Frequently Asked Questions about Psychotherapy
Psychotherapy is a treatment based on psychological theories and empirical evidence
Therapists are professionally trained to help you using psychological theories and techniques. In Hong Kong, psychotherapy is usually conducted by a psychologist; unlike psychiatrists, psychologists cannot prescribe medication to you.
Psychotherapy is a time-limited and goal-oriented process
During therapy, the therapist will build a cooperative relationship with you and set up the goals of therapy together. The length of therapy varies and depends on your treatment needs and goals.
Psychotherapy is a process of self-change and learning
Psychotherapy cannot change the past or other people (unless they also participate in therapy), but it can help you to change yourself. Changing yourself might also change other people’s attitude towards you, but that is not the ultimate goal of therapy. To participate in therapy is to learn a better way to perceive and handle things in life, so that you can overcome difficulties and improve your ability to cope with challenges. If you can actively participate in therapy, do the exercise or activity outside therapy session as suggested by the therapist, and apply what you have learned in your daily life, you could significantly improve your treatment outcome.
Take cognitive behavioural therapy (a common form of psychotherapy) for example, studies showed that if a person keeps practicing the skills they learned from therapy, new neurological connections would form in their brain. This would affect their emotion, thinking, and behaviour, eventually forming new habits. Learning a new skill might be difficult at the beginning, but as long as you keep practicing it becomes easier as time goes by.
Regular and on-time attendance
Therapy sessions will be pre-arranged on a schedule, so you should plan ahead to make sure you can arrive on time and stay for the whole session. It is important to attend therapy regularly and on time. Arriving late would shorten the length of session, and frequently missing sessions would negatively affect treatment progress and outcome.
Share with therapist
Before you attend your first session, it is normal to feel worried and/or uncertain. To make an accurate assessment, clarify expectations and set up treatment goals, the therapist would need to first understand the problems you are experiencing. Therefore it might be necessary to discuss your family, work, and other background information during the first few sessions. This discussion could evoke emotional responses and remind you of negative memories. You may feel uneasy to share these personal issues and feelings in front of a therapist you just met, so it is okay to share at a pace you feel comfortable with.
There are various contributing factors to mental health problems. In addition to physiological causes, factors such as personality, thoughts, habits, behavioural patterns, social relationships etc. could also affect your mental health status. Therefore, a psychiatrist or psychologist would use different treatment strategies to tackle these different factors and speed up recovery.
Functions of different treatment strategies:
| Psychiatric medication | Psychotherapy |
| Handle chemical imbalances in the brain | Handle emotions, thoughts and behaviours that contributed to the mental health problem |
Being referred to receive psychotherapy does not mean your condition is getting more serious.
Psychotherapy offers an alternative approach to handle mental health problems besides medication. It could focus on factors of thoughts and behaviours that are symptomatic. To receive psychotherapy is to find more effective ways to treat the problem from different angles. Psychotherapy can potentially accelerate recovery and reduce chances of relapse.
In TV drama or movies, psychotherapy is often represented by hypnosis. But in reality, while hypnosis might be used in some cases, it is not a mainstream or common treatment technique.
Some common examples of modern evidence-based therapy include cognitive-behavioural therapy, interpersonal psychotherapy, mindfulness-based cognitive therapy, etc. These approaches are developed through psychological principles and empirical studies, and they follow different theories in treating mental health problems. If you have questions about your treatment, you can always discuss it with your therapist.
Psychotherapy is not one-way teaching, but a collaborative process between the therapist and the client, and therefore your participation is very important. The therapist needs your perspective to help create the treatment plan and goals.
Each person has a different way of living. Your therapist may suggest to you general principles or methods in handling problems, but you are the only one who knows best how to integrate them into your life.
Psychotherapy is conducted through talks. However, different from a casual chat, the therapist will focus on treating the cause and symptom of mental health problems with systematic discussions based on established theories. This process emphasises on helping the client better understand their thoughts and emotions, and both parties will work together to find out how to create positive change. Therefore, psychotherapy might involve sharing your thoughts and feelings, but it is not just a process of confession.
When necessary, your therapist may conduct some psychometric tests to help understand your mental status, but it does not mean your therapist can see through all your secrets.
During the process of psychological assessment, the therapist would systematically collect information from you and may use tools such as questionnaires to assess your cognitive ability, thoughts, emotional status etc. The whole process is conducted with you being conscious and you may choose at will whether or not to take the assessment or answer any specific questions.
Regardless of whether you are doing psychometric tests or in therapy, it is possible that some negative thoughts, emotions, or past traumatic memories may be recorded. Processing these difficult topics could be a necessary step in reaching the treatment goal, but it is also understandable if you feel worried or scared at first. A successful therapy requires that the therapist and client build a trusting relationship which inspires a sense of safety. It is only after such relationship is built could the sensitive topics be effectively processed, and the time it takes varies case by case. If you feel that you are not yet ready to answer some questions, you can always express your concerns to the therapist. The therapist will not force you to disclose things you are not ready to share.
At the end of therapy sessions, you may often feel that some negative feelings have been relieved, but that is not always the case. Sometimes you may feel stressed due to what is being processed during therapy. These are all normal reactions. Psychotherapy is a treatment aimed at long-term recovery rather than just immediate relief, and therefore we should not judge the effectiveness of each session by how we immediately feel after it.
During therapy you may be asked about your unhappy memories as well as negative thoughts and feelings, with the purpose of understanding your current challenges and helping you cope with them. As if treating a flesh wound, the process may not always be comfortable and pleasant; it may also be painful, but it is good for your recovery in the long run. Before the end of a difficult session, the therapist may also use relaxation techniques to help relieve some negative feelings brought up during the session, improving how you feel when you are leaving.
The job of a therapist is not to solve problems in your life directly, but if you have a problem related to your treatment goal, the therapist can help you find out what you could do to better solve this problem. The purpose of therapy is to let you understand and change the way to handle problems, eventually learning a better way of coping, so that you can continue to overcome difficulties after therapy has ended.
If you encounter any critical situation that needs immediate intervention (such as difficult to resist suicidal thoughts), please call emergency services.
Don’t get stuck in self-blaming
If you wish to maximise your gain from psychotherapy, you need to cooperate with the therapist and actively participate in the therapy process. If you are given “homework” such as some exercise to do at home, you should try your best to complete them. Having said that, the process of therapy is not always smooth and the path to positive change may be littered with obstacles. You may find yourself disagreeing with some advice from the therapist, or you may not be able to complete your “homework” for a variety of reasons. Many people experience these during therapy, so try not to blame yourself too much for it.
Be honest to your therapist
If you find yourself in the above-mentioned situation, or if you have other questions about therapy, the best thing to do is to bring them up during a session and have a frank discussion with your therapist on what caused the problem and what could be the solution. Honest response from the client, be it positive or negative, will help the progression of therapy. But if you continue to hide or evade these problems and make no effort to change, it would be very difficult for your therapist to help you effectively.
Reference source(s): Website of the Institute of Mental Health Castle Peak Hospital