in which I work, addressing a patient's most pressing concerns is my primary goal. If achieving their goals are significantly impeded by the childhood issues, I will address them as needed.

7. Therapy is a painful process.

Change is difficult for most people. And therapy often is about making changes in unhealthy and nonproductive behavior. But there is also the opportunity for patients to discover hidden strengths and new, exciting perspectives. I often tell patients that it is very rare for someone to wake up in the morning and say, "Wow, I think I'd like to get into therapy!" There may be aspects of the process that are uncomfortable or unfamiliar, but a good therapist will help you through it.

- - -

These are just a few of the common concerns that patients have expressed to me over the years. I feel very strongly that therapy shouldn't be portrayed as a "magical" or "mysterious" process. Patients have the right to be informed and enlightened about this service that we therapists perform.


  1. I agree that depression is prevelent with Parkinson's patients--particularly in the elderly.

    My mother suffered with Parkinson's for over a decade and although she was naturally a very optimistic person, the frustrations of the disease could at times, take its toll.

    Another aspect that makes it difficult to even recognize is the "Parkinson's Mask" that renders their facial expressions almost benign. The caregiver might not be able to tell by simply observing their loved ones.

    Along with limited mobility and lack of purpose as their lives no longer include a career or caring for a family, it's no wonder that the dark cloud of depression would descend.

    I tried to uplift my mother's spirits with music, tv shows she enjoyed, including her in daily life and chores and celebrating every holiday we could with much of of a flare and hoopla than I truly had the energy to do. But I felt it was important--not only for my mother, but for my whole family.

    Depression is contagious--if you're not careful, that somber mood can travel throughout your home.

    In the end, my mother's tenacious spirit kept her above the swell of sorrow a good amount of the time, and I began to appreciate the small moments of grace and tried to capture them by journaling every day.

    I found that journaling eased my own melancholy and gave me a safe place to put my fears and frustrations--as well as capturing the sweet moments that can do easily slip by.

    Our journey became a book, MOTHERING MOTHER: A Daughter's Humorous and Heartbreaking Memoir, avaiable now on Amazon and in most bookstores.
    ~Carol D. O'Dell

  2. Great list Nancy. The expectation that therapists will delve into your childhood is a common one. Freud has a lot to answer for!

  3. I agree with the list. Because of the simple and easy life we experience through technology, we often think that there is an easy and faster way of treating those problems.

  4. I agree with Terri. Since therapy is situational, most people have no idea of the capabilities of therapy. People often have high expectations when it comes to the efficiency of the treatment.

  5. Thanks to all for your comments.

    I find that many people expect some magical solution to their problems when they first come to therapy. Since most of my work is utilizing thier strengths and re-framing their thinking patterns, I assure them that I don't have any magic answers.



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