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What to Know Before Starting Therapy

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Therapy has other names that you might hear it referred to as. For example, it can be called counseling or psychotherapy. Regardless of what it’s called, after finding a qualified licensed therapist, you begin working with them to resolve problematic beliefs, feelings, behaviours, or relationship issues you’re experiencing. 

When you start therapy, it’s a major step you can take toward being the best, healthiest version of yourself. When you participate in therapy, you can begin to tackle particular challenges, and you can improve relationships with other people, how you feel about yourself, you can deal with feelings or emotions that are painful for you and can change self-destructive behaviors you might engage in. 

There are a lot of different models of therapy, but getting started can be overwhelming.

Types of therapy

The following is an overview of some of the approaches to psychotherapy that may be used. 

  • Psychoanalysis and psychodynamic therapy. This approach is one that focuses on changing your problematic thoughts, feelings, and behaviours. You’ll work with a therapist to uncover some of your unconscious or underlying motivations. You have a close partnership with your therapist when you participate in this approach. 
  • Behaviour therapy. The goal of behavioural therapy is to help you identify normal and abnormal behaviors and change them. Cognitive-behavioral therapy is one of the most commonly used types of behavior therapy. Cognitive-behavioural therapy focuses on both your thoughts and behaviors. Behavioral therapy is very action-oriented. 
  • Humanistic therapy. In this approach, you learn how your view of the world is affecting the choices you make, particularly when those choices cause distress to you. Humanistic therapists work with patients to help them understand their experiences, and they provide guidance, but they don’t interpret the feelings of their patients for them. You learn how to increase your sense of self-acceptance, and you’re working toward the goal of living your version of your best life. 
  • Dialectical behavioural therapy. This is a subtype of behavioral therapy that was initially developed to treat borderline personality disorder. With dialectical behaviour therapy, there are usually four elements. These are skills training, individual psychotherapy, phone consultation, and team therapist consultation. These elements are designed to help patients learn the behavioral skills they need to deal with their symptoms. The skills can include distress tolerance, mindfulness, and emotional regulation as examples. 
  • Cognitive-behavioural therapy. We talked about this above, but it’s such a commonly used therapeutic approach that it’s also important to discuss on its own. CBT can help with a variety of mental health conditions as well as substance use disorders. With this form of therapy, the focus is on the connection between thoughts, feelings, and behaviours. The treatment is short-term and skills-focused. You work with a therapist to identify your negative ways of thinking, and then you start to work to understand how their affecting your behaviors and emotions. You can work together with your therapist to learn how to replace your negative thought patterns with ones that are more positive and productive. You’re not focusing on the past with this therapeutic approach; instead, you’re working on current symptoms. 
  • Group therapy. When you participate in group therapy, it’s often targeted at helping people with a certain issue, such as substance abuse or social anxiety. The benefit of group therapy is that you’re building a support network through listening and talking to one another. You can also put your problems into perspective by being in a group setting. 

Types of therapists

Just like there are many types of therapy, there are also a lot of different types of providers. Two of the most common types are a counselor and a therapist. 

The terms can be used interchangeably, but in the technical sense, they aren’t the same. 

A licensed or certified counsellor can treat a wide range of conditions, including behavioral problems, substance use, anxiety or depression, and loss or grief. 

A counselor is likely to focus on the everyday problems that are impacting your quality of life and well-being. Typically, the treatments a counsellor provides aren’t going to go into past experiences or issues from previous relationships as much as other types of therapists. 

A therapist also focuses on helping you improve your mental health and well-being, like a counselor. The difference is that a therapist has to be licensed in the state where they practice. Therapists also have to go through more education. Most therapists have gone through a doctorate level of education. 

Therapists focus primarily on talk therapy, which means you’re verbalisng your issues so that you can work through them and change how you think and your behavior. 

The term therapist might also include a psychologist or psychiatrist. 

A psychologist will use evidence-based practices in their treatment approach, while psychiatrists can prescribe medicines that work along with therapy. 

If you have more complex mental health issues, a therapist may be better for you than a counsellor. 

Counsellor qualifications

For a counsellor to treat patients in a clinical setting, they need to have at least a master’s degree in counseling. Depending on the state, a counselor might also need certain licensing. For example, the licensed professional counselor or LPC designation is one you’ll often see. 

It’s common for counselors to get certifications in areas of specialty like addiction or marriage and family counseling. 

Therapist qualifications

A therapist will usually have a higher level of completed education than a counsellor, with most having at least a master’s degree in psychology but often a doctoral level of education. 

Some therapists might have a doctor of philosophy (PhD) in psychology. There’s also the doctor of psychology designation or PsyD. 

Short vs long-term treatment

As you’re deciding on a therapist, one big consideration that can help guide your decision is whether you want short- or long-term treatment. 

If you want help with a short-term and more specific issue, such as a problem in your marriage, you might work with a counselor. On the other hand, if you have a deeper, more complex issue like trauma or anger issues, you might work with a  therapist. Therapists are more likely to work on getting to the underlying causes of the issues you experience.

What else to know about starting therapy

Here are some general things to know about starting therapy:

  • When you start therapy, you have to focus on being honest. If you’re not ready to be completely honest in therapy, you’re going to miss out on opportunities. It can feel embarrassing, to be honest about certain things, but doing so is the only way you’re going to make progress. 
  • You are going to have to invest in therapy. It can be expensive, but you have to look at it as a long-term investment in your present happiness and also your future well-being. 
  • Consistency is key in therapy. You need to keep your appointments, be on time and follow the plan that your therapist creates for you. If you aren’t consistent, you’re not going to get optimal outcomes. 
  • If you are ever concerned with your therapist or how they’re approaching things, tell them. Therapy means that you need to have an open, transparent relationship with your care provider. Your therapist may have no idea you’re having an issue with them unless you tell them.
  • Therapy isn’t always enjoyable. You might dread going, and when you’re there at the time, it can be tough, but it’s somewhat like a workout. You’ll feel better afterward if you can push yourself through the discomfort. 
  • You can have goals for your therapy, and you should. Whatever your goals are, discuss them with your therapist. Most of the time, therapy isn’t as open-ended as people think; it is very much goal-oriented. 
  • You may realise that the first therapist you start working with isn’t the best fit for you. This is normal. That doesn’t mean there’s anything wrong with you or the therapist. It’s just that therapy is very personal, and we all tend to find that our personalities fit better with some people than others. 
  • You can write down what you want to talk about beforehand. This can actually be helpful for your therapist, and it ensures you’re getting the most out of each of your sessions.
  • During your first therapy session, you can expect that you’re going to spend most of it getting to know each other. This is when you begin to build a relationship with your therapist. Your therapist will want to talk about why you’re there and what you want to address. They may also ask more about your family history, your symptoms, and your home life. 

After your first therapy session, you want to check in with yourself and think about how you felt and whether you’d like to continue working with the therapist or you think you’d like to work with someone else. 

Maybe you didn’t feel comfortable with the person, or you didn’t feel like you clicked, and again, it’s normal and perfectly okay to interview a few therapists to find who’s going to work best for you.

Dennis Relojo-Howell is the managing director of Psychreg.


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