It’s 2015, and yet navigating the world of mental healthcare can still be a little overwhelming and downright tricky for those who have never sought mental health treatment before. So confusing, amirite? It's true no matter how seemingly great or small your needs are. Maybe it's depression, anxiety, stress, mood swings, bipolar disorder, addiction, couples counseling, family therapy, ADD/ADHD, or life coaching. I’ve talked to some pretty smart savvy people over the years, and the same questions and concerns seem to pop up every time. Here I’ve compiled some of the most important things you should know so that you can move forward and make some informed decisions. I'm going to pull back the curtain for you and give you all sorts of insider information. Stuff only the pros know.
Let's get started. Hold my hand 'cause Heerrre...weeee....GOOOOO!!
GROWN-UP SUPER SERIOUS DISCLAIMER: Keep in mind as you read this, I am a therapist, or Licensed Professional Counselor to be exact, and I'm admittedly biased towards other therapists. I love us. Specifically us LPC's. Yeah, I think we're pretty great! Basically, everything you are about to read is my professional opinion, so please keep that in mind. After all, I am a therapist, not a professional journalist. So sue me! Please don't sue me.
1. “Do I Need Therapy?”
Only you can make that judgment call. Have you been struggling lately? Have you been having troubling thoughts, feelings, or moods? Are you experiencing a loss of enjoyment or loss of motivation? Are you feeling overwhelmed or unlike yourself? Do you think it would help if you talked to someone like a mental health professional? Lemme drop a knowledge bomb on you: Yes it can really help.
Even if you don't think your needs justify therapy, it can help. Like a lot of people, you might be thinking "Therapy is only for crazy people, and I'm not crazy." This is an old-fashioned stigma that often prevents people from getting a little help during a difficult time. That stigma might be holding you back right this second and preventing you from turning your entire life around. This stigma needs to go away because mental health care is nothing to fear. It's here to stay, and it's awesome!
Sometimes people ask themselves the wrong questions: “Am I crazy? I’m not crazy, am I? I think I'm normal. I mean, therapy and psychology, those are only for crazy people, right?” Therapy can help people struggling with issues great or small. It’s counterproductive to use words like “crazy,” “insane,” and “normal” and that kind of thinking may be holding you back. Create some positive change in your life by asking yourself these questions instead: “Is life leaving me wanting more? If so, then would I like to change that?” Well then, treat yo'self. Therapy style. Trust me. It really can get better. I see it every. Single. Day.
NOTE: If you are currently experiencing suicidal thoughts or thoughts to harm yourself or others, call 9-1-1 immediately.
2. “What is the Difference Between Psychiatrists, Psychologists, and Therapists?”
Hold up. *record scratch* There's a difference?! This trips up a lot of people. I would say this is by far the most common concern I get from people who are considering getting mental health treatment for the first time. I'ma break it down for ya.
Psychiatrists
These are medical doctors who have specialized in the field of psychiatry, and they are able to prescribe medication. Medical doctors are the only people who can prescribe meds. Psychiatrists are great. However, when considering making an appointment with a psychiatrist, be aware that most do not sit with their patients for one-hour talk therapy sessions every week like Frasier Crane or Dr. Melfi on The Sopranos. Whaddaya know. The media has lied to us. Patients are sometimes shocked to find that when seeing a psychiatrist, you will typically meet with them for 10-15 minutes at a time, and that you usually won’t meet with them every week. Some patients might only meet with their psychiatrist once a month or every other month for medication management. Basically, I only recommend someone see a psychiatrist when medication appears to be necessary.
Psychologists
These are mental health practitioners who in some ways are very similar to therapists. Some psychologists might even call themselves therapists. There are many different types of psychologists with many different specialties and functions. Among psychologists there are many different guiding principles and techniques. They're all a little different. Also some psychologists are entirely focused on research and study rather than conducting actual therapy sessions with patients. Typically I only recommend someone see a psychologist when there are significant concerns about complex diagnoses. For instance, let’s say someone may have ADD/ADHD, autism, Asperger’s, a learning disability, or some complex combination of two or more disorders. I would probably recommend that person see a psychologist who specializes in working with those disorders. Or let’s say someone has been in therapy for many years and they are wanting a specific, pragmatic, clinical approach perhaps involving education and specific statistical evidence. In that case, I would consider recommending a psychologist. There. That’s my take on psychologists. See I wasn't too hard on them. At least not in my opinion. Now on to us wonderful therapists!
Therapists
My favorite! Did I mention I am a therapist and that I love us? Well guess what. I can't help it! I love what I do, and I love my profession.
When people envision themselves sitting down in a cozy office with a warm, welcoming, non-judgmental professional and talking it out, this is where us therapists come in. Typically when people say to themselves "I want to see a psychiatrist but I don't want to just be medicated. I want to talk to someone." Chances, are what you're really wanting is a therapist.
We are a broader category comprised of psychotherapists, counselors, licensed marriage and family therapists, and social workers. The term "therapist" is a bit of an umbrella term for many different professional licenses. The specific designations sometimes vary from state to state. I myself am a Licensed Professional Counselor in the state of Texas, but I generally refer to myself informally as a therapist because typically when people here the term “counselor” they imagine a school guidance counselor rather than a mental health therapist. If you see a practitioner with any of these initials after their name: LPC, LPC-Intern, LMFT, LMSW, LCSW, that means they are a therapist!
Much like psychologists, every therapist is a little different. We all use different sets of guiding principles and techniques (more on that in a different blog entry though. Coming soon!). Whether we are social workers, counselors, or LMFT's, we all serve the same functions. We perform therapy sessions with clients, either one-on-one, couples, families, groups, children, teens or adults, you name it.
Typically these are one-hour sessions, once a week. Many years ago, most psychiatrists used to do all this themselves, hence the media's portrayal of psychiatry sessions (Frasier, The Sopranos, Woody Allen movies, etc), but those days are long gone. Nowadays, the psychiatrists handle the meds, and if you want to talk it out, they'll refer you to someone like me.
So let me explain why I am so biased in favor of therapists. I believe psychiatrists are absolutely necessary for medication management. Meds can be a very helpful thing after all. Psychologists are great for highly specialized fields as well as determining difficult, complex diagnoses. So my apologies to all other practitioners, but I'm inclined to suggest that if someone is simply wanting to sit and talk with a mental health professional, learn how to cope with something like anxiety, stress, depression, marriage/family problems, or addiction, I believe therapists are your best bet.
Why? Because we place our focus on you. The client. The therapeutic relationship. Trust and rapport. Our focus is you. Not just treating the symptoms. Not the medication you're on. Not letting your diagnosis define who you are as a person. Not treating you like a disorder, like some sort of disease that has to be eradicated. We are trained to help people discover the answers for themselves, and those are the discoveries that lead to the most meaningful forms of change. REAL TALK. That brings me to my next lesson.
3. “What Will Therapy Do For Me?”
Will you be successful in therapy? Is it effective? Will you achieve your goals? Will your depression, anxiety, or mood swings be alleviated? Will you be successful in addiction recovery? Will you be satisfied with therapy? Will you feel that you have been helped? Will you be better off as a result of having gone to therapy? I think these are perhaps the most important questions you should be asking about the therapy process.
You might think success depends on how many PhD’s your therapist has or what license they have after their name. Turns out, it really doesn't matter whether your mental health practitioner is a counselor, social worker, a licensed therapist, or even a psychologist. Nor does it matter so much how many fancy degrees they have. The single most important factor is… The therapeutic relationship. That's basically a fancy term for the trust and rapport you have between you and your therapist.
If you like your therapist. If you “click” with them. If you trust them. If you look forward to going to therapy. Then chances are, you are going to be successful. Other things to consider include your therapist's treatment approach, the techniques they use, and the efficacy of those. I promise to devote a future entry just on this topic alone, but for now just know that different therapists have different treatment approaches or what are sometimes called "guiding theories." When researching a therapist, ask about their treatment approach and techniques as well as effectiveness.
Upside Wellness for example performs cognitive-behavioral therapy, or CBT as it's often called, which is one of the most well-researched, most effective treatment approaches. Cognitive-behavioral therapy, because of its research-based approach and its effectiveness, is very popular in psychiatric hospitals and drug rehab treatment centers, which makes sense because I have extensive experience working at psychiatric hospitals and drug treatment facilities. However, what really sets Upside Wellness apart from other mental health therapy clinics is that here we also use the healing power of laughter to enhance the therapy experience. We use fun, interactive techniques including laughter therapy, improv comedy exercises, and theater games to foster positivity, self-actualization, creativity and play. I should probably mention that in addition to being a therapist, I am a comedy performer too! And yet all the while a cognitive-behavioral therapeutic framework remains in place to ensure effectiveness.
Did I mention how much people love coming to Upside Wellness? How we make therapy fun and enjoyable as well as helpful and effective? How we're all about the therapeutic relationship and the healing power of laughter, and as we all know, it's supes fun to laugh. Sorry! Cut me some slack. This is my blog after all.
4. “How Do I Get Medication?”
Let’s say you believe you need medication. Maybe you currently do not have a psychiatrist, but you strongly believe you should be placed on a psychiatric medication for something like depression, anxiety, a mood stabilizer, ADD/ADHD meds, or a relapse prevention medication. Scheduling a first-time appointment with a psychiatrist can take a while. You want a psychiatrist to prescribe you meds, and they often have waiting lists. They’re medical doctor specialists after all. Try scheduling an appointment with a cardiologist for I dunno… Today. Inconceivable!
First-time appointments with a psychiatrist often book up a month or two in advance. That’s why I’m going to tell you a very very important piece of insider information: Go see your primary care physician. That’s right, go see your GP and tell them all about your situation. A good GP can prescribe you psychiatric medication as they deem necessary. Typically this should only be temporary, but it's still a very good short-term option. Definitely still schedule that appointment with the psychiatrist, but instead of waiting around 6-8 weeks without meds, you can take meds as prescribed from your GP in the meantime. Then when you finally do get in to see your new psychiatrist, they can simply adjust your meds as they choose.
NOTE: In Louisiana and New Mexico, in addition to psychiatrists specially trained psychologists are also allowed to prescribe psychiatric medication.
5. “How Do I Find a Good Therapist?”
You’ve decided you need help. You know which type of mental health professional you want to see. Now what? People seem to get hung up on this step pretty frequently. Finding a good therapist can seem difficult because most people don’t go around saying “Hey, I see a therapist for anxiety. Do you need to see a therapist for anxiety? You should see mine! Yay, therapy!” Maybe someday, but for now, we just don’t speak openly in our society about the importance of wellness and mental healthcare. That would be pretty sweet though. A therapist-dude like myself can dream.
So what do you do? I would suggest checking out Psychology Today. Therapists are listed in their online directory and you can easily research all different kinds of therapists in your area and even scan over their specialties. Did I mention Upside Wellness is listed on Psychology Today? Boom. There it is.
Psychology Today is usually a good bet and very easy to navigate, but if you are looking for other options, you can also run an internet search for therapists in your area. Let's say you live in Austin and your zip code is 78703 and you are looking for a couples counselor, then Google: Couples counselors Austin 78703. It may take several tries and using different wording and phrasing, but you should come back with some results. Also you may want to check out your insurance company website for providers in your plan, and don't forget you can always request a referral for a therapist from your primary care physician or your psychiatrist if you already have one.
6. “I’m Going to Get Help Later”
This is where people stall out. We are only human after all, and we don’t always do things in order - because life. I see it all the time. People do the research, they figure out who they want to see, they look up phone numbers, they check out Psychology Today, and then they just… stop. They try to ignore the problem. They tell themselves “I’ll get help later. I’m really busy this week.” Or they say to themselves “I thought I needed help, but then I had a pretty good day, so I guess I don’t need help after all.”
Reaching out can seem scary, but it doesn't have to be. Admitting you need help can seem scary too, but there is no shame in it. It doesn't mean you are broken. It just means you have decided to break the cycle. It’s a first step towards change. Things can get better. If you are on the fence, try reaching out to a therapist today and just see what you think.
Pick up the phone. Send an email. Or if you still don’t feel ready, talk to a loved one. Reach out to someone right now. Think of all the people who are suffering just as you are, but they are perhaps too afraid to create change. Make your mental and emotional wellness a priority right now. Break the cycle today. It can get better. Let me know if Upside Wellness can help or even if not, maybe I can help you find a therapist that's better suited for you. If you don’t deal with your problems, sooner or later your problems will deal with you.
-This post written by Lane Ingram, M.Ed., LPC