You may have decided to seek help from a clinical psychologist, or you may have been referred by your physician, psychiatrist, friend, parent, school/college or workplace. Whatever the reason for visiting maybe, the first 2-3 visits maybe awkward and fraught with uncertainties. Once you reach the psychologist, you are generally asked a lot of questions first before being offered any guidance.

Through this document, I hope to address some of the myths surrounding psychologists; process of assessment and therapy and your role as a client.

Myths and Misconceptions

Myth: Psychologists can read minds

Truth: We are NOT mind-readers. We are trained in the study of human behavior. Based on what you say, your body-language, emotions you display and your actions, we can make inferences or hypothesis about what you may be thinking or feeling.

Myth: It’s just “talk therapy”, anyone can do that.

Truth: Its NOT just “talk therapy”. We are NOT “agony aunts” and we do NOT give advises. We are trained into the art of “active listening”, that is, hearing without judging. Moreover, we have specific psychological techniques to bring changes in your lives and alleviating symptoms.

Myth: All Psychologists know hypnosis and can make me do activities against my wishes

Truth: No, hypnosis is a specific technique that psychologists using psychodynamic framework may use. Also, even when you are under hypnosis, no one can make you do things against your wishes.

Myth: I will become over-dependent on the psychologist for every decision.

Truth: Initially, you may become dependent on the therapist to seek answers or advise, but the ultimate task of therapy is to make you self-reliant and teach you skills to make your own decisions and cope with stress.

Myth: I need the psychologist to provide me with ready solutions.

Truth: No, we do not and should not be giving you ready-made solutions. Its your life and you know it better than anyone else. Also, every decision has a consequence that you will have to wear. Thus, we act as facilitators and discuss solutions, but eventually you would have to make the decision.

Assessment

Human psyche is complex and no two human beings even with the same psychiatric diagnosis will have same issues. To provide psychological treatment, we need to understand the person behind the diagnosis.

A comprehensive assessment is undertaken in the first 2 sessions and information is added as therapy begins. Assessment begins with a detailed case history to understand the current issues, their origin, and dysfunction and distress caused by these issues. History also focuses on past medical and psychiatric issues, if any; understanding family and its dynamics and other relationships and the client’s personality and coping abilities. Also, client and their family member’s understanding of the current issues is taken.  

Once a detailed history is taken, one or more of the other assessment tools may be administered:

1. Psychological tests like personality tests (MMPI, MCMI, NEO-PI-R), Thematic Apperception Test, Rorschach Inkblot Test

2. Neuropsychological Assessment or assessment of memory, attention-concentration, executive functions, intelligence, visuo-spatial functioning etc.

3. Rating Scales to assess severity of symptoms, e.g., Beck Depressive Inventory, Beck Anxiety Inventory, Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Young Mania Rating Scale etc.

Therapy Process

Once the assessment is complete, the therapist will educate the client and his/her family-members (if required and if available) regarding:

• Diagnosis and its implication (if the client has a psychiatric diagnosis)
• Conceptualization of current issues (connecting past and present; role of client and significant others; maintaining factors; dysfunctional thinking patterns etc.)
• Therapy Process (primarily one-to-one sessions; family to be included if required)
• Relationship between thoughts, emotions, behaviors and physiological responses
• Logistic (approximate number of sessions, gap between sessions, duration of each session, pricing etc.)

The therapist may take a consent from the client for therapy. Once the formalities and psychoeducation are over, the therapist and client work together on developing therapy goals, which are relevant to the client. It is important to make goals as specific as possible. For example, “I want to be a better version of me” is too vague; but “I want to learn how to deal with stressful situations” is more specific and workable.

Each goal is embedded with a skill that can be taught to the client, e.g., understanding errors in thinking. Once the skill is introduced in the session, an “action plan” will be made till the next session. An “Action Plan” consists of activities that the client needs to do before he/she meets the therapist again. Some examples may include:

• Exercising daily for 20 minutes
• Maintaining a Dysfunctional Thought Record
• Practicing meditation daily
• Talk assertively to person X

Each session begins with the discussion on “Action Plan”, how it was completed. If its done partially or not done, therapist will discuss the issues that client faced because of which tasks were not done. Then the issues client faced in the intervening days are discussed. If required, a new skill is introduced and the session closes with an “Action Plan”.

Once the goals are achieved, the therapist will start preparing client for termination of therapy process and plan “booster sessions”.

Role of Client

We don’t expect “perfect” clients. We are not going to judge you for your short-comings and it’s OK to be vulnerable with us. We strive to provide you with a safe space wherein you can explore and accept yourself. However, there are certain things we hope the client would possess:

• Truthfulness: we believe in what you say and therefore, if you want to heal, you have to be truthful to us.
• TRY: you may not be able to accomplish tasks, but at least give a honest try.
• Be an active participant: We are facilitators and we expect you to be active in your therapy process – ask Questions, raise concerns, tell us if our therapy style is not working for you.

We sincerely hope that we can make a difference to your lives by helping you accept yourself; learning new skills to make your life more beautiful and meaningful!