11 Expert Tips For Starting & Getting The Most Out Of Therapy
Thankfully, mental health is now a topic that’s discussed more candidly than it was in the past. That’s not to say it isn’t still a difficult issue to share. As a person who struggles with depression and anxiety, I admit that despite this acceptance, it will never be high on my list of subjects that I care to dive into with anyone.
Because of this, it can be hard to find people to talk to without feeling like you’re unloading on them. While sharing your feelings is obviously a good thing, it may not be best for the relationship and could be more beneficial to find an unbiased person who can offer additional support. That’s where the professionals come in (AKA the people we pay to let us word vomit).
Therapists, psychologists, counselors, and psychiatrists are labels that get tossed around interchangeably; but who are they, what do they do, and what’s the difference? To keep it (somewhat) brief and mildly entertaining, I’ve outlined definitions below from both Psychology Today (PT) and Urban Dictionary (UD):
PT: This is an umbrella term for any professional who is trained to treat people for their emotional problems. Depending upon their academic degree, a psychotherapist can be a psychiatrist, psychologist, or social worker (among others), and work with individuals, couples, groups, or families.
UD: Someone you go to when you have too much money and need to get rid of it.
PT: This person has a medical degree and, unlike most psychotherapists, can prescribe psychotropic (psychiatric) medication. Many psychiatrists—referred to as psychopharmacologists—provide only prescriptions and medication management; you would need to see a psychotherapist additionally for talk therapy. Traditional psychiatrists continue to practice psychotherapy.
UD: A modern-day, cultured witchdoctor.
PT: This person has a PhD in psychology. In addition to performing talk therapy, they have training in psychological testing (i.e., the Rorschach test, among others). They can also perform research protocols. (Psychologists who concentrate on research generally work in academic or research settings.) Some psychologists who are trained specifically to do clinical work (rather than research) have "PsyD" (Psychology Doctorate) as their academic degree, rather than PhD.
UD: Someone who thinks that problems thought up by the mind can be solved by even more thinking.
PT: When people hear "social worker," they think of professionals who provide social services in hospitals and agencies. However, some social workers also practice psychotherapy. Their education is somewhat similar to that of a psychologist (although they may have only a master's degree), but they are usually more attuned to the individual in their environment, and they do not provide psychological testing. Depending upon the state in which they are licensed, social workers may be LCSWs (Licensed Clinical Social Worker), LICSWs (Licensed Independent Clinical Social Worker), LSWs (Licensed Social Worker), among an alphabet soup of titles.
UD: A person who can handle the most mentally draining times, again and again, but continue to wake up feeling driven to serve.
Seeking help from a licensed professional isn’t always an easy task. I’ve often heard people suggest asking a friend for a therapist recommendation, but as mentioned above, for some, therapy isn’t exactly on par with asking about where someone got their haircut or cute shoes. It can be a delicate topic, and I don’t suggest seeing the same therapist as your mother, best friend, teacher, waxer, or anyone remotely close to you.
The best thing about seeing a therapist is that they are a completely unbiased party. So, where do you find a therapist? How do you know if it’s the right fit? What if it isn’t the right fit? After reaching out to some mental health professionals, I discovered some helpful tips and resources to answer these questions.
When it comes to finding a therapist, there are some key criteria to keep in mind. Some are logistical aspects: Is this person covered by insurance? While others are not as tangible, for instance: Does this person’s approach feel productive? This can be difficult to determine over the phone, so licensed mental health professional and relationship expert, Tzlil Hertzberg, was able to shed some light on this topic.
She says, “There are multiple factors that contribute to finding a therapist that works for you. Some of those could be available time slots, price, insurance coverage, gender of the therapist, or theoretical orientation. Firstly, consider your priority. Which factor is the most important to you right now? In your search, consider this factor first and if you can’t make it work, compromise if you find a combination of other factors you are looking for.”
Once you’ve assessed what kind of guidance you’re looking for, what are the best resources for finding that person? Marriage and family therapist, Christine Scott-Hudson, offered up some great resources for anyone seeking a therapist, especially those who might be on a budget:
1. Call your local community mental health center. These non-profit agencies usually are funded by local government or are funded by Medicaid and Medicare. To find one in your area, call 211 or SAMHSA’s National Helpline at 1-800-662-HELP.
2. Call your local university or medical school and see if they have a low-cost clinic with student therapists. Try reaching out to any of the following departments: clinical psychology, counseling psychology, professional psychology, psychiatry, social work, professional counseling, marriage, and family therapy. If they do not have an in-house clinic, ask them if they can give you a referral to low-cost clinic.
3. Try therapist locator sites such as Psychology Today, Good Therapist, Open Path Collective, Art Therapy Credentialing Board, or American Art Therapy Association and search for a therapist. You can even search for a therapist who takes sliding scale payments, if money is a barrier. Some therapists will reduce their session fee according to the clients’ ability to pay. Therapists indicate on their profiles whether or not they take sliding scale payments and /or people with or without health insurance. You can also call to confirm with the provider by directly asking them if they have a sliding scale for those who do not have insurance and cannot afford the full fee.
4. Check with human resources at your place of employment and ask if your job offers EAP (employee assistance program). EAPs provide counseling to companies’ employees. With EAPs, your employer pays for the service, not you. These sessions are usually limited in number, say, three to five sessions, but can be useful in a crisis.
5. Join group therapy. Groups may decrease feelings of isolation, keep you connected to a professional therapist, and cost much less than individual therapy.
6. If you are grieving, look up your local hospice and see if they have a group you can join.
7. Google your symptoms, and the words “therapist,” and your town’s name. Check out therapists in your area who treat your symptoms.
Finding a therapist is similar to the dating process. You can’t always make a decision right off the bat from a text or phone call. It can take time and the relationship between a therapist and a patient is important. For many, this is a very vulnerable place, so it is crucial that you feel heard, your feelings validated, and in time, that you’re gaining a new perspective that allows you to move forward in life.
So what does this kind of relationship look like?
Hertzberg says, “A healthy relationship with a therapist is one that has boundaries, yet is empathic and caring. A therapist is not a friend, but rather a professional guide. When disclosing your inner most world to someone else, it is tempting to get attached or dependent. Therapists should reinforce boundaries while staying present and empowering their clients to be autonomous. A therapist doesn’t have to understand what you are going through to be effective. It is important that he/she/they be a good listener with strong empathy skills.
Much of the therapeutic process is dependent upon a good relationship between the therapist and client. If you don’t like your therapist, you are less likely to disclose. Don’t be discouraged if you can’t find a good fit right away. You are looking for someone who you can trust with your inner most thoughts and feelings. Just like you would change medical doctors if you felt uncomfortable, you should do the same with a therapist.”
But self-work is hard work. How do you differentiate between hitting a wall with your therapist as a person or diving into challenging issues that don’t feel comfortable?
Hertzberg says, “There is a difference between feeling uncomfortable in a session because you are exploring difficult topics and not connecting with the therapist. In those moments of ambiguity, ask yourself if you would feel the same discomfort talking about these topics with a friend. If so, then it’s most likely the content of the topic that is distressing. Going through a therapeutic process is not easy and you will most likely be uncomfortable for parts of it. It comes down to feeling heard and not judged.
If those components aren’t there, it could be that the therapist is not a good fit. Trust your instincts and don’t be afraid to terminate with that therapist. You will be dealing with a lot of things in the therapeutic process—not feeling comfortable with your therapist should not be one of them.”
This can be difficult to decipher, Florida-based clinical psychologist, Dr. Jamie Long, offered this interesting analogy: “Going to therapy should feel less like easing into a warm bath and more like attending a hot yoga class. A good therapy session can be tolerably challenging (you might even sweat), but you’ll leave feeling clearer, more flexible, and glad you did it.
The cliché, ‘we grow the most when we’re uncomfortable’ is true. If comfort is the number one priority, you might bounce around to several different therapists looking for someone to tell you what you want to hear—yielding minimal results. You'll know you’re with a great therapist when they successfully toe the line between validating your feelings (even the difficult ones) and helping you lower the intensity of emotions that don’t fit the facts and change behaviors that are ineffective. That’s the sweet spot of therapy, the gentle nudges onward and upward.”
Asking for help can be difficult and therapy is a commitment, but I do believe it’s one worth trying. Times when I find myself “unloading” on close friends consistently is usually when I know something is going on, and while friends and family are great resources for support, relying on one or two people all the time can strain the relationship. Therapists are also trained at length to ask the questions that people who know you in a certain way may not ask. If you’re interested in seeking therapy try some of the tips above and resources below.