Therapy 101: A beginner’s guide to counseling

Life can be stressful. Whether its school, work or relationships, there are always going to be things that can leave you uneasy—or overwhelmed. This is completely normal, but that doesn’t mean it isn’t difficult. Seeing a therapist could help ease the daily stresses of life and give you the tools needed to power through difficult times—and making an appointment certainly doesn’t make you any less strong.

Why get therapy?   

There are many different psychological conditions that warrant therapy. While chronic severe conditions, such as schizophrenia and dissociative identity disorder (DID), typically warrant the close watch of a psychiatrist along with counseling and medication, there are other conditions—perhaps not as severe but just as troubling—that may go undiagnosed.

According to the National Alliance on Mental Illness (NAMI), anxiety disorders are the most common mental illness in the United States, affecting 40 million adults, or 18 percent of the population. Unfortunately, only about one-third of those suffering receive treatment for their condition.

According to the Anxiety and Depression Association of America (ADAA), depressive disorders are the leading cause of disability in the United States for people ages 15 to 44 and affect about 18 million Americans in a given year.

Even for those people without levels of depression or anxiety reaching the levels of a diagnosable condition, life can be stressful, and it certainly has its times when it’s easy to think you’ve been dealt an overwhelming hand. It may be best to talk to your health care provider about your options if you begin noticing changes in your health, mood or behavior.

“When you begin to struggle with daily activities is when you should begin to consider talking to your health care provider,” said Whitney Landman, MSN, RN, a clinical assistant professor with the Texas A&M College of Nursing. “Also, if you begin to lose interest in things that normally you enjoy, struggle to sleep or find that your appetite is different, it may be beneficial to ask your health care provider about seeing a therapist.”

How should you start?  

If you start to think that therapy may be right for you, it’s best to talk to your health care provider about the best way to access services. “Your primary care provider may be better plugged in to counseling services that could be utilized, and can point you in the right direction of the various mental health specialties,” Landman said.

Mental health professionals

There are various types of mental health providers, and knowing what each is qualified to do is important in choosing one best suited for your needs.

Psychiatrists are licensed medical doctors with medical and psychiatric training who can diagnose conditions and prescribe medications. Psychiatric or mental health nurse practitioners can also provide assessment, diagnosis and therapy for mental health conditions.

Clinical psychologists are trained to make diagnoses and provide specific forms of assessment or therapy, such as cognitive behavioral therapy or dialectical behavior therapy. These forms of therapy are common and focus on helping patients learn how their thoughts can actually change their feelings and behaviors.

Clinical social workers have a master’s degree in social work and are trained to make diagnoses and provide counseling, case management and advocacy. They can work in hospitals or in private practices.

You may need a combination of mental health professionals to best treat your condition. For example, a psychiatrist may prescribe your medications and help coordinate your care, while a clinical psychologist may provide weekly therapy sessions. For more information on mental health professionals, visit the NAMI website.

Assessing your needs 

Many people may be wary of seeing a therapist for a variety of reasons, whether it’s the stigma that therapy is somehow correlated with weakness instead of illness, or that medication will alter their personalities too much. However, Landman recommends openness with your health care provider to discuss what steps should be taken.

“A lot of people can benefit from counseling,” Landman said. “Have open dialogue with your provider, and treat it as if it were any other condition. Health care providers won’t automatically jump to medications if they aren’t necessary and use the least invasive methods first.”

Therapy can be done either individually or in a group setting. Group settings can provide a sense of community acceptance, which can be therapeutic in itself. However, individual therapy can be more focused to a person’s specific needs and successes as opposed to that of the entire group’s. Talk to your mental health provider about which type of therapy—or which combination of therapies—may be best for you.

There are also many different types of activities that offer therapeutic benefits, such as art therapy or equine-assisted therapy. Although these may not be recognized as standard practice, it could be a good idea to talk to your mental health provider about different options that could assist with your therapy.

Also, if you are prescribed medication, it’s crucial to use as directed and to finish your course. “Keep taking your medication for as long as you’re prescribed, and don’t just stop when you start feeling better,” Landman said. “An abrupt stop in medications can have serious effects, such as flu-like symptoms, withdrawal symptoms or uncontrolled or disturbing thoughts. Work with your physician to safely wean yourself off of these medications.”

Seeing a therapist or a counselor can be a trying time, but talking could be extremely beneficial in itself. “Talking about your problems can be extremely helpful,” Landman said. “Many of these conditions can be managed, and therapy or counseling—and communication with your provider—is a great way to map out a plan to deal with your condition.”