What to Expect at the Psychotherapist
Once you’ve found the right psychotherapist for you, you’ll have to do initial paperwork so they can understand you and your medical history. The first few sessions will help your therapist to get to know you and your situation. This let’s them determine the best style of treatment.
Psychotherapists can treat both adults and children. There may be short-term plans to heal immediate issues or long-term treatment plans to treat more complex challenges.
There are multiple types of therapy based on your particular circumstance and preference. These include:
Cognitive behavioral therapy (CBT)
This type of therapy helps you identify and change behavior patterns and thinking that may be harmful to you. You’ll work on replacing them with accurate thoughts and functional behaviors.
Interpersonal therapy (IPT)
This short-term treatment helps you understand your underlying interpersonal issues. It trains you to express your emotions better and improve communication with others.
Psychodynamic therapy
Psychotherapists use this method to address and treat childhood trauma in order to improve behavior and mental wellness.
What exactly does a psychotherapist do?
A psychotherapist helps people cope with and overcome mental health problems.
A psychotherapist or therapist is a trained professional who assists people with various mental health conditions such as stress, depression, anxiety, insomnia, addiction, bipolar disorder, negative behavior patterns, bipolar disorder, schizophrenia and other debilitating feelings. Psychotherapy is also called talk therapy and can help treat challenges and symptoms associated with mental health and emotional conditions by helping a person understand their repressed feelings, hence equipping them to face new challenges both in the present and future. Psychotherapists are nonjudgmental and compassionate. They are specifically trained to carefully listen and analyze the psychological needs of their patients and help them accordingly.
Psychotherapy is similar to counselling and the two can overlap. Psychotherapy is deeper and addresses the underlying causes of the problems, as well as helps the person solve them. There are different licenses held by professionals who practice psychotherapy, including social workers, licensed professional counselors, psychologists, psychiatrists and mental health nurse practitioners. Although each of them may have different approaches in treating psychological difficulties, many mental health conditions may involve a team of various mental health professionals. This is especially true for more serious conditions such as addiction, schizophrenia, bipolar disorder and major depressive disorder with suicidal tendencies. In many cases, based on the mental health condition, patients require psychotherapy and medication. Healthy lifestyle improvements, such as regular exercise, adequate rest and other specific activities recommended by the psychotherapist also play an important role in the recovery process and overall well-being.
In general, psychotherapists act as a guide toward helping their patients understand their condition and feelings, cope with daily life and manage their mental health to be able to function normally. This includes maintaining relationships and performing adequately at work or school, thus improving their quality of life. The time taken for patients to feel better varies based on their primary diagnosis, their support system and the patients themselves. Some patients feel better after a few sessions, whereas some may need years or lifelong sessions of psychotherapy to manage their mental health. To see positive results, patients ultimately need to understand they have a problem, recognize the need for change and follow the treatment plan advised by the specialist. About 75% of people who have undergone psychotherapy have been shown to benefit from it.
Psychotherapy and medication: In many cases, based on the mental health condition, patients require psychotherapy and medication. For many mental health disorders, medication has proven to be more useful than psychotherapy. In other cases, patients benefit more from a combination of medication and psychotherapy than from either one alone.
Psychotherapy can help treat challenges and symptoms relating to mental health and emotions.
Also known as talk therapy, psychotherapy aims to help a person understand their feelings and equip them to face new challenges, both in the present and the future.
Psychotherapy is similar to counseling, and the two can overlap. However, the former tends to look more deeply, addressing the underlying causes of a person’s problems as well as how to solve them.
To see positive results, a person will usually need to understand the need for change and be willing to follow the treatment plan as the specialist advises. They will also need to find a suitable therapist they can trust.
Psychotherapy can help when depression, low self-esteem, addiction, bereavement, or other factors leave a person feeling overwhelmed. It can also help treat bipolar disorder, schizophrenia, and certain other mental health conditions.
People often, but not always, use both psychotherapy and medication.
In this article, learn more about what psychotherapy involves.
What to expect
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There are many approaches to psychotherapy.
Some forms last for only a few sessions, while others may continue for months or years, depending on the person’s needs. Individual sessions usually last for around 45–90 minutes and follow a structured process.
Sessions may be one-to-one, in pairs, or in groups. Techniques can include talking and other forms of communication, such as drama, story-telling, or music.
A psychotherapist may be:
- a psychologist
- a marriage and family therapist
- a licensed clinical social worker
- a licensed clinical professional counselor
- a mental health counselor
- a psychiatric nurse practitioner
- a psychoanalyst
- a psychiatrist
Who can benefit?
Psychotherapy can help people in a range of situations. For example, it may benefit someone who:
- has overwhelming feelings of sadness or helplessness
- feels anxious most of the time
- has difficulty facing everyday challenges or focusing on work or studies
- is using drugs or alcohol in a way that is not healthful
- is at risk of harming themselves or others
- feels that their situation will never improve, despite receiving help from friends and family
- has experienced an abusive situation
- has a mental health condition, such as schizophrenia, that affects their daily life
Some people attend psychotherapy after a doctor recommends it, but many seek help independently.
Types
There are several styles of and approaches to psychotherapy. The sections below will outline these in more detail.
Cognitive behavioral therapy
Cognitive behavioral therapy (CBT) helps a person understand and change how their thoughts and behaviors can affect the way they feel and act.
CBT can help people with many issues, including:
- depression
- anxiety
- post-traumatic stress disorder
- eating disorders
- low self-esteem
Interpersonal therapy
Under this approach, a person learns new ways to communicate or express their feelings. It can help with building and maintaining healthy relationships.
For example, if someone who responds to feeling neglected by getting angry, this may trigger a negative reaction in others. This can lead to depression and isolation.
The individual will learn to understand and modify their approach to interpersonal problems and acquire ways of managing them more constructively.
Psychodynamic therapy
Psychodynamic therapy addresses the ways in which past experiences, such as those during childhood, can impact a person’s current thoughts and behaviors. Often, the person is unaware that this influence is even present.
Identifying these influences can help people understand the source of feelings such as distress and anxiety. Once they identify these sources, the psychotherapist can help the person address them. This can help an individual feel more in control of their life.
It is similar to psychoanalysis but less intense.
Family therapy
Family therapy can provide a safe space for family members to:
- express their views
- explore difficult feelings
- understand each other
- build on existing strengths
- find solutions to problems
This form of psychotherapy can be useful when problems stem from family relationships, or when a child or young person is facing difficulties.
In fact, one 2019 article suggests that family therapy may help adolescents with mental health problems. It may also improve family cohesion and enhance parenting skills.
Relationship therapy is another type of psychotherapy. It is very similar to family therapy, but a person may instead wish to present to therapy with their partner to address issues within a relationship.
Group therapy
Group therapy sessions usually involve one therapist and around 5–15 participants with similar concerns, such as:
- depression
- chronic pain
- substance misuse
The group will usually meet for 1 or 2 hours each week, and individuals may also attend one-on-one therapy.
People can benefit from interacting with the therapist but also by interacting with others who are experiencing similar challenges. Group members can also support each other.
Although participating in a group may seem intimidating, it can help people realize that they are not alone with their problem.
Online therapy
Many people are now opting for online therapy, otherwise known as telehealth. This can have many benefits, especially for someone who:
- has mobility problems
- cannot find a suitable specialist in their area
- has difficulty fitting therapy into their schedule
- does not feel comfortable with face-to-face communication
Tools include video meetings and messaging services.
Although online services have helped “normalize” psychotherapy, making it easier to integrate into daily life, a person should check carefully before choosing a provider.
For example, they should consider:
- the qualifications and experience of the therapist
- the online and other security measures the provider has in place
- using a company that psychologists run and that has links with professional associations
Other types
There are many other types of psychotherapy, including:
- animal-assisted therapy
- creative arts therapy
- play therapy
Effectiveness
Each person’s experience of psychotherapy will be different, and the time it takes to see an improvement will also vary.
Some people will notice a difference after around six to 12 sessions, while others may need ongoing treatment for several years.
Psychotherapy can help a person by:
- giving them someone to explore their problem with confidentially
- enabling them to see things in a new way
- helping them move toward a solution
Participants can:
- learn more about themselves and their goals and values
- identify causes of tension in relationships
- develop skills for facing challenges
- overcome specific problems, such as a phobia
To benefit from the process, a person needs to:
- have a desire to participate
- engage actively in treatment
- attend appointments and complete any assignments between sessions
- be honest when describing symptoms and situations
Effectiveness can also depend on:
- the reason for seeking therapy
- the skill of the practitioner
- the relationship between the therapist and the individual
- any support the person may have outside the therapy sessions
A trusting relationship between the individual and the therapist is also essential to the process.
Risks and cautions
Psychotherapy can offer many benefits, but there are some cautions to be aware of before starting. The following sections will outline these in more detail.
Unexpected effects
During psychotherapy, some people may experience changes they had not expected or did not want.
Recalling past events can sometimes trigger unwanted emotions. Addressing and resolving these emotions is an integral part of therapy, but it can be challenging.
It is essential to find a trusted and qualified psychotherapist who is skilled at guiding people through these situations in a constructive way.
Unhelpful therapy
Most people feel better as a result of therapy, but it can take time to work — and sometimes, the approach the therapist takes is not suitable. In fact, according to some research, around 10% of people feel worse after starting therapy.
Some experts have expressed concerns about potentially harmful therapies. These could be techniques that leave a person feeling worse rather than better or approaches that may actually slow an individual’s progress.
Some approaches may not have enough research evidence to support their use. In some cases, the approach or “chemistry” between the individual and the therapist may not be suitable.
However, if the practitioner monitors the person’s progress regularly and asks for feedback, the risk of therapy not working or having a negative impact will be lower.
Using an interpreter
Not everyone can find a psychotherapist who speaks their primary language. This can pose a challenge for people who are already at a disadvantage in society.
One option is to find an interpreter, but it is essential to find someone who understands the complex issues that treatment is likely to involve.
Ideally, the person should also have the skills and training necessary for managing the specific dynamics the relationship will involve.
Cost in time and money
Psychotherapy can be expensive and time consuming. This is another reason that it is essential to find a qualified practitioner.
If a health professional considers treatment necessary, the Mental Health Parity Act requires that insurance companies pay for mental healthcare in a similar way to paying for physical medical care.
It is worth noting that the definitions of “reasonable and appropriate” or “medically necessary” may vary.
Summary
Psychotherapy can help people with various mental health needs, ranging from overcoming stress to living with bipolar disorder.
A doctor will often prescribe it alongside medication, though some people may only benefit from psychotherapy.
It is essential to find a professional. The person should be well-qualified and experienced, and they should inspire a person’s trust and confidence.
Family physicians can usually recommend a suitable psychotherapist, or a person can find a suitable practitioner through a register, such as the APA’s psychologist locator.
