FAQ
Therapy is an endeavor of growth. Anytime we try something new, it is natural to feel nervousness or trepidation. That’s one way our hearts and minds inform us that we are genuinely turning towards change. It’s also natural to feel nervous to let a stranger so close to our fears, insecurities, fantasies, and emotions. The therapy relationship is unlike any other relationship in modern society. We sometimes let therapists closer to our inner emotions than we let our partners, spouses, parents and our friends! Once we make a decision to begin this endeavor it is imperative that we find a therapist who we feel genuinely can meet us where we are. Someone that we get the sense can actually hear us, can give us reflections, and can engage with us honestly - while also having our best interests in mind.
How do I choose a therapist?
If I were looking for a therapist, I would consider the following:
How I feel inside when I talk to them on the consultation. Do I feel comfortable? Even if I am anxious, does part of me feel at ease talking to them?
This is the most important thing I would consider. More gets communicated non-verbally and subconsciously than we know. If the therapeutic relationship is to be healing, the foundation of that healing comes from feeling comfortable to share with the therapist. My body can tell. That doesn’t mean I am going to be comfortable in sharing everything, necessarily. Or not feel anxious. It just means I get the sense that my experience is welcomed. This is what we call “attunement.”
How do they approach therapy?
I myself, would not go to a therapist who is highly structured, gives me worksheets or thinks they can have all the answers. I probably would not go to a primarily CBT therapist. I don’t share that epistemology in regards to therapy. Though, that doesn’t mean that kind of approach wouldn’t work for you.
What is their background - both in training/education and in their own healing process
It is important that I understand how they think about therapy process. Perhaps because I am an insider, but I have belief about what is healing in therapy. So I am interested in their background and training because of that. I don’t want to bash other therapists, but not all trainings are equal in their depth. I want to know that my therapist has committed to a life of self-reflection on their emotional patterns and has done a good amount of their own work in their own therapy. Otherwise, I would be very concerned about that therapist’s ability to hold space for me and not be critical or pathologizing.
If we must talk about modalities…
There are many different theories of psychology applied under the umbrella of therapy. It is not essential that you know all about all of them (unless you want to investigate). Many therapy methods overlap in function, while using different terms. Some therapy methods repurpose older therapy methods in new words and simply have good marketing or public exposure (IFS is an example of this).
CBT is the most widely practiced form of psychotherapy in the US. It focuses on the relationship between our thinking, our emotions, and our behavior. Other therapy approaches definitely focus on these things, however CBT tends to do so in a highly structured way. I think CBT is useful at times for some people, but I find that it can too easily reinforce the suppression of our internal states; bringing short-term relief but in the long-term not really supporting deep change. Of course there are many excellent and skilled clinicians who practice CBT; choice of modality doesn’t equal clinical skill or competence.
My orientation…
My approach to therapy is integrative and grounded in a neurodevelopmental perspective. I am primarily a relational therapist; meaning I observe emotional and behavioral patterns that unfold in relationship experiences and help clients develop insight into them. I draw from psychodynamic, developmental, behavioral and neuroaffective theories. I help clients connect with their bodies as a source of wisdom, which is often called somatic work. I believe that our default patterns have served a purpose that we want to understand. If we try to just push past them without developing insight into their role, most often we get stuck. As we understand these patterns more and more, we develop new pathways for both self-expression and self soothing. I see our emotional patterns as systems, and I help my clients learn the signals of these systems.
If you want to read more in-depth about my thoughts and approach to therapy, check out my substack post below
Does what we talk about in therapy remain confidential?
Confidentiality is a cornerstone of the therapeutic relationship. What you discuss in therapy sessions remains private and protected by strict ethical and legal standards. Therapists are bound by confidentiality rules, meaning they cannot share your information without your explicit consent. There are, however, a few exceptions to this rule, such as situations involving imminent harm to yourself or others, or cases of abuse. These exceptions are in place to ensure safety and well-being. Understanding these boundaries can help you feel more secure in sharing openly during your sessions. Confidentiality fosters a trusting environment where you can explore your thoughts and feelings without fear of judgment or exposure.
How long will therapy take?
The duration of therapy varies greatly depending on individual needs and goals. Factors such as the complexity of the issues being addressed, the frequency of sessions, and the therapeutic approach used can all influence the length of therapy.
Very often, however, progress is non-linear. This is what I have come to expect in therapy. We may take two steps forward and one step back. Sometimes we take several back. However, each time we learn something new about ourselves that we can apply in the future. We deepen our awareness into our emotional patterns giving us more freedom and flexibility.
What can I expect during the first session?
In a first session we discuss the nature of our agreement; what it means to enter into a therapy relationship. We will discuss your history, your concerns, and what you hope to get out of therapy.
How can I get started?
I'm here to talk during a free phone consultation where you can share what’s going on for you and I can share my ideas around how I can help you.
Email me today to get your free phone consultation at scott@scottmenasco.com.
or sign up through the calendar below!