Therapy is no big mystery. Although it happens in the privacy of four walls, practically all of our clients will have had some level of exposure to it, whether it be through media representations, word of mouth, or past experience.
There are benefits to this level of awareness. It gives prospective clients a basic sense of what therapy entails and what it can offer, making them more likely to seek our services.
But popular conceptions about therapy can also be inaccurate. This can lead to specific misconceptions that lead to difficulties during therapy.
In this article, we’ll review some common misconceptions about therapy, and see how they might influence a client’s treatment. Then, we’ll consider some guidelines for how to address these misconceptions. This will allow us to ensure that our clients’ therapy gets off on the right note.
Misconception #1: Therapy is for people in crisis
Being in therapy can have a connotation of dealing with serious problems. A phrase we sometimes hear in our vernacular is ‘they need therapy’, a common — if not derogatory — suggestion that a person’s problems are sufficiently severe to warrant professional intervention.
Of course, therapy can be a first-line treatment for serious mood disorders or dealing with acute crises. But by no means is therapy limited to these cases. And in fact, some therapies are specifically designed for more common conditions.
For example, solution-focused brief therapy is an evidence-based therapy modality that emphasizes the client’s strengths, and tries to allocate their resources to solving common problems like adjusting to a new environment or relationship.
Data also suggest that therapy isn’t confined to the most serious cases. In 2019, 10% of the United States population utilized psychotherapy, suggesting that the problems they address do not need to be rare and severe events.
How might this misconception about therapy influence our clients? First, it may cause them to assume that their concerns aren’t severe enough to warrant psychotherapy. Second, it may add to the stigma of seeking psychotherapy, as they worry that doing so indicates that their problems are somehow severe, or set them apart in some way.
Therapists can respond to this misconception by normalizing the client’s concerns. By showing them that their concerns are shared by many people, we can lessen the degree to which they view psychotherapy as only in the ‘fringe cases’
Second, we can also bring a strength-based approach to the treatment. As early as the intake session, we can mention these modalities to them. If they give us the indication, we can start to use them, and this will help them to again believe that therapy is simply a process available to anybody who wants to improve themselves, regardless of the severity of their concerns.
Misconception #2: Therapy primarily involves talking about the past
One stereotype about therapy is that it focuses on past events. A common caricature of therapy portrays the client reclined on a couch and sharing details about some formative childhood experience.
This is likely a relic from the earliest form of psychotherapy, Freudian psychoanalysis. But today, it has hardly become an accurate representation. For example, many therapy modalities focus instead on the here-and-now of the client’s experience, including their relationship with the therapist and their interpretation of their present circumstances.
How might this misconception influence our clients? First, it may lead to some hesitancy about engaging with or committing to therapy. If they believe that an expectation is placed on talking about past events, especially challenging ones, they may decide not to do it altogether.
Second, clients may artificially focus on the past during their sessions. In certain cases, this may even be used as a defense mechanism, as they recapitulate their history to avoid dealing with present concerns or feelings about their therapist.
Therapists can respond to this misconception by providing education about therapy modalities that emphasize the present. This can be done as early as the intake session, and depending on the client’s interests, the treatment plan can even be shaped with these modalities in mind.
Provided that the client expresses an interest in these modalities, therapists can start to utilize them in the session. The therapist can continually return the client’s attention to the here-and-now with prompts like:
- “As you recall that event in this moment, how do you feel?”
- “In what way do you feel that this experience has stayed with you today?”
In this way, the therapist can balance the importance of explaining past events with the insight of remaining present-minded.
Misconception #3: As the expert, the therapist must have resolved their own problems
Although recent therapy modalities encourage a collaborative approach to sessions, the fact remains that many clients perceive us as the “expert in the room.” This often comes along with an assumption that we are free of our own faults, as clients project an image of wholeness onto who we are.
In some cases, this misconception may have some benefits. It can give clients hope that improvement is possible, especially when we’ve already disclosed that we went through similar problems as them. It also gives clients, particularly young children and adolescents, a positive figure to emulate and aspire towards.
Nonetheless, this misconception can come with downsides. First, the therapeutic relationship can be limited by the client’s idealization of us. For example, the client may not feel comfortable being vulnerable or sharing difficult feelings, as they don’t want to risk being perceived negatively by us.
Additionally, being perceived as the expert can prevent the client from setting their own goals and priorities during the session. When they rely on us too much, they may forfeit their own autonomy and refrain from directing the session in their own way.
Therapists can respond to this misconception by using mindful and judicious self-disclosure. Sharing the right story can convey to the client that the therapist, much like them, is also in a process of becoming, and is not immune to the common problems and frustrations of life.
Additionally, the therapist may utilize the client’s idealization as a source of insight. By curiously exploring what the client assumes to be the reason for the therapist’s success, the client and therapists can discover what the client already assumes to be the requirement for success. From there, it’s only a matter of applying them to the client’s individual life.
Addressing Common Misconceptions about Therapy to Empower Clients in Therapy
Clients don’t enter our therapy rooms as blank slates. They already have common misconceptions about therapy that have been given to them by popular culture, other people, and their own therapy experiences.
The three misconceptions discussed in this article can have real impacts on client’s perceptions of therapy, their participation in therapy, and the development of the therapeutic relationship. By responding to them in an effective way, we can ensure that the therapy process is as useful as possible to our clients.
