Frequently Asked Questions

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What is psychotherapy?
How can psychotherapy help you?
What happens on your first visit?
What are the types of psychotherapy?
How do you choose a therapist?
How do you evaluate whether therapy is working?

What is psychotherapy?

Steadman’s Medical Dictionary defines psychotherapy as: treatment of emotional, behavioral, personality, and psychiatric disorders based primarily upon verbal or nonverbal communication with the patient, in contrast to treatments utilizing chemical and physical measures. (Stedman’s Electronic Medical Dictionary, 1994).

Counseling is a broader term than psychotherapy. Psychotherapy can be thought of as a form of counseling that is used as a treatment for mental disorders. In actual practice, psychotherapy can involve both treating a disorder and helping someone solve problems in their life. There are several different “schools” of psychotherapy, and the therapists trained in these methods emerge with different theoretical orientations that affect their practice of therapy.

How can psychotherapy help you?

From time to time, we all experience situations where we can benefit from a trained professional. Psychotherapy is helpful with significant life changes, decisions that need to be made and difficulties at home or work. Talk therapy is also helpful for serious problems that interfere with day-to-day life, such as physical or mental illness.

According to the National Institute of Mental Health, one-third of adults in the United States have an emotional or substance abuse problem for which they need help. Also, nearly 25 percent of the adult population suffers at some point from depression or anxiety. Therapy can help depression, anxiety disorders and other emotional difficulties,
either alone or in combination with medication.

The National Mental Health Association suggests psychotherapy for people when:

• 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.
• They are having problems with interpersonal relationships.

Talk therapy brings concrete results for many people. Research shows emotional and physical health are closely linked, and that therapy can improve a person’s overall health.

Therapy can effectively decrease depression and anxiety, and related symptoms such as pain, fatigue and nausea. More than 80 percent of people with depressive disorders improve when they receive appropriate treatment, according to the National Institute of Mental Health. Psychotherapy has also been found to increase survival time for heart surgery and cancer patients, and it can have a positive effect on the body’s immune system.

What happens on your first visit?

On your first visit, the mental health professional wants to get to know you and find out why you are interested in counseling. The therapist asks about your life, what you do, where you live, with whom you live and what you think the problem is. It is also common to be asked about your family and friends. This information helps the professional assess your situation and develop a plan for treatment.

Psychotherapy is an active collaboration between therapist and client. It isn’t always easy. But people 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. If you don’t feel comfortable with your therapist, talk about your feelings at your next meeting. Don’t be afraid to change to another therapist. Feeling comfortable with the professional you choose and the style of therapy is important to the success of your treatment.

What are the types of psychotherapy?

Psychotherapy is a method of talking with a clinical social worker, psychotherapist, psychiatrist, psychologist or professional counselor.

Many forms of psychotherapy can help people having difficulty in life, those who wish to make some kind of change in their personal or professional life, or people suffering from depression, anxiety or other serious mental health problems. The recovery success rate for those with depression who combine psychotherapy with medication to control symptoms is more than 80 percent, according to some studies.

Although best in person, therapy is also provided on the phone, via e-mail, and online. Therapy can be held in one-on-one sessions, family or couple sessions, or in a group led by a trained counselor.

Family therapy or couples therapy

Family therapy includes discussion and problem-solving sessions with every member of the family. Some sessions are done as a group, in couples, or one on one. Family or couples therapy is helpful when one of the family member’s physical or mental health is directly affecting family dynamics or the well-being of significant relationships.

In therapy, interpersonal relationships shared among family members are examined and communication is strengthened. If a family member suffers from depression, the roles played by various family members in reinforcing the depression often areexa mined.

Group therapy

In group therapy, a small group of people meet regularly to discuss individual issues and help each other with problems with the guidance of a trained therapist.

Different approaches to psychotherapy

Psychotherapy is not limited to a particular type or technique. Many therapists are trained in several different approaches. They then combine techniques from these various approaches that fit their own style and personality and the needs of the patient.

Medication may be used with psychotherapy. For many people, this is the best approach to treatment. People with moderate-to-severe depression typically do best with a combination of antidepressants and some form of psychotherapy. Children, teens and adults being treated with antidepressants, particularly anyone being treated for depression, should be watched closely for worsening of depression and for increased suicidal thinking or behavior. Close watching may be especially important early in treatment or when the dose is changed – either increased or decreased. Bring up your concerns immediately with a doctor.

The following are the common types of therapy available:

Behavior therapy

Behavior therapy, also called behavior modification or behaviorism, sets up rewards and punishments to change thinking patterns and shape behavior. Behavioral therapy can involve relaxation training, stress management, biofeedback and desensitization of phobias. Behavioral therapists help patients learn how to get more satisfaction and rewards through their own actions and how to unlearn the behavioral patterns that contribute to, or result from, their problems.

Cognitive therapy

Cognitive therapy seeks to identify and correct thinking patterns that can lead to troublesome feelings and behaviors. Beliefs and expectations are explored to identify how they shape a person’s experiences. If a thought or belief is too rigid and causes problems, the therapist helps the client to modify his or her belief so that it is less extreme.

Cognitive-behavioral therapy

Cognitive-behavioral therapy (CBT) helps a person to recognize his or her own negative thought patterns and behaviors and to replace them with positive ones. Used both with and without medication, cognitive-behavioral therapy is the most popular and commonly used therapy for the treatment of depression. A major aim of CBT is to reduce anxiety and depression by eliminating beliefs or behaviors that help to maintain problematic emotions. CBT generally lasts about 12 weeks and may be conducted individually or in a group. There is evidence that the beneficial effects of CBT last longer than those of medication for people with panic disorder, obsessive-compulsive disorder, posttraumatic stress syndrome and social phobia.

Interpersonal therapy

Interpersonal therapy (IPT) is a short-term therapy often used to treat depression. This treatment approach focuses on an individual’s social relationships and how to improve social support. IPT therapy seeks to improve a person’s relationship skills, working on communication more effectively, expressing emotions appropriately and being properly assertive in social and work situations. In depression, IPT helps patients learn how to deal more effectively with others to reduce conflict and gain support from family and friends. It is usually conducted, like cognitive-behavioral therapy, on an individual basis but also can be used in a group therapy setting.

Psychoanalysis

Also called psychodynamic or psychoanalytic therapy, this type of treatment helps a person look inside himself or herself to discover and understand emotional conflicts that may be contributing to emotional problems. The therapist (psychoanalyst) helps the client “uncover” unconscious motivations, unresolved problems from childhood and early patterns to resolve issues and to become aware of how those motivations influence present actions and feelings. This is a lengthy process, typically taking several years.

There are different types of psychoanalysis, each with a different focus. Freudian psychoanalysis has been criticized because of its tendency to create long-term dependent relationships between the therapist and the client. Other types of psychoanalytically oriented therapy have become popular, such as Jungian therapy. Jungian therapy sessions focus more on the immediate situation and life problems than on the root of the problem to help individuals develop greater self-realization.

How do you choose a therapist?

When choosing a therapist, first talk with him or her on the phone or in person to find out about licensure and level of training, philosophy, approach to psychotherapy, participation in insurance plans and fees, and any specialty that they have (such as depression, women’s or men’s issues, substance abuse or grief). Such a discussion should help you sort through your options and choose someone appropriate for you. If you feel comfortable talking to the counselor or doctor, the next step is to make an appointment. If at any time you feel uncomfortable with your therapist or wish to try another approach, feel free to talk to other therapists and even change therapists. Feeling comfortable with the professional you choose is very important to the success of your treatment.

How do you evaluate whether therapy is working?

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 is truly 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. Patients often feel a wide range of emotions during psychotherapy. Some have qualms about it because they have difficulty 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. 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. Also, let your therapist know you are seeking a second opinion. You should spend time with your therapist periodically reviewing your progress (or your concern that you are not making sufficient headway, if you feel discouraged). 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.

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