Psychotherapy 101

How does therapy work?

Congratulations! You’ve taken the first brave step to make an appointment and now you’re wondering:

  1. What to expect the first appointment
  2. Is therapy right for me?
  3. What makes therapy work?


It can be scary meeting a new stranger for the first time and that’s true in all settings but even more so when you’re expected to pour out your life to this person. The first appointment is called the intake and it’s generally one hour. Depending on the office, you may fill some paperwork online, at home or when you get to the office. The paperwork consists of the basics: your personal information, your mental health needs, some pertinent medical information and the legal aspect to therapy (like confidentially, your consent to treatment and if you wish to involve someone else in your treatment, like your partner or parent). The first appointment consists of expressing why you’re there in the first place, assessing if you’re right for the therapist (perhaps you need a different specialty) and you assessing if this therapist is right for you. Think of it like an interview where you’re asked questions and you get to ask questions too. The therapist is trying to assess whether you’re the right fit for the office (if for example, you’re in an outpatient setting and you’re an active substance user, they may direct you to AA or perhaps an inpatient setting that offers more intensive care). Even if you don’t like the therapist or the office, it wasn’t a waste of your time because A) they may have helped direct you in the right direction, in terms of care and B) you may have narrowed your search in terms of the therapist that’s right for you (or isn’t right for you).

So how do you know if therapy is right for you? Well we all have our challenges and even if you have an amazing support system of people you can speak to, you may need someone who’s objective and won’t tell you what they think you want to hear.  For example, if you’re unsure about relationships (whether to stay in one) or if you find that you’re struggling with finding or creating healthy relationships, you may want to speak to someone objective. Here’s what it comes down to: If you’re looking to make changes in your life, learn more about yourself and your relationships then therapy is the way to go. If you’re looking for someone to agree with you or dispense advice, then perhaps you’re not ready for therapy right now and that’s okay too.

So what makes therapy work? The short answer is you. Now I know that sounds confusing but I find that the biggest difference between what makes therapy successful for some versus others is honesty. If you’re ready to be honest about yourself, your situation and ready to take an honest look at your current reality then it will work. I find that what creates an impact on clients is when clients come in, they come in with the mindset of the ability to be introspective. Introspection is defined as: the examination or observation of one's own mental and emotional processes. So they come in making connections and being aware of themselves when they’re not in therapy. So what do I mean by making connections? Being aware of what we do and why we do it. So for example, making a connection would be “I realized that I started to ignore him because I feel like he always ignores me and it was the only way to get his attention”.  It's also okay if you don't possess this ability quite yet; it normally goes along with the process in therapy. What makes therapy work is working collaboratively (together with) a therapist and exploring one’s self: One’s own world, own thoughts, own feelings and own’s actions. Each therapist does this differently. I am goal-oriented, which means that together, we will come up with goals of what you want to accomplish in therapy and for yourself as an individual. Other therapists follow the model of psychodynamic, which means to let you talk it out on your own and they just sit and listen without much feedback or direction. You need to consider your own personality and what you need; there is no wrong or right way, it’s what works for you and at the end of the day, that’s what makes it work.





Shlomit Liz Sanders is a licensed Marriage and family therapist licensed in NY and NJ. She has worked in mental health agencies with severely mentally ill population that created a passion for learning more about trauma and the neuroscience behind it. Shlomit then got certified in trauma counseling and integrates work of neuroscience into her psychotherapy empowering people to learn about themselves and how they have an inner ability to heal. Shlomit has continued to work in private practice for the last six years helping individuals, couples and families on how to have healthy relationships, learn how to thrive with anxiety and depression, as well as provide parenting coaching and educate individuals on how to improve confidence and increase self-empowerment. She can be reached at [email protected]