When I treat patients for anxiety, depression, or other mental health problems, I usually recommend psychotherapy as part of the treatment plan because it helps in recovery. Some patients ask two logical questions: How do they find a good therapist? And what should they expect from therapy?
You can get a recommendation for a therapist from your psychiatrist (who may also be able to function as your therapist), your primary care doctor, a friend who's been through therapy, or your insurance company. But it's important to find out about a therapist's background and training to help you feel comfortable with your choice.
Before beginning work with the therapist, consider asking about the individual's training, experience, and views about different types of therapies. Remember that no single therapist or type of treatment is best for everyone. In general, however, it's best if the therapist has formal training and certification, or is on the way to getting it.
There's a tendency for mental health professionals to offer the particular type of psychotherapy that they do best. It's good if the person can describe the merits and drawbacks of different types of treatment, including ones they don't do.
As for what to expect during therapy, there are many different approaches, but all good therapy shares some common elements. While psychotherapy isn't always comfortable, you should feel reasonably at ease with your therapist; that he or she listens well and seems to "get" your situation.
Good treatment should help you to feel better. You and your therapist should agree upon realistic goals for the therapy early on, recognizing that frequently goals may change during treatment. While well-defined problems might be addressed relatively quickly, you may need to approach more difficult problems from many angles, which will take longer.
Since mood and anxiety disorders can have a broad influence on relationships, work, school, and leisure activities, therapy should address these areas when — or if possible before — they become a problem. Therapy isn't just for uncovering painful thoughts, although that's part of the work. Good therapy also addresses how you can adjust, adapt, or function better. And it helps you understand the nature of your distress. You should feel that your therapist approaches the important issues in your life in a way that's unique to your needs, not from a one-size-fits-all perspective. Pertinent issues springing from your culture, sex, and age, as well as individual differences, may influence the direction therapy takes.
If a doctor other than your therapist prescribes medications for you, the two should communicate. If they don't do so on their own, you may want to encourage collaboration by asking your therapist and doctor to speak regularly. Your therapist ought to understand the medication portion of your treatment, encourage you to take medications as prescribed, and help monitor your response.
Although it's not uncommon to feel stuck at times, don't persist for months with that feeling. Some difficult problems take a long time to unravel, but you should sense progress. If you don't, it's a sign that the match between you and either the technique or the therapist isn't right. If four to six months have gone by and you don't feel better, it may be a good idea to consult another therapist.
What have you found to be most helpful in selecting a therapist or type of therapy? Have you ever had to switch therapists or techniques, because the first wasn't working?
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Comments: 12
I was once told by a therapist that if someone's problem was money that there is not much therapy can do; do you find that true?
Blessings
I was under the impression that I had to take whoever the insurance gave me. It's hard to go to therapy at all when you're depressed -- you have to fight to get an appointment (it's not unusual to be told there is a 2-4 month wait), wade through all the paperwork, find the money for the co-pay, and then try to explain how you're feeling.
It would be nice if articles like this were available in waiting rooms.
When you lose your 9-year job, your breasts, your 28-year marriage, and your dad, but the property taxes still have to be paid, this can be a money problem that dialectical cognitive therapy and medications cannot solve.
When I worked in social work, I saw the barriers to work as a difficult problem. So much of our work is arranged by privilege and irrelevant costly preconditions rather than what is required by the job.
If you do not see people who lack health insurance, I can understand how this issue might be hidden from your point of view.
A newspaper in Portland called Street Roots tries to address this for homeless by making a useful newspaper that homeless people can sell. They keep 75 cents on the dollar that the paper costs.
Below-the-radar grassroots efforts are being made to address issues around marginalized populations who are disadvantaged in a recessionary economy.
In some cities, service organizations are doing things like farming in the back yards of employed persons who don't have time to take care of their yards. As energy increases in cost as the dollar falls, growing more food close-in makes all kinds of sense.
In Portland, there is some cooperation between Oregon Health Sciences University Psychiatric Department and social service agencies, but I think it is still pretty rare.
When I was working in social-service, we would be called in if a client had been around more than once with a suicide attempt. I do not know if that still happens at all. The agency I worked for stopped supporting severe-and-chronic-mental-health and fragile-elder populations, and the entire Health at Home group were reduction-in-forced.
I was a living-skills coach, and I worked with suicidal clients. Three of my clients stopped the cycle. Through my own challenges, I have been able to think back to that and how good it felt to be able to help.
My hope is the Trieste model will make it here in force some day. Employment, entrepreneurship, and community connection can be so helpful.
my Depression is good for me