Why do people consider using psychotherapy?

Psychotherapy is a partnership between an individual and a professional who is licensed or certified and trained to help people understand their feelings and assist them with changing their behavior. According to the National Institute of Mental Health, one-third of adults in the United States experience an emotional or substance abuse problem. Nearly 25 percent of the adult population suffers at some point from depression or anxiety.
People often consider psychotherapy, also known as therapy, under the following circumstances:

  • They feel an overwhelming and prolonged sense of sadness and helplessness, and they
    lack hope in their lives.
  • Their emotional difficulties make it hard for them to function from day to day. For example, they are unable to concentrate on assignments and their job performance suffers as a result.
  • Their actions are harmful to themselves or to others. For instance, they drink too much
    alcohol and become overly aggressive.
  • They are troubled by emotional difficulties facing family members or close friends.How do I choose the right therapist?

As you go through the process of choosing the therapist that will best serve your needs, trying to first decipher the confusing array of academic degrees, licenses, and certifications used in the psychology profession can seem daunting, to say the least. You may come across literally dozens of designations, such as MSW, CASAC, MA, Psy.D, or PhD.

Some will be “licensed”, some “certified”, some “credentialed”, and others will be “registered.” They may also list a particular orientation like psychodynamic, cognitive/behavioral, gestalt, or solution-focused. Quite understandably, many people are confused about what all of these initials and titles mean. They may be unsure about just what they should be looking for, and they worry about making a wrong choice. These concerns can be heightened by the fact that when you’re in emotional pain, you want help and you want it right away.

Wisdom, empathy, compassion and character are all attributes you’ll want your therapist to have, but they aren’t enough. Knowledge and good professional training are essential. You will want a therapist who has acquired all of the following:

1. Intensive academic study in a field of mental health.

A good, competent therapist starts with a master’s or a
doctorate in a field of mental health (e.g., MA, MS, MSW, PhD,
PsyD, MD).

2. Supervised clinical experience.

It is important to know whether or not the therapist you are considering choosing has completed an extensive psychotherapy training program (“clinical training”). This could have been part of their academic degree, or it could have been a separate postgraduate program. Some MA’s and PhD’s have academic knowledge about psychological research or medication, but have never had actual training or practice in psychotherapy. Psychotherapy cannot simply be learned out of a book or in a classroom. You want a therapist who has also benefited from supervised training.

3. Certification or registration or licensure.

Following their successful training, the therapist is pronounced worthy by an authority to which they will then be accountable. This can be a government licensing board, or some other credentialing organization. Some of the more common designations you might see include: CSW, MFT, CASAC, MFCC, CGP, LPC, or NCC. The type of credential is not as important as some may want you to believe. For instance, a psychologist may not necessarily be a better therapist than a licensed professional counselor or social worker.

Individuals often wonder if they would do better with a female or a male therapist. Trust your instincts to determine if the gender of the therapist is a significant issue for you. It could be that the nature of your particular problem, as well as your own preferences, will lead to a decision that is best suited to you. While the therapist’s age and cultural background are certainly not determinates of their capacity for empathy or their skill at providing effective therapy, these may also be characteristics that you have either an intuitive or preferential response to. Choose what feels right for you personally.

As you evaluate a potential therapist, there are some specific questions to ask that can provide valuable insight into how good a match they are for you. Information that’s included in the 4therapy Therapist Locator will answer many of these key questions. You can ask for further details during the initial phone call to the therapist (usually the first phone call is quite brief and primarily focused on setting a first appointment), or during your first meeting.

Basic questions to ask that will help you decide if a therapist is right for you include:

“What expertise do they have with my type of problem?”

Although the therapist doesn’t necessarily need to have had experience in helping with your exact problem, she or he should be at least familiar with your type of situation and be prepared to tell you how they’ve helped others in similar circumstances.

“What do they think is usually the cause of most people’s
problems?”

There are many ways to approach people’s problems. Depending on their personal background, training, and preferences, therapists attribute problems to different sources. Some look to childhood events, some to the interrelationship of family members, others to faulty thinking, bad habits, or societal and cultural influences. Make sure your therapist’s beliefs are at least somewhat in sync with your own views.

“What will my fee be?”

During the first session, you and the therapist will determine a fee. The approximate length of therapy necessary to help with your particular issues and goals which will provide you with a “ballpark” figure for the total cost of therapy will also be discussed.

“What would my appointment schedule be?”

If time is a factor (e.g., if your only availability for appointments is on Monday evenings, or every other week), you should make sure that the therapist can accommodate your requirements—and will be comfortable working with you on that basis.

When you feel confident that a particular therapist’s overall criteria meets your needs, you’re ready for the first phone call. Although you might be feeling nervous during this initial conversation with the therapist, it can still offer an opportunity to evaluate how clearly you are able to communicate with one another and how the rapport feels. Remember, you are the one doing the choosing.

During your first meeting with the therapist, pay attention to how you feel in their presence and in the therapeutic setting they’ve created. Note how “listened to” you feel and how their style of responding to you and sharing information makes you feel. Although making yourself vulnerable to another human being is always anxiety provoking, observe how you feel as the session progresses, including changes in your level of ease and shifts in the depth of information you reveal.

It’s important to remember that therapy is a much, much richer experience than just problem-solving. The foundation of good therapy is the relationship you and the therapist build together. Because this relationship is going to be so crucial to the effectiveness of your therapy, it is essential you find someone with whom you feel a comfortable connection, someone who makes you feel understood and accepted, a therapist who creates and maintains an environment within which you can feel safe to explore even the most deeply felt sources of pain or conflict. Choose a therapist with whom it feels very right to establish such a life-changing and life-enhancing relationship. You deserve the best possible therapy experience.

If I begin psychotherapy, how should I try to gain the most from it?

There are many approaches to outpatient psychotherapy and various formats in which it may occur — including individual, group and family psychotherapy. Despite the variations, all psychotherapy is a two-way process that works especially well when patients and their therapists communicate openly. Research has shown that the outcome of psychotherapy is improved when the therapist and patient agree early about what the major problems are and how psychotherapy can help.
You and your therapist both have responsibilities in establishing and maintaining a good working relationship. Be clear with your therapist about your expectations and share any concerns that may arise. Psychotherapy works best when you attend all scheduled sessions and give some forethought to what you want to discuss during each one.

How can I evaluate whether therapy is working well?

As you begin psychotherapy, you should establish clear goals with your therapist. Perhaps you want to overcome feelings of hopelessness associated with depression. Or maybe you would like to control a fear that disrupts your daily life. Keep in mind that certain tasks require more time to accomplish than others. You may need to adjust your goals depending on how long you plan to be in psychotherapy.
After a few sessions, it’s a good sign if you feel the experience truly is a joint effort and that you and the therapist enjoy a good rapport. On the other hand, you should be open with your therapist if you find yourself feeling ‘stuck’ or lacking direction once you’ve been in psychotherapy awhile.
There may be times when a therapist appears cold and disinterested or doesn’t seem to regard you positively. Tell your therapist if this is the situation, or if you question other aspects of his or her approach. If you find yourself thinking about discontinuing psychotherapy, talk with your therapist. It might be helpful to consult another professional, provided you let your therapist know you are seeking a second opinion.
Patients often feel a wide range of emotions during psychotherapy. Some qualms about psychotherapy that people may have result from the difficulty of discussing painful and troubling experiences. When this happens, it can actually be a positive sign indicating that you are starting to explore your thoughts and behaviors.
You should spend time with your therapist periodically reviewing your progress (or your concern that you are not making sufficient headway). Although there are other considerations affecting the duration of psychotherapy, success in reaching your primary goals should be a major factor in deciding when your psychotherapy should end.

Psychotherapy isn’t easy. But clients who are willing to work in close partnership with their therapist often find relief from their emotional distress and begin to lead more productive and fulfilling lives.