Should I consider entering psychotherapy?

Many people think psychotherapy is something only for those who have a serious mental health issue, such as major depression or debilitating anxiety. However, many individuals with problems or issues of a smaller magnitude may also benefit from therapy. Some individuals enter therapy with a vague sense of emptiness or uneasiness and the feeling that their lives are unfulfilling. Others enter therapy seeking assistance in clarifying and pursuing their short-term and long-term goals, such as career and relationship objectives. Psychotherapy offers the help and support of a professional who has been trained to assist you in dealing with these issues. As you contemplate the above question, you might also ask yourself: “Have I been unsuccessful in resolving a particular issue in my life using my usual approach or resources?” If the answer is "Yes," you might very well benefit from psychotherapy.

What happens in therapy?

There are many different methods I may use to deal with the problems that clients hope to address. For example, I may present information about a particular disorder to clients in order to educate them about the nature of their problem. When dealing with stress or anxiety, I often teach the client relaxation techniques that have proven to be effective. At other times, clients benefit from active listening and support as they deal with intense emotions. Effective therapy calls for an active effort on the part of the therapist and the client. In order for the therapy to be most successful, the client has to work on things we talk about both during our sessions and in between sessions.

Psychotherapy can have benefits and risks. Since therapy often involves discussing unpleasant aspects of one’s life, clients may experience uncomfortable feelings like sadness, guilt, anger, frustration, loneliness, and helplessness. On the other hand, psychotherapy often leads to improvements in relationships, solutions to specific problems, and significant reductions in feelings of distress.

How does therapy work?

People enter psychotherapy for various reasons. As each client is unique, so too are the goals of therapy and the ways in which clients measure progress toward their goals. However individualized therapy may be, research on psychotherapy effectiveness has identified two measurable key variables related to successful treatment outcomes in general, namely, the client's assessment of progress toward goals within therapy and the client's measure of a positive working relationship with the therapist. Fortunately, there are brief, valid and reliable measures of these two variables that I use to provide quick and useful feedback to clients. Such feedback facilitates a positive and successful therapeutic relationship, brings a sharpened focus to what is most important and relevant to a client, and generally leads to more rapid gains for the client.

How long will I be in therapy?

The duration of therapy may be short-term in nature. For example, some clients enter therapy for support during a crisis and feel ready to stop within a matter of weeks. Also, some clients enter therapy with a specific goal in mind, which is met relatively quickly, and then discontinue therapy or opt to continue in pursuit of another goal. Clients with more challenging issues may need therapy of a longer duration. Many individuals remain in therapy as long as they are seeing ongoing progress as measured by feeling better, achieving goals, resolving issues, and experiencing an improved quality of life.

Should I consider taking medication?

While I cannot prescribe medication, sometimes it is clearly warranted, and numerous research studies suggest that psychotherapy and medication often work best in tandem. Sometimes a combination of psychotherapy and medication is the treatment of choice for a given problem. In other cases, medication is indicated as a short-term support to therapy for those individuals who are having significant difficulty meeting the demands of their day-to-day lives. Clients I see in therapy who may benefit from medication are typically referred to a psychiatrist for an evaluation. The psychiatrists with whom I consult approach medication conservatively - that is, it is prescribed at the lowest effective dosage and discontinued when possible. Individuals are maintained on medication only when the benefits clearly outweigh any potential drawbacks. While I will offer my opinion and call upon the expertise of a psychiatrist in regard to this matter, the decision to take medication or not is ultimately the client’s.

How should I go about choosing a psychotherapist?

Studies have shown that a comfortable working relationship is one of the factors most highly associated with successful therapy outcomes. Specifically, a client's positive ratings of the "alliance," or working relationship between therapist and client, is the best predictor of success, regardless of the client's diagnosis or presenting problem, or the theoretical orientation or particular training of the therapist. Therefore, taking the time to interview and select a therapist who's feels just right to you, and trusting your judgment in doing so, is not just a good idea - it's essential!