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| What is psychotherapy?
Psychotherapy is a powerful, time-honored, and proven method of helping people change the way they feel and manage their lives. Therapy is the practice of talking things through with a skilled and trusted professional who, by using a variety of techniques, can help clients make positive changes in their lives. It is a healing method based upon both the science of psychology and the skills of understanding, teaching, supporting and confronting.
Psychotherapy is confidential and private. No information about therapy sessions can be released to anyone without client permission. (There are legal exceptions to confidentiality when someone is a danger to themselves or others and when there is evidence of the physical or sexual abuse of children. These exceptions can be explained in more detail by a therapist.)
Psychotherapy is individual. A skilled professional has a knowledge of many therapeutic techniques and is able to use them to meet individual needs. Effective therapy moves at the client's individual pace. A therapist knows how to time interventions according to a client's readiness. Together, client and therapist decide the frequency of sessions and when it is time to end the therapy.
Research shows that with trained, empathic and experienced therapists, people can make great improvements in their personal, emotional, occupational and interpersonal lives. In fact, millions of people have benefited from psychotherapy. Solving problems in therapy can prevent many of the social tragedies of our time, including depression, domestic violence, child abuse, school failure, substance abuse, and suicide.
How much does psychotherapy help?
Psychotherapy can help almost everyone. A useful way to think about success in therapy is that the client has grown, improved, gained insight, or solved specific problems. Studies show that, on the average, people with emotional or interpersonal problems who use psychotherapy do better than those who don't. The amount of improvement depends on the person, the type of therapy, the length of therapy, and the type of problem.
Sometimes people have a chronic mental illness, and psychotherapy helps the person to cope with the illness. In many of these cases, the symptoms and problems cannot be completely cured. But here, psychotherapy is helpful because it can make an important difference in improving the quality of a person's life.
Each person is different and unique. The amount of improvement you should expect is something you can discuss with your therapist.
Why should I pay for my services instead of using my insurance?
You want privacy.
Whenever insurance is used, some information (such as your diagnosis) is available to the insurance company and, at times, to employers. Managed care companies often ask for detailed personal information about clients in order to make payment decisions. This judgmental review can undermine the sense of privacy necessary for effective psychotherapy. When clients pay for psychotherapy out of pocket, there is no loss of privacy to managed care companies, insurance companies or employers.
You want to choose your own therapist.
Many insurance companies limit the choice of therapists. Many clients prefer to choose their psychotherapist personally and avoid seeing a therapist with a potential conflict of interest between the client and the insurance company. Other clients may want to work with a therapist who was highly recommended but may not be on the company or preferred provider list.
You want to choose the type and length of treatment.
Managed care programs often limit the choice of therapy. While some interfere very little with the consumer's choice of type or length of therapy, others make many of the important treatment decisions - the length of treatment, the type of therapy, the use of medication and referral to selfhelp groups instead of professional services. Selfpaying for therapy may be necessary in order to receive the type and length of treatment needed.
You don't want a managed care employee making judgments about you.
When managed care is responsible for payment, they have the power to influence your treatment. A company employee evaluates your motivation, the severity of your problem, and your progress, and makes treatment recommendations. The therapist must take the company's recommendations into consideration or risk losing the contract to work with the company altogether. Many clients prefer paying for their own treatment to eliminate influence from an outsider.
You don't want to be labeled 'sick.'
Whenever insurance is used for psychotherapy, the treatment must be 'medically necessary', which means that your therapist must give you a psychiatric diagnosis. When you pay directly, you may seek consultation from a mental health professional for any reason you choose. People use therapy for personal growth, for help coping with stressful life situations, and for marriage and family difficulties, as well as for chronic and serious psychological problems.
What about brief therapy?
Consumers generally want their therapy to be as brief as possible, and today more people are talking about brief therapy techniques. Many researchers and therapists call 30 sessions of therapy - 'brief.' Other therapists consider 'brief' to be just a few sessions. It is important to know what a therapist means when referring to 'brief therapy'. Research generally shows that therapy must be longer than a few sessions to be helpful. The research that proved psychotherapy is beneficial was based on analyzing hundreds of studies of therapy that averaged 17 or more sessions.
Whether brief therapy works for you depends on what you are looking for from therapy and the kind of problem you bring to therapy. Many times, people see a therapist for just a few visits. This can be successful if a client is looking for a brief consultation or is dealing with a temporary crisis. What is important is making sure that your goals are accomplished.
Because it can be helpful for many people, it makes sense to consider brief therapy. However, long standing, difficult, complicated, or more serious problems often need more time. Longstanding problems rarely change overnight. As an informed consumer, you should ask your therapist about the length of your therapy. Your therapist may not know the exact duration of your therapy, but can help you understand how therapy moves forward and how you can tell when it is complete.
When does a child need therapy?
Contrary to the wishful myth we have often heard, children are not more adaptable and less affected by problems than adults. The opposite is true -- children have fewer coping skills and less control over themselves or their environment. They are not able to verbally describe emotional problems but exhibit their distress in a number of symptoms that include irritability, sleeping problems, eating problems, personality change, physical complaints, disregard for personal safety, school problems, problems getting along with others, acting younger than their age and acting older than their age.
Every child will be distressed at times. How does a parent know when psychotherapy is needed? This depends on how severely distressed a child is, how long the child has been distressed, the child's personal strengths for handling problems and what kind of supportive relationships with adults are available. Child therapists can help evaluate if therapy is necessary. If therapy is needed, therapists may work in several different ways: sometimes they assist the parents and teachers to design techniques for helping the child, sometimes they see children and parents together in family therapy and sometimes they see children alone. If recommended, the goal of therapy is to resolve symptoms and assist the child to resume his or her positive growth and development.
What if the school says my child needs help?
When school personnel express concern about a child, it generally means that they are observing behaviors that differ in some way from that of most other same-age children. School behavioral problems may relate to the child's school environment, home environment, social environment, or factors related to all of these environments. Problems in school are often observed in impaired learning, social-emotional conflicts or defiance with peers and adults, or these problems in combination.
It is generally helpful when school personnel and parents work together to understand the nature of the problem, and jointly develop and implement a plan to make school a more successful environment for the child. The assessment of the child's learning and behavior may include the input of the school psychologist, social worker, and Child Study Team. The family may seek an independent evaluation by a consulting psychologist. Some problems can be resolved with relatively brief interventions and combined home and school support. Others may require sustained interventions and educational support. If a disability is determined to be negatively affecting the child's educational progress, an Individual Education Plan (IEP) may be established in accordance with State Law. Procedures and guidelines for parents regarding their child's right to an appropriate education are readily available through the school district office.
What about medication?
Making a decision to use medication is individual and complicated. Some problems get better primarily with medication and other kinds of problems get better primarily with psychotherapy. Still other problems respond best to medication and psychotherapy combined. Most often, when people take medication for emotional problems, they do better if they also seek psychotherapy.
It is important to be an informed consumer. Ask your psychotherapist for advice and information about referral to a medical doctor for a medication evaluation. Ask your medical doctor for advice also. Get as much information as you can about the different treatments for your own individual problem. Then use this information to make your personal decision about when and how to use medication and/or psychotherapy.
Who should I talk to if I am considering medication?
When considering medication for mental health problems, a person must ask a medical doctor for a medication evaluation. Sometimes the family doctor or a general practitioner is consulted, and other times it makes sense to see a specialist - a psychiatrist. If a person has a therapist, the therapist can be helpful in making the decision to try medication and may recommend a specific doctor or assist with the referral to a doctor of your choice.
Why do some patients have a one-time consultation with a psychiatrist? Although patients may receive medication from a family doctor, there are still times that it makes sense to consult with a psychiatrist. If the medication and treatment are not working as well as hoped, patients may decide to consult with a specialist about additional ideas for treatment. Sometimes the psychiatrist can give the general practitioner recommendations for changes in medication or treatment that will give better results. Helpful Links
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