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Goals
Setting expectations :
In order to keep psychotherapy moving forward, we like to set goals that make sense to both the therapist and the client. Goals may be relatively specific (e.g., eliminate panic attacks, improve sleep, become more assertive in my relationships), or they can be quite general, especially at first (achieve more sense of control over my life, feel more confident around others). Of course, goals will evolve over time and can be quite flexible. But keeping goals in mind has two strong advantages in psychotherapy.
First, it keeps the focus on positive change. Without that focus, psychotherapy sometimes lapses into being directionless. Talking about problems with a professional can sometimes create the illusion of helpfulness, even when there is no real direction - a situation that we want to avoid.
Second, it is much easier to keep track of how well psychotherapy is progressing if we have a clear sense of where we started and what we would expect the course of treatment to look like. We do try to give a general estimate of the number of sessions recommended for a particular type of problem. For most problems, this number will range between 5 and 50 sessions.
Experimental attitude :
Another aspect of therapy we like to emphasize is a trial-and-error approach, where we try out different possibilities, building on the ones that are the most effective and modifying or discarding the ones that do not work. Psychotherapy can get bogged down when there is an assumption that the techniques or approaches being tried will eventually work for all people. Surprisingly, being flexible in this way is relatively rare in therapy - with many therapists and clients sticking with an approach for long periods of time even when it is not working.
It is sometimes easy to believe that things may need to get worse before they get better or that sticking with the same method will eventually bear results. In fact, the evidence tends to suggest that if an approach is not working relatively soon, it is necessary to change directions for improvement to occur. Therapists and clients need to take an honest and curious approach and be willing to move away from ideas that are not helpful in order to find the ones that actually are effective. Otherwise, therapy can create an illusion of being helpful and important without actually leading to desired changes.