BEGINNER’S GUIDE TO THERAPY: STEPS IN THE THERAPEUTIC PROCESS

*Beginning therapy can be tough! There are so many different aspects that unless you’re in the know or have sought therapy before, you wouldn’t really have any idea about. My “Beginner’s Guide to Therapy” blog series will go over some of the most common questions I get from those seeking out therapy for the first time as well as helpful tips and tricks to make sure that you find the perfect fit for your therapeutic journey. Follow along on my blog for all the latest posts.

Have you ever wondered what exactly happens in a therapy session or how you proceed through therapy? Do you just sit down and start talking or is there a plan? Do you go to session a couple times and you’re fine or are you stuck in therapy for the rest of your life? Today I’m answering all those questions by pulling back the veil so you can see the exact steps involved in a therapeutic journey with me.

STEP 1: GOAL SETTING

I approach counseling as a collaborative, non-shaming process. I may have training in specific therapeutic techniques, but you are the expert of your own life. This means we work together to form the goals you want to achieve.

Whether you come in knowing that you want to reprocess a specific situation/belief or with a vague idea of  “I’m unhappy and I don’t want to be anymore”–we’ll work together to figure it out. We form goals Day 1 of therapy and continue to review them throughout our work together to guide the direction of your sessions. These are moving targets so if something isn’t working or we need to switch things up, we can.

STEP 2: A FOUNDATION OF SAFETY

We have to feel safe and secure to be vulnerable. It’s a necessity. Not only do you need to build trust in our therapeutic relationship, but also in yourself to do the work. One of the biggest fears my clients often have is that if they open up, they will emotionally flood and will no longer be able to control their feelings. It’s a paralyzing fear that leads us to pushing down our emotions until we simply can’t anymore. I work with you, at your own pace, to develop skills to deal with distress so that you can feel confident exploring emotionally charged topics–knowing that you can successfully bring yourself back to an emotionally neutral place. This is an ongoing process that we revisit throughout the therapeutic process, but an essential component that we start discussing in the very first session.

STEP 3: HISTORY TAKING & TARGET SELECTION

In order to know how we got here and what is causing the distress, we have to look in the past. Through an attachment and family systems lens we look at your history to start to conceptualize what your negative beliefs are and how they formed. This is an involved process that moves at your own pace and can include homework to help you get a deeper understanding of themes, patterns, behaviors, and meaning taken from certain situations you have experienced. This process helps clients gain the insight and understanding they need to feel confident in reprocessing. During this stage we also get a really good idea at what situations and beliefs you want to target with EMDR. With specific targets in hand we’re ready for the next step.

STEP 4: EMDR REPROCESSING

For most clients, EMDR reprocessing is the goal that we’re working towards. We’ve identified the distressing situations and beliefs that are holding them back, have coping skills and resources in place to handle emotions that come up, and we’re ready to start the process.

Our first target is always a minimally distressing target so that we can get our feet wet and you can see just how the process works without too much on the line. After a successful session (typically 45-50 minutes) with a minimal target we will move on to our main goal targets.

I like to use the phrase that we can either “pull leaves or cut branches” when it comes to reprocessing our big targets in EMDR. In this analogy we think of our brain as a tree with the the trunk being our sense of “self” and the branches coming off of it being various negative beliefs. Where the branch meets the trunk is our “touchstone event” or the first memory we have of a particular belief. It is the strongest connector of that belief to our self, which means two things: 1) It is a powerful and sometimes difficult event to reprocess 2) We will typically get the most relief from reprocessing it. These events are often rather young in our development and as we get older we have more and more events that occur that reinforce that original beliefs (these are the “leaves” growing on the branches). These reinforcing events are often a little easier to reprocess and definitely provide some relief, but they don’t get rid of the whole branch as easily as reprocessing the touchstone does. This means that we will still get to reprocessing the whole belief, it will just take a little bit more time and that’s okay. The important part is that you feel comfortable and confident with the work.

STEP 5: MAINTENANCE

Hooray! You made it to the maintenance stage! This means that you’ve done the hard work to reprocess the distressing beliefs and experiences that have been holding you back. You’re probably noticing some significant changes in your life and may be feeling pretty good right about now. This is awesome and I’m super proud of you. So where do we go from here? Well, that’s up to you. Throughout this process you’ve gained all sorts of skills to help you tackle life’s challenges as they come at you. That means that you will most likely be able to handle the day to day type stuff that comes up. Most clients at this stage go to once a month sessions. These are more check-in style sessions where we make sure things are running smoothly and therapeutically address anything that you may need a little help with. 

After a while of once a month maintenance sessions, with no significant issues coming up, it may be time to “terminate” aka end therapy sessions. This is a really beautiful moment in the therapeutic process because it is a culmination of all the work we’ve done together. Don’t worry, if something does come up in the future and you need help you can always reach out. But for now, go enjoy your life 🙂

So there we have it, all the steps in my therapeutic process with clients. Hopefully this helps demystify the process for anyone who has been curious about therapy, but scared to reach out because they don’t know what it actually entails.

Remember: You are worthy. You are capable. You are enough ❤

Best, Jess

About the author
Jess Kraemer, MA, PLPC

Hi, I’m Jess. I’m an EMDR therapist here is St. Louis, MO. I use EMDR in combination with CBT, attachment theory, and family systems theory to help adult individuals, adolescents, couples, and families work through the issues that have been holding them back from the life they want. I specialize in working with clients experiencing attachment issues and negative core beliefs–those pesky feelings of being “not enough”, “bad”, “unworthy”, and more. If things have not been feeling “quite right” in your life, let’s chat! Give me a call at 314-484-1196 for a free 15 minute consultation or send me an email at jkraemer@psychservstl.com.

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Jessica L. Kraemer, MA, PLPC is under the supervision of Dr. Brittany N. Murphy, PhD, LPC, BC-TMH MO License 2013022876

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THE INFORMATION PROVIDED BY ME ON THIS SITE IS FOR INFORMATIONAL AND EDUCATIONAL PURPOSES ONLY. NO THERAPEUTIC OR PROFESSIONAL RELATIONSHIP IS ESTABLISHED BY YOUR REVIEW OF THIS MATERIAL AND USE OF THIS SITE. NO DIAGNOSIS, TREATMENT, OR SPECIFIC THERAPEUTIC ADVICE IS BEING PROVIDED TO YOU. THERE IS NO INTENT FOR ME OR THIS SITE TO OFFER SPECIFIC PSYCHOLOGICAL OR MEDICAL ADVICE TO ANY PERSON. THE INFORMATION CONTAINED ON THIS SITE SHOULD ONLY BE USED BY YOU IN CONSULTATION WITH A QUALIFIED MENTAL HEALTH PROFESSIONAL THAT YOU ENGAGE FOR CONSULTATION AND/OR TREATMENT. NO GUARANTEES OR WARRANTIES ARE MADE WITH REGARD TO ANY INFORMATION PROVIDED BY ME ON THIS SITE. I TAKE NO RESPONSIBILITY FOR WEBSITES, VIDEOS, OR PRODUCTS HYPERLINKED BY THIS SITE, AND SUCH HYPERLINKING DOES NOT IMPLY ANY RELATIONSHIP WITH ME OR ENDORSEMENT BY ME OF THE LINKED SITES.

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