What Happens in Therapy – Stays in Therapy. This is in fact the code of confidentiality for all mental health professionals whether they are a PhD, provide Marriage and Family Therapy, Mental Health Counseling or are Clinical Social Workers.  If you or a loved one have participated in a counseling session, you’re probably aware that confidentially is of utmost importance when it comes to mental health services. Depending on the professional code of conduct and other state laws and regulations, you have may have heard or read this confidentially clause with one caveat – “except when the client threatens or attempt to commit suicide; if the client(s) threatens grave bodily harm or death to another person” and so on and so on. The confidentially clause may be revoked under very few and specific circumstances that are carefully reviewed during the initial appointment. 

Therapy Can Be Tricky

The tricky part can be finding the right therapist for you. There are decisions clients must make as they navigate through their journey to find a counselor. As important as this process is for the actual client, it often goes unnoticed by the actual professional. The searching process generally takes one of  the following scenarios – client browses Google, contact their insurance provider for in-network therapists, search by recommendations and word of mouth, viewing an ad on one (or multiple) social media websites, searching on Psychology Today, Good Therapy or  other online directories. Ultimately, one way or the other, clients will make up their own mind as to who they think they can work with.  And so the first challenge – finding a therapist who fits with their idea of what a mental health counselor should look like is finally completed. This initial phase of the searching process establishes the grounds for the potential therapeutic relationship that is to occur. Typically this is a one sided decision that clients make which signals that they are ready to begin.

Once a client has taken taken this step, has booked the first appointment and attends their first session, the mental health professional begins to lay the foundations of the mutual therapeutic relationship. The actual work may be scary, sometimes too scary even for clients who have done extensive research and have read several therapists profiles. Often, the ideas clients have of the selected counselor clashes with reality during the actual appointment. The vibe is not right, the fee is too high, clients begin to realize that there is a lot of work that they need to be willing to do. And sometime that may be very scary… Why you might ask? Well, for starters,  clients may feel uncomfortable bringing up long held beliefs or deeply rooted feelings of unworthiness and self-hatred as these are very personal and can be difficult to talk about. They may feel that these topics are taboo, should be left untouched and unspoken for fear they may unveil traumatic memories and events hidden behind carefully crafted defense mechanisms. Whatever the reason may be, therapy is a very private and intimate matter. And that privacy is to be honored and respected.

The tricky part of the therapeutic relationship applies equally for the clients as well as the counselors. Why you might ask? The relationship is not equal in terms of power. On one side you have a person seeing help as their coping mechanism may not be able to sustain the stressors affecting their lives. On the other hand, the counselors are sought out and paid for the services and knowledge they provide. Clients deserve to be respected and recognized as owners of their own destiny. One of the first things I inform all of my new clients is that I can not guarantee  immediate change in their behaviors or current circumstances. Growth is painful! Remembering unpleasant events and becoming aware of feelings attached to those events can bring on strong feelings. What I can offer is to show a wholehearted support and do my very best to understand them and their repeating patterns. I work with my clients to clarify what it is they want for themselves, what do they want to achieve? What are their goal? Once clarified, both client and therapist can begin working towards progress and improvement of current symptoms.

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