Coping with Mental Health: Psychotherapy

What is psychotherapy?

Psychotherapy as a discipline can be roughly divided into two groups: insight based therapy, and behavioral based therapy. Insight based therapy generally focuses on thoughts and emotions and their relationship to past development and learning. The goal is to better understand yourself, your motivations, and your way of experiencing others and the world. Understanding allows you to work towards personal goals and changes, as well as greater coping with mental health conditions. Behavioral based therapies in contrast are generally present focused. They include plans for behavioral change with exposure to new experiences, homework assignments like journaling and trying new adaptive behaviors, the learning of coping skills (mindfulness for example), and modifying your thoughts and feelings to be more in tune with your circumstances. Likewise behavioral based therapy is targeted at improving coping with mental health conditions and/or meeting personal goals. A commonality between both groups is that the relationship a client has to the therapist is one of the most important variables for improvement. If you don’t get along with your therapist, therapy is far less likely to be successful regardless of the type of therapy implemented.
Some therapists practice “eclectic psychotherapy” meaning they blend different schools of thought to suit an individual’s needs.

Where to begin if seeking psychotherapy?

If you are seeking psychotherapy for help with mental health, it is important to understand the many varieties of services. You can find mental health professionals in hospitals, in clinics, in private practice, through social programs, at colleges and universities, and online.

You will first need to assess which type of service is most suitable for your circumstances. If you are a student for instance, you may consider your campus mental health and counseling services for easy access, cost, and familiarity with student life. If you are an adult suffering from a mental illness or think you might be, discussing your mental health with a primary care physician and requesting a referral, or speaking to your insurance company to determine what type of professional services are covered under your plan and available in your area, are good places to start. If you live with a physical health condition, ask your treating doctor for a referral to a professional who will understand the complications of illness and mental health. Many hospitals and clinics offer qualified services of this kind.

The primary goal is to find a service that is targeted towards your specific needs. Psychotherapists are trained broadly, but often specialize in specific areas like adolescence, sexuality, autism, depression, health, or ageing for example. Email or call to ask if your mental health needs can be addressed by the services offered. Be prepared to do a bit of searching and interviewing.

After finding a mental health professional, expect the first meeting to be a general assessment. You may fill out a questionnaire, provide your personal and family medical and mental health history, or verbally answer many questions. The initial meeting is a time for the professional to assess your situation, possibly diagnose your condition, and formulate a treatment approach. It is also a time for you to assess the professional and get answers to any of your questions.

What should you look for in a therapist?

Therapy often involves being vulnerable. Whether it is discussing your private life, or working to overcome something like a phobia that makes you uncomfortable, you will need to have trust in your therapist. Trust is not something that can be objectively defined, but when you meet a therapist for the first time reflect on whether or not this is someone you can see yourself working with. If you have the option, some shopping around may be warranted.

Another thing to consider is what you want out of therapy and your particular circumstances. Do you have specific goals or personal issues you would like to resolve? Or perhaps you want to learn better coping skills and strategies? Do you belong to a group — religious, ethnic, racial, sexual orientation or gender identity — that will require specific knowledge on the part of the therapist? Be sure to ask if the therapist can provide the type of services that will meet your needs. If they cannot, they are ethically required to refer you to a professional who can.

The practicalities

Insurance coverage often dictates how often and for how long you can see a therapist, as well as which ones are covered by your policy. Typically, a therapist meets with clients on a weekly or bi-weekly basis for 45-90 minutes, and therapy can be brief (6-8 sessions) or prolonged (a year or more). Likewise, there is group therapy that follows a similar schedule with many individuals meeting together. These considerations will all depend on your specific needs as well as your source of funding. If paying out of pocket, prices can range from $60-150 an hour depending on the credentials of the therapist.

Aside from professional services, there are also lay support groups. Though not technically psychotherapy, these groups often help people cope with mental health conditions. The National Alliance on Mental Illness for example provides weekly hour-long support groups in many cities throughout the United States. Alcoholics Anonymous is another community run support group that has branches worldwide. Utilizing an online search for support groups that meet your specific needs and in your area, could yield potential beneficial results.

The different professionals

There are many different professionals who can treat mental health conditions with psychotherapy or counseling services. The following lists the major educational and professional terms to look for:

Ph.D.

In clinical psychology, a professional with a Ph.D. has done at least four years of graduate training, their own research, and a residency term. They are trained specifically to treat and do research on mental health disorders.

Psy.D.

These professionals hold a doctorate of counseling, generally requiring four years or more of study. The emphasis of training is on clinical practice/counseling rather than research, with a required residency. They are qualified to treat mental health conditions, but might also specialize in broader areas like life counseling, or coaching to meet personal or academic goals.

LCSW

A Licensed Clinical Social Worker holds a Master’s degree requiring approximately two years of graduate study and supervised experience. Licensed clinical status denotes specific training for providing mental health therapy based services.

LPC & LMHC

Licensed Professional Counselors and Licensed Mental Health Counselors both require two years of Master’s degree training and supervised experience. Both licensures can provide mental health based therapy and counseling services.

Seeking psychotherapy for mental health conditions can be beneficial. For the diagnoses of major depressive disorder, panic disorder, and seasonal affective disorder, for example, reviews of the research have shown psychotherapy to be approximately equal in effectiveness to medication. The most promising outcomes for depressive, anxiety, and obsessive compulsive disorder have been found in a combination of medication and psychotherapy. The positive effect of psychotherapy in improving many mental health conditions is moderate, and is more effective than doing nothing at all. There is no cure for mental health disorders. Not all clients will benefit from the same therapist or the same type of therapy, or therapy as an intervention. There are many things to consider in choosing a therapist: cost, availability, time, the type of professional, and your own goals and specific needs that will inform the process.

View References
  1. Cuijpers, Pim et al. “The Efficacy of Psychotherapy and Pharmacotherapy in Treating Depressive and Anxiety Disorders: A Meta-Analysis of Direct Comparisons.” World Psychiatry 12.2 (2013): 137–148. PMC. Web. 10 Aug. 2017.
  2. Cuijpers, Pim et al. “Adding Psychotherapy to Antidepressant Medication in Depression and Anxiety Disorders: A Meta-Analysis.” World Psychiatry 13.1 (2014): 56–67. PMC. Web. 10 Aug. 2017.