what goals do I need to make therapy effective?
February 9, 2018 7:06 AM   Subscribe

so I've been thinking I should go back to therapy, I'm kind of struggling to cope with really low moods at the moment, but I don't want to go back on antidepressants , I don't think I've reached that point yet, and to be honest, they've never felt right to me and to be honest I cant stand the thought of going back to a psych doctor. The trouble is I've been to six different therapists / counselors in the past and its never really worked out.

Feed back from therapists in the past is that I havn't had a proper goal, and my goals such as get better, talk about family grievances, learn to cope, have not been acceptable in the last two therapists eyes, so my question is to have effective therapy what goals should I have in mind, also is therapy only effective, if I really want to do it? not because I feel It's the right thing to be doing it? I'd really like it to work I just don't know what mind set I need?
posted by anonymous to Health & Fitness (6 answers total) 3 users marked this as a favorite
Just to offer my own experience - therapy has been effective for me and my only goal was "feel less anxious." Your goals seem to me like a fine place to start.

So I don't really know what your therapist's problem was. Can you send the mods a message with your city? Maybe people could offer recommendations.
posted by mai at 7:28 AM on February 9, 2018

my goals such as get better, talk about family grievances, learn to cope, have not been acceptable in the last two therapists

Any therapist who can not tell you how to shift from a goal that may be "unacceptable" to one that is "acceptable" is a therapist that should be moved on from. And yes, usually therapy is best, I've found, if there is some sort of problem to be solved which would, to my mind, mean that you want to be doing it.

Put another way: some people like being in therapy because they feel like the act of having a therapist and going to one, as a thing, has utility in their lives (so they can tell an SO they are trying, so they can have a place to talk, so they can have some structure), other people walk in with a problem to be solved and a sense of being willing to work on whatever that problem is with the goal of some sort of measurable improvement. The latter have a tendency to do better since, as the adage goes, you can only change yourself, your reactions to things, etc. So therapy as a griping session is fine but probably less effective overall than therapy as a means to, over time, moving past your terrible childhood (or whatever).

So just from your post a few "goals" you could set

- I have been struggling with low moods and I don't want everything to feel so HARD all the time
- I would like to build up my toolkit for responding to low moods
- I want to be able to (concrete thing) more/less than I do now.

I'm in therapy for my anxiety and it's really helped. It gives me some structure but also it's helped me set up some routines in my life that are good for my mental health. Me and my therapist check in about how these are going. There are good months and bad months, but overall it's a regular thing I have in my life which I think makes me a more stable person, a better girlfriend and happier inside my own mind.
posted by jessamyn at 1:34 PM on February 9, 2018 [2 favorites]

The idea that you should have to come up with a goal for treatment to be effective is absurd. We don't expect this for any other type of treatment for illness or injury. Would you think treatment for cancer or heart disease failed because the patient didn't have a goal? I hope not. Mental illness is an illness like any other.
posted by Violet Hour at 4:19 PM on February 9, 2018 [1 favorite]

When I went to EAP (the common workplace benefit that offers 3 free therapy appoinments) we had to fill out a form stating the treatment goals because that's a formality with EAP. I don't remember the specifics, but it was only slightly less vague than "I want to feel better/develop better coping skills/etc." I can assure you this was a conversation and she was on my side. I was not made to feel bad for not knowing how to clearly articulate this. I think a conversation about what you expect to get out of treatment is useful, but not as a way to determine how worthy you are of getting counseling.

I do think therapy was effective and I want to get back to it as soon as I can. I think you already have the right mindset despite you second-guessing yourself.
posted by O9scar at 5:18 PM on February 9, 2018

Feed back from therapists in the past is that I havn't had a proper goal, and my goals ..., have not been acceptable in the last two therapists eyes,

As you can tell from the answers above, this wouldn't/shouldn't ordinarily be this kind of problem.
That makes me wonder you have gotten this feedback so many times. It could really be that you just got a series of unusually poor therapists. Two other possibilities that might be thinking about:
Is it the way that you seek therapists? Are you limited to particular facility or style of therapy that have a very goal-focused perspective that is not the usual? In that case, finding a therapist outside of that circle might be really helpful.

If not, is it possible that they are trying to say something else (more subtle or more complicated) about how you are approaching therapy? I realize that this is probably an impossible question - I just invite you to spend a minute thinking back in more detail about your various therapists and see if you can tease out what else might going on.

I'm not saying either of my suggestions are right - just suggesting that you think more broadly about why this keeps happening when the goals that you have such as "better coping tools" "feel less depressed" "improve family interactions" seem perfectly reasonable.
posted by metahawk at 5:53 PM on February 9, 2018

The mindset that helped me the most in therapy was one of radical honesty with myself and with my therapist.
The other mindset that helped is that therapy is your work, it’s what you do, not the therapists work. It really is up to you whether you get better or not. That idea scared me at first, and then it set me free.
posted by SyraCarol at 6:52 PM on February 9, 2018 [1 favorite]

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