NOTE: Answers to the following questions are in line with my experience, training, and personal philosophy regarding therapy. They may not be representative of all mental health providers.
What’s the difference between the terms “counseling”, therapy”, and “psychotherapy”?
In one sense, there are no differences since they all imply you talk to a mental health professional to help solve various problems in your life. In another sense, there a significant difference. I view the term counseling to mean that a short-term and more focused approach is taken toward solving the client’s problems. I view the term psychotherapy to mean that a long-term and more in-depth approach is taken. The term therapy is simply an abbreviated version of the term psychotherapy.
Can’t I just talk to someone I know who is a good listener and get the same help that I would from a therapist?
The answer to that question is a resounding “no”. The bottom line is that clients want to and need to be listened to. They want a therapist who can listen to them in depth. That is what we offer. We listen to people in depth, over an extended period of time and with great intensity. We listen to what they say and to what they don’t say. We listen to their life stories and to the story that they live with us in the room; their past, their present, and future. We listen to ourselves listening. “ Whatever managed care says, and whatever drugs are prescribed, and whatever the research findings, people still want to be listened to in depth and always will” (Aron, 2009).
Will I be sent off to a mental hospital against my will?
No, this does not happen often to most people. There are very few instances that would dictate hospitalization, namely, when safety issues are a concern. Out of the general population, only a very small percentage ever need to be hospitalized for psychological reasons, and even fewer are taken again their will. (Again, these few have to threaten harm to themselves or someone else.)
What can I expect in the first session?
In the first session, you will most likely be asked “What prompted/made you call a therapist?” From there, the therapist will seek to gain a clear understanding of what issue(s) you want to work on, how and to what extent the issue gives you difficulty or concern on a regular basis, what factors led to the development of the issue, and how can you and the therapist address the issue in terms of working toward a solution. I like to ask my clients what they want to accomplish in therapy, what goals they seek, and how would their lives be different if therapy worked for them.
What's the difference between a counselor, therapist, psychotherapist, psychologist, psychiatrist, social worker, marriage and family therapist, etc?
At the basic level, there are no differences in that all of these mental health professionals talk to clients to help them solve their problems. At another level, however, there are significant differences in education and training that can impact the type of help you receive. For instance, typically the terms therapist, psychotherapist, psychologist, and psychiatrist denote practitioners with a doctoral level of training, while the other terms denote practitioners with a master’s level of training. However, I believe that what determines how much a client resolves their problems while in treatment lies more within the client that within the therapist. Clients who are internally motivated to participate in the therapy process are more likely to see helpful changes than those who are not fully invested in the process. My personal belief regarding this issue, is that all persons have their answers within themselves, but life circumstances or choices may have made the person unable to access those answers. I see my role as a therapist as a facilitator and guide in the discovery of the answers that the client seeks.
How can simply talking about a problem fix it?
The way this commonly asked question is worded tells us a lot about the culture in which we live today. We are action-oriented and usually want to know several action steps that we can take in order to solve our problems. The idea of thinking and talking about a given problems seems almost ridiculous and certainly a waste of time. But truly meaningful, significant change has to begin from within and changing from within requires a shift in perspective (a paradigm shift). This in turn usually happens only after contemplating an issue for a while and after talking to caring others and feeling strength from their support and guidance.
How do I know if I need to see a therapist?
This is typically indicated when our daily functioning is compromised, and we are only walking through each day with little joy in our life. Most all aspects of our lives are affected and nothing we have tried seems to help. Things that helped before are not helping anymore. You may have reached a point at which you recognize that the problem is too big or complex to handle easily by yourself.
Will what I say in therapy be kept private and confidential?
Generally, what you say in therapy sessions will be kept confidential. However, there are exceptions to this confidentiality. The most common exceptions are 1) you are threat to yourself or others; 2) child abuse or neglect is suspected. This exception also applies to elder abuse or neglect. 3) your treatment records are requested by subpoena; or 4) to collect payment for services rendered.