How To Therapy: Frequently Asked Questions
I used Google to identify some commonly asked questions about therapy. This blog post answers some of these questions. If you have questions about therapy and you’re not sure where to go to find the answers, keep reading below:
What do therapists write down during sessions?
Every therapist is different, so there is not one single answer to this question. I have known therapists who write down as much as possible about the session as part of their documentation and I know other therapists who never write anything down. I rarely take notes in session. When I do, it’s usually because we are doing some kind of exploration where it is important to document the details, such as exploring core values or creating a detailed plan for the client to reach a personal goal. Occasionally I will document a word or statement that I think is important to remember exactly, such as if a client recognizes a specific negative core belief that impacts their self-worth. And sometimes I’m just documenting something that needs to become part of the client’s file that I’m not likely to remember when I write the notes. For example, most insurance companies require that I document the exact start and end time of the session (ex: 9:02 am - 9:57 am). Since I’m unlikely to remember the specific time when I write the progress note several hours later, I’ll quickly write down the start time of the session.
You should always feel safe to ask your therapist what they have written during your session.
Can I ask a therapist for my notes?
The answer to this depends on where you are located, as different states/regions/countries have different rules and laws about this. In the state of Colorado, where I practice, the client is the legal owner of their client file and therefore can request their case file at any time. This would include notes. The therapist does have a little discretion in what to share, and they can hold back on documentation that they feel may cause the client harm if the client were to misunderstand the note.
Therapists are allowed to charge a fee for the time spent preparing the documentation and sending it to you. We are also required to have you sign a written Release of Information document giving us permission to send you the documentation.
Also, please note that I am not a lawyer and by stating the above information I am not giving any legal advice.
Can a therapist hug a client?
Yes, we can hug a client. Therapists are permitted to have physical contact with clients, just not sexual or romantic contact with clients. Each therapist is different and has different approaches to this. First, we must respect the autonomy of the client. If you feel that a therapist is coercing you or forcing you to have physical contact, that is not okay and you can tell the therapist to stop. At the same time, clients must respect the boundaries of the therapist. If your therapist has a rule that they do not engage in physical contact with clients, you must respect that rule.
Personally, my policy is that I only have physical contact - including hugging - during my last session with the client, and only if the client specifically requests it. Some clients choose to say goodbye without physical contact. Some request a handshake. Some request a hug. If we are saying goodbye, then I’m happy to oblige, but I will not engage in physical contact with clients at any other time. I choose this policy because it is aligned with my own personal boundaries and it ensures that the client does not feel coerced or forced into unwanted physical contact. It also maintains strong boundaries about our relationship. But, there is no law stating that it has to be this way. I know therapists who choose to hug clients regularly, and that’s just fine.
Can you tell your therapist good things?
Yes! Most clients understandably do not want to spend a lot of time in therapy talking about good things because they are there to resolve unwanted symptoms that are causing them pain. But, it’s both healthy and exciting when a client shares good news in therapy! Sometimes it’s healthy to have a session where the client just tells the therapist things that they are proud of, they are excited about, and that they are happy about. It helps us to better understand the client and helps the client to recognize that their life isn’t just about pain, anxiety, or depression.
If your therapist doesn’t encourage you to share good things, go ahead and let them know that you want to share something good with them. They are likely going to encourage you to do so and will enjoy sharing in something positive with you.
How do you politely quit therapy?
This is a good question to ask because it’s not always clear how to do this. Typically, a therapist is going to want to hold a final session (called a “termination session” because you are terminating the relationship). In this session, we go over the history of our work with the client, we gauge how well they met their treatment goals, and we say our goodbyes. This session is not required. It is completely okay to send a message to your therapist using whatever means you use to communicate with them outside of session (in my case, usually text messages) and say that you want to either stop or take a break from therapy.
If you have been working with your therapist on suicide ideation, self-harm, substance use, eating disorders, or other symptoms that could put you at risk, your therapist will likely want to either continue working with you or will want to ensure that you are going to work with another therapist. While this may feel intrusive, it’s important. We have an ethical duty to ensure that our clients are safe. If a client has symptoms that put them at risk, we need to do our due diligence to make sure that the client is safe. If this applies to you, then it is best to have a conversation with your therapist and see what your options are to maintain your safety.
If you do not have symptoms that put you at risk, then your therapist should respect your decision. You should expect to see some kind of confirmation that your therapist has closed your client file (usually it is a letter sent either via mail or electronically). Some therapists will ask you to come in for a final session with them. This is your choice and you do not have to have a final session with your therapist. (Note: some jurisdictions are different and I do not know the laws outside of Colorado, so if your state/country requires a final session then this does not apply).
Please do not ghost your therapist. I know it’s difficult to tell someone that you don’t want to work with them, but it is important to communicate that you are no longer going to attend sessions. Ethically, we have to follow up with clients and check on their safety. So, if you ghost your therapist you may hear from them multiple times before they close your file. This is because they are doing their due diligence to attempt to ensure that you are safe and that you know that you are welcome to attend sessions. We are required to make at least some kind of attempt to reach out, so expect that you’ll hear from your therapist if you try ghosting them.
Do you have more questions about therapy? If so, feel free to contact me. If you’re in Colorado and you’re interested in working with me to overcome anxiety, burnout, trauma, or to help you figure out what you want to do with your life, contact me to schedule a free 15-minute consultation. There’s no obligation, so contact me today!