Many people I see for counseling have seen other psychologists in the past. When I ask about these experiences, a common response is “It didn’t work.” It is important for me to understand why it didn’t work and what expectations and goals my patient has for counseling. Sometimes the perception that counseling didn’t work results from lack of understanding about how the counseling process works.

Things to consider about counseling:

• Many people approach counseling expecting that they will feel better. They are often in a lot of emotional distress, and want to feel better right away. Counseling can stir up difficult emotions, which can leave people feeling sad, anxious, or tired after a counseling session. If these emotions feel too overwhelming for you, talk to your counselor about finding ways to cope with these emotions. One goal of counseling may be to feel better, but this may not happen right away.

• In most cases, emotional difficulties developed over a period of months or years. Just as these difficulties took time to develop, they will take time to resolve. Some research shows that, on average, people attend 3-4 counseling sessions before terminating therapy. This is not enough time to allow significant, lasting changes to occur.

• Counseling is like exercise: You get out of it what you put into it. Counseling, like exercise, can be challenging, tiring, and something that many people try to avoid.

• Your counselor understands you more as time progresses, and they will use counseling to help you understand yourself better too. Counseling is a collaborative process in which counselor and patient work together to set goals and monitor progress on those goals.

• Counseling sometimes brings up feelings and reactions that psychologists refer to as “transference.” Transference occurs when patients transfer feelings about other people in their lives onto the counselor. For example, a female patient may feel that people in her life constantly judge and reject her. She may then begin to feel like her therapist is judging her, and will look for signs that this is happening.

• If transference develops or you have any concerns about therapy, you can bring this up to your counselor. A good counselor will be open to receiving this feedback and discussing your concerns with you.

• Give counseling a chance before you decide to terminate. Consider sticking with it for at least 10 sessions. After those 10 sessions, you can talk with your counselor about your progress. Many times people are able to identify some progress they have made in those 10 sessions, even though they may still have more work to do in order to reach their therapy goals.