I think this is one of the most important questions people can have about therapy. Knowing when to seek out services for your mental health isn’t as clear cut as say, going to a doctor for a broken bone. I need to clarify a few terms before we go too far though. First, there are three terms most commonly used for mental health services. Many use the generic “therapy” to describe services which is straightforward but can be mixed up with other kinds of therapy, like physical therapy. Some people say “counseling” since that refers to the license that some (like myself) have, but it sometimes lacks a mental health connotation. Less commonly used is the word psychotherapy (not to be confused with psychoanalysis, which is different) which definitely sounds mental health related but has a few more syllables so it isn’t as easy to say. I tend to use those words interchangeably, but I’ll stick to either counseling or therapy more often.
The other important thing to clarify is who it is your going to see. Not everyone who provides mental health services do the same thing. The most common providers are master’s level therapists who have a degree in either psychology (like me) or social work. I’ve heard those called the “workhorse degrees”. If you’ve ever been to therapy you’ve probably seen someone in this category. Then there are Doctors of Psychology (Ph.D or PsyD) who provide counseling just as well as master’s level providers but have further education in areas like psychological testing and research. Finally, there are psychiatrists who are technically medical doctors. They can provide counseling but also prescribe medication as well. Psychiatrists in Alaska also tend to be much busier because they are much less common. Child psychiatrists in Alaska are rarer than unicorns. Where I can give a client 50 minutes of my undivided attention some psychiatrists are so overburdened that they can only schedule 15-20 minutes per client.
Now, back to the main question. When do you need to go to therapy? Every provider is going to give you a different answer. I can only give you my own professional opinion on this one. There’s two main schools of thought to that question. The first comes from a medical model approach which would say that you need to seek out services when you have a diagnosable mental disorder like major depression or borderline personality disorder. From that perspective you’d get a manualized treatment for a specific window of time until your symptoms have been reduced at which point you stop going.
I tend to be on the other side of the fence. I would say someone should go to therapy when they want to make a change for the better in their life. That could mean that they have a specific condition they need help with, but it could also mean they just want to enrich their life. Maybe they need to grieve the death of a loved one, or get over a difficult ex, or learn how to calm their anger, or they are a teen having behavioral problems at school, or they want to get over their fear of public speaking, or the piles of mess have grown so high in their home they are afraid to even look at them, or maybe they have a trauma from their past they just can’t let go of on their own. When you have a behavior, emotion, or thought pattern you just can’t seem to change on your own that’s the time to go get some therapy.
Therapy is a collaborative process though. That means it must be a problem that you want another person to help you with. If you can make the change all on your own that’s fantastic! I encourage everyone who can go it alone to keep it up, but some problems are too big to tackle alone. That also means it has to be something you are willing to talk about. You don’t have to share every little detail of your life, but if you aren’t comfortable enough to talk about the problem your therapist won’t be able to help you. That being said, a good therapist should be able to help you feel more comfortable with bringing up the tough stuff.
When it comes to specific services, the letters after someone’s name are important. Remember how I talked about different kinds of providers? The person you should call depends on your problem. If you just need some counseling call someone with LPC or LCSW after their name (or LMFT if you have marital/family problems). Those are those master’s degree people I was talking about. If you need specific kinds of testing, like intelligence testing, look for a Ph.D. If you want someone who can manage your meds but can’t see you as regularly a psychiatrist could be the way to go.
Finally, the best thing you can do is just give a therapist a call. Most providers are willing to do a phone screening to see if your concerns are a good fit for them. I offer a free 15-20 minute call to see how I can be helpful in your situation. I can’t give an answer for every situation, but I hope I’ve given you some idea to help you know if it’s right for you.
-Travis
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