exactly is therapy?
Therapy is actually a generic term applied to the
application of any technique used to improve a person's
physical or mental health functioning. We are
using the term on this site as synonymous with
psychotherapy, which is the application of techniques
aimed at improving a person's mental, social, and
should I expect from my therapist?
The relationship between a therapist and a client is an
extremely important one and should not be taken lightly.
Your therapist is the person with whom you need to be
honest, the one with whom you will share some of your
darkest secrets, your fears, and your dreams. He
or she will need to listen to you, understand what it's
like to be you, and guide you to the answers. Your
therapist will need to be honest with you and to educate
you on issues related to mental health and your current
Knowing this, your therapist above all should be someone
with whom you feel comfortable. There are a lot of
therapists out there, from Master's level counselors to
doctoral level psychologists, each one with a different
personality and a slightly different approach to
treatment. Find one you like. If you don't
feel comfortable, discuss it. If that doesn't
help, then consider a different therapist.
Remember, you are the client, which means the therapist
works for you.
There are many
reasons people seek the help of a mental health
professional, from simply wanting someone to talk with
and use as a sounding board to serious mental illnesses.
There are several reasons therapy might be considered
needed: (1) if you are seriously thinking about suicide;
(2) if you are seriously thinking about hurting someone
else; (3) if your thoughts, behaviors, or emotions are
causing significant problems in your life or have the
immediate potential to cause significant problems (such
as in kleptomania, pyromania, manic episodes, serious
depression, or agoraphobia).
The next question is 'who could benefit from therapy?'
Simple, pretty much anyone. Therapy isn't just for
people with a serious mental illness, it's also very
helpful for people with mild to moderate depression,
anxiety, relationship difficulties, sexual concerns,
etc., etc., etc. Recent studies have concluded
that approximately one in five people in this country
will suffer from depression at some point in their
lives, and that around 20 million people are suffering
from its consequences as you read this. Studies
also show that one in every ten people has a diagnosable
mental illness, but that only 20% are seeking help.
but it really depends on how you define success.
Therapy can help a person solve significant issues in
their life, can greatly reduce and even eliminate
symptoms of depression and anxiety, can improve
relationships, social skills, and even work performance
and motivation. But can it cure you of all your
woes? It's not a magic wand, unfortunately, and
therapy only works as well as the factors involved
(client's motivation, dedication, and openness,
therapists experience and skill, and external factors
such as time, resources, and support).
there different types of psychotherapy?
'talk' therapy or psychotherapy, there are several
factors that are common among most types. First
and foremost is empathy. It is a requirement for a
successful practitioner to be able to understand his or
her client's feelings, thoughts, and behaviors.
Second, being non-judgmental is vital if the
relationship and treatment are going to work.
Everybody makes mistakes, everybody does stuff they
aren't proud of. If your therapist judges you,
then you don't feel safe talking about similar issues
again. Finally, expertise. The therapist
must have experience with issues similar to yours, be
abreast of the research, and be adequately trained.
Aside from these commonalties, therapists approach
clients from slightly different angles, although the
ultimate goal remains the same: to help the client
reduce negative symptoms, gain insight into why these
symptoms occurred and work through those issues, and
reduce the emergence of the symptoms in the future.
The three main branches include Cognitive, Behavioral,
Therapists who lean toward the cognitive branch
will look at dysfunctions and difficulties as arising
from irrational or faulty thinking. In other
words, we perceive the world in a certain way (which may
or may not be accurate) and this results in acting and
feeling a certain way. Those who follow more
behavioral models look at problems as arising from our
behaviors which we have learned to perform over years of
reinforcement. The dynamic camp stem more from the
teaching of Sigmund Freud and look more at issues
beginning in early childhood which then motivate us as
adults at an unconscious level.
Cognitive approaches appear to work better with most
types of depression, and behavioral treatments tend to
work better with phobias. Other than these two, no
differences in terms of outcome have been found to
exist. Most mental health professionals nowadays
are more eclectic in that they study how to treat people
using different approaches. These professionals
are sometimes referred to as integrationists.
long does therapy take?
The length of therapy
really depends mainly on the issues being addressed and
the desire of the individual to feel better. Other
factors play a role, such as support from friends and
family, stressors, intelligence, and amount of insight.
Typically, however, some disorders require only short
term treatment such as simple phobias, impotence, and
other very specific issues. Some disorders can
take years to get to a resolution such as with victims
of severe sexual or physical abuse, bipolar disorder, or
some personality disorders. During this time,
however, treatment can wax and wane, so to speak, with
periods of really good days, weeks, and months, and
periods of not so good days. Treatment can also
progress more stepwise, with small gains being made at a
much does therapy cost?
Much like the
previous question, this one doesn't have an absolute
answer. Several variables play a role in the cost
of treatment for mental illness: (1) education and
experience of provider; (2) type and length of therapy;
(3) geographical location. When discussing cost of
treatment, most look at the amount of money it costs for
a one hour therapeutic session. The average rate
varies from location and professional, but can range
anywhere from $5 or $10 at a community mental health
center or other government funded agency to over $200
for a doctoral level practitioner in private practice.
are the differences between therapy and medication in
terms of treatment and outcome?
Therapy and medication are not necessarily rivals, and
are often used together for the maximum benefit of the
client. There are some disorders where medications
are almost always used, such as with schizophrenia and
bipolar disorder (manic-depressive disorder).
Those suffering from other disorders, such as those
related to depression and anxiety, can benefit from
medication, even if it only serves as a temporary fix
until the effects of therapy take hold.
Those who oppose the increased use of medication for the
treatment of mental disorders argue that they provide a
quick fix but do not address the underlying issues
involved. In other words, medication covers up the
symptoms without getting at the disorder. Therapy,
on the other hand can be focused on both the symptoms
and the underlying issues.
In summary, medication is the treatment of choice,
although often combined with therapy, for disorders such
as schizophrenia and bipolar disorder. Medications
typically work faster than therapy but once
discontinued, the symptoms will return unless the
underlying issues are resolved. Therapy is a
slower process and results may not be felt as quickly,
but it is a longer term solution for many mental health
the difference between mental health professionals?
A doctoral degree
which means a minimum of four years of graduate training
beyond the bachelors degree is required in most states,
as well as one year of internship and at least one year
of post-graduate residency. Typically psychologists
complete core coursework in therapy, assessment, and
research and are required to pass competency exams and
complete a dissertation prior to receiving their degree.
To be licensed, psychologists must pass a national and
state examination. Some states grant different licenses
for school, counseling, and clinical psychologists.
School psychologists usually work in
educational settings and specialize in working with and
providing assessment to children and their families.
Counseling psychologists typically work with individuals
dealing with transitional and developmental problems,
career issues, and mental health problems of less severe
psychopathology. Clinical psychologists are
trained to work with all mental health issues but may
have more training with more severe psychopathology and
less with developmental and career issues. Most states
license counseling and clinical psychologists under the
general term 'psychologist' and the scope of treatment
overlaps much more than it has in the past.
Psychologists treat all forms of mental illness although
specialties are not uncommon. Specialties include
children, adolescents, adults, geriatric, forensic,
neuropsychology, and health psychology. All
psychologists are trained as generalists but may have
one or more specialties depending on their training and
Social workers must hold a bachelors degree
in social work although many complete a Master's
program (two years beyond their bachelor degree) leading
to the Master of Social Work degree. Social
workers are often referred to as the liaison between the
patient or client and the community.
According to the Occupational Outlook Handbook
(1998-1999), "Social work is a profession for those
with a strong desire to help people. Social workers help
people deal with their relationships with others;
solve their personal, family, and community problems;
and grow and develop as they learn to cope with or shape
the social and environmental forces affecting daily
life. Social workers often encounter clients facing a
life-threatening disease or a social problem requiring a
quick solution. These situations may include inadequate
housing, unemployment, lack of job skills, financial
distress, serious illness or disability, substance
abuse, unwanted pregnancy, or antisocial behavior. They
also assist families that have serious conflicts,
including those involving child or spousal abuse."
Mental Health Counselor
Mental health counselors typically have a
Masters degree in psychology, social work, counseling,
mental health counseling or related field and pass a
state exam in order to be licensed. Mental health
counselors can practice independently in some states,
although most are employed in clinics and hospitals.
They perform individual, couples/family, and group
therapy, and may assist psychologists with testing and
other forms of treatment.
Marriage and Family
Like mental health counselors, a Master's
degree is typically the minimal requirement for marriage
and family therapists. They receive special
training in the dynamics of families and relationships
and often treat couples who are having marital or
relationship difficulties and families struggling with
dysfunctional interactions. Many marriage and family
therapists are provided more general training, allowing
them to perform individual and group therapy as well for
a variety of mental health related issues.