People seek out therapy for a number of different reasons. For example, prospective clients may see a psychologist to work on personal growth or development, learn how to become more stable, work through their struggles with a particular problem, better communicate with friends and family members, or develop coping skills that resolve their symptoms. Depending on their reason for seeking therapy, clients may see a psychologist once, weekly for a few months, or enter into a long-term psychotherapeutic relationship.
Pretty common reasons for seeking psychotherapy:
- Prolonged anxiety or panic attacks
- Depression or mood swings
- School problems or employment issues
- Relationship problems or co-dependency
- Life events: marriage, divorce, death, parenthood, blended family issues, retirement, aging process, adolescence, etc.
- Chronic physical conditions and medical complications
- Experiencing traumatic events such as accidents, childhood abuse, etc.
- Problems with domestic violence or other forms of abuse
- Constant worrying or obsessions
- Excessive anger, frustration, or guilt
- Self-destructive thoughts and behavior
- Addiction problems with drugs or alcohol
Clients may not be cured by therapy immediately (or ever) but they should definitely experience an obvious change in how they think, feel, and act, or how they approach situations. Clients should feel more equipped to handle their problems or manage their symptoms on their own. Problems, situations, or symptoms that are longer-lasting or more profoundly impairing tend to take longer to resolve in therapy, while recent or short-term concerns typically require fewer sessions.
There are three main motivations for clients to get psychologically tested, evaluated, or assessed:
1. The judge/court or other governing body or agency may request information or recommendations to make important decisions about legal matters (children in foster care, criminals who may be insane or incompetent, parents facing CPS allegations, parolees requesting release, child custody disputes, employment and injury litigation, etc).
2. Tracking neurocognitive functioning (progress due to cognitive rehabilitation, or regression due to head injuries or stroke).
3. Concerns about a student’s academic progress, obstacles, patterns of behavioral problems, attention difficulties, or need for special education accommodations.
Psychological testing, evaluation, and assessment is useful for clarifying diagnosis, to informing treatment plans, and considering medication options or appropriate referrals. Your therapist will let you know (or you will already be informed) if you need any testing, evaluation, or assessment conducted.
During the first session, clients will learn what to expect from therapy and their therapist, including signing a psychotherapeutic contract, confidentiality, cancellation or lateness policies, fees agreements, and/or sliding scale options. Clients should expect to discuss the reasons they are attending therapy, provide important historical anecdotes and context, inform their therapist about any medical conditions or medications taken, and set therapeutic treatment goals to work on. It can take up to 3 or 4 sessions for a therapist to formulate a treatment plan and elicit their clients’ agreement, including how sessions will be conducted, whether therapeutic homework activities will be assigned between sessions, and how often the client will attend therapy.
A “therapeutic hour” or “clinical hour” is pretty standard in the industry and lasts 45-50 minutes with the remaining 10-15 minutes set aside for administrative tasks like completing session progress notes, dealing with insurance requests, replying to emails and voicemails, writing reports, and responding to clients’ requests for letters. Occasionally, family or couples’ sessions typically extend a little longer than individual sessions, unless a client has made a special request for longer individual sessions. Typically, therapy occurs weekly and decreases over time; however, some clients prefer to start off on a less frequent schedule (biweekly or monthly), which requires more catching-up between sessions. On the other the hand, a week may be too short of a period of time to practice new techniques and assess how treatment is progressing.
Every client should know that there are bad therapists amongst the ranks, just like any other occupation or industry, and that a therapist cannot be a perfect match for every one of their clients. Clients should know how important it is to feel comfortable and capable of being honest and vulnerable with their therapist, believe in their therapists’ techniques or proposed methods, and recognize when therapy is not progressing or working out as expected.
A psychiatrist is a medical doctor who specializes in mental disorders, is licensed to practice medicine, and has completed a year of internship and three years of specialty training. A board-certified psychiatrist has, in addition, practiced for at least two years and passed the written and oral examinations of the American Board of Psychiatry and Neurology. Psychiatrists can evaluate and diagnose all types of mental disorders, carry out biomedical treatments and psychotherapy, and work with psychological problems associated with medical disorders. Like other medical doctors, they can prescribe medication. Child psychiatrists specialize in working with children; geriatric psychiatrists concentrate on helping the aged.
Psychologists who conduct psychotherapy and work with individuals, groups, or families to resolve problems generally are called clinical or counseling psychologists. They work in many settings – for example, mental health centers, hospitals and clinics, schools, employee assistance programs, and private practice. In most states, a licensed clinical psychologist has completed a doctoral degree from a university program with specialized training and experience requirements and has successfully completed a professional licensure examination.
The field of psychology also includes those who specialize in such areas as testing, community organization, industrial relations, and laboratory research.
Clinical Social Workers:
Clinical social workers have master's or doctoral degrees in social work, at least two years of post-graduate experience in a supervised clinical setting, and have passed an examination required for state licensure. In addition to individual, family, and group counseling and psychotherapy, they are trained in client-centered advocacy. This includes information, referral, direct intervention with governmental and civic agencies, and expansion of community resources.
Marriage and Family Therapists:
Marriage and Family Therapist are state licensed as counselors to provide psychotherapy and counseling for families, couples, groups, and individuals. They have at least a master's degree, two years of supervised post-degree experience, and have passed a state comprehensive examination. Therapists with other licenses may also be qualified to conduct marriage and family therapy.
Professional Counselors have at least a master's degree, two years of supervised clinical experience, and have passed an examination required for state licensure. In states without licensure or certification laws, professional counselors are certified by the National Board for Certified Counselors (NBCC). They provide quality mental health and substance abuse care to individuals, families, groups and organizations. They may be trained in a variety of therapeutic techniques and approaches.
Psychiatric nursing is a specialized area of professional nursing practice that is concerned with prevention, treatment, and rehabilitation of mental-health-related problems. These nurses are registered professional nurses, and those who have advanced academic degrees at the master's degree level or above can become advanced practice registered nurses (APRNs). APRNs are qualified to practice independently and provide the full range of primary mental health care services to individuals, families, groups and communities. In most states, psychiatric nurses in advanced practice have the authority to prescribe medication.