Who seeks therapy?

People make the decision to come to therapy for many different reasons.  Often they are experiencing significant challenges in their personal or professional lives. Others come out of a sense that something is missing from their lives and a desire for something greater.  Whether the goal is to seek relief or understanding, the process of finding and choosing a therapist can be overwhelming.

Who provides therapy?

Psychiatrists, Psychologists, Therapists, Counselors, Social Workers, oh my! All those letters after a person’s name can make a person want to buy a vowel!  But who does what?

• A psychiatrist (MD) is a medical doctor with a specialization in the diagnosis and treatment of mental illnesses. Psychiatrists can prescribe medicine in addition to providing therapy.
• A psychologist (PsyD. Or Ph.D) also has a doctoral degree. Psychologists can provide therapy and can provide psychological tests and assessments.
• Social workers (MSW, LSW, LCSW) are trained in counseling but can serve many other roles as well. Their training addresses the influences around an individual’s life including housing, assistance, education, etc.
• Licensed counselors (LHMC, LAC, LPC) are licensed therapists with Master’s degrees in counseling psychology.

There are other designations and certifications that denote specialties in marriage and family therapy, addictions therapy and other modalities.  When using insurance to pay for therapy, it is important to verify with your provider which types of professionals they cover and what percentage.

What kind of therapy?

Choosing the type of professional is not the only decision to make. Next, you will likely be faced with decisions about the modality or psychological orientation of the provider.  Simply stated, this refers to the professional’s view on how people change. There are hundreds of approaches or philosophies therapists use and combine in their work. Understanding some of the basic approaches can help you know what to expect in a session.

• Gestalt Therapy is based on the theory that in order for something to change, we must first fully understand what it already is. This is a strengths-based approach to therapy that uses the client/therapist relationship as a tool to explore how he/she has come to be the way he/she is and accept him/herself before making a decision to change.
• Cognitive Behavioral Therapy assumes that thoughts, behaviors and beliefs are all linked. CBT focuses on identifying a problem behavior and working to create a solution by changing negative or irrational thoughts. This is a popular choice of therapy for those who are solution-focused and prefer a more directed approach.
• Psychodynamic/Psychoanalytical Therapy has in its roots the work of Sigmund Freud. Although many of his original teachings have been abandoned, this approach still focusses on unconscious motives and drives.  Therapists in this orientation traditionally adapt the ‘expert’ role, guiding clients through examination of thoughts and feelings with the belief that this insight can help the client make decisions for change.
• Client Centered (Rogerian) Therapy is based on the work of Carl Rogers. It is non-directive therapy, meaning that the therapist avoids providing any suggestions, treatment or direction, focusing instead on the creation of an empathetic, non-judgmental environment where the client controls the pace and content of therapy.  Rogers believed this type of environment was crucial to therapy and his principles are taught as the cornerstones to most other therapeutic orientations.

Teachers can appreciate the tension between outcome-driven quick-fix approaches to therapy and longer term, sustainable change.  Many educators and parents alike bemoan the fact that Socratic teaching and critical thinking skills are often overlooked in standardized education focused on test scores and memorization. The same is true for managed mental health care.  When parents are directed to seek CBT for their children by their insurance carriers, pediatricians or others, without understanding how these therapies view the change process, they may be missing the chance to provide a richer, more long-lasting learning experience.

 

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