Speaking of Mental Health, Part 2

The efficacy of psychotherapy as treatment for a wide variety of conditions is well-established.  It is also a natural partner, along with psychopharmacology, in the treatment of serious mental illness and addiction.  Still, lots of misconceptions persist in the general population about what counseling is and how it works. In fact, while mental health services are becoming more widely available, they remain underutilized.  In addition to factors of availability and access to treatment, limited understanding of psychotherapy also contributes to undermining or shunning of this treatment option.  Consequently, rudimentary knowledge of the field is essential for those looking to engage.

What is psychotherapy?

The American Psychological and Psychiatric Associations define psychotherapy as a collaborative process aimed at improving overall client functioning and wellbeing that is built on the open, nonjudgmental and supportive atmosphere of the client-clinician relationship. Though forms and schools of thought abound, and new approaches are developed every day, psychotherapy is essentially the pursuit of self-improvement through greater self-awareness and mastery.  The process can last from as little as six weeks to many years depending on treatment needs.  Clients typically attend sessions on a weekly basis in the early stage of treatment and shift to biweekly or monthly as treatment progresses. 

Choosing a Therapist

The choice of a therapist should be primarily informed by the chief complaint.  While many therapists work with a wide range of clients and issues, more and more clinicians are specializing in the treatment of specific conditions, such as eating disorders and addiction, or treatment modalities, such as DBT or EMDR.  The specialist is more likely to be comprehensively fluent in the treatment of the ailments within their area of expertise, thus able to provide customized support.  In addition, the resources and networks accessible to niche practitioners tend to be more abundant than is generally available.

The second factor to consider in selecting a therapist should be one’s own constitution.  This includes, for example, the client’s motivation, social adjustment, self-direction and current functioning.  While this may seem like a lot to ask of a novice client, the recognition of those factors is key to the change work that clients will undertake in therapy. While very few clients have an exact idea of the type of relationship they want with a therapist, they are generally very well aware of how they interact with other people. Unsurprisingly, clients repeat the same patterns from their personal lives in their therapy relationship.  Someone with a deep sense of distrust in their personal relationships will have the same initial response in therapy, for instance. 

Having a general sense of that constitution at the outset allows for a more informed orientation in the first session. The flip side would be to figure it out with the clinician.

Lastly, the collaborative nature of the psychotherapy relationship requires what is typically referred to as the goodness of fit or client-clinician compatibility.  The strength and quality of this alliance have been shown to be the best predictor of successful treatment outcomes–more reliable in predicting success than the therapeutic techniques or theoretical leaning of the therapist. Clients who successfully match up with compatible therapists report a greater degree of satisfaction in their treatment and show better outcomes.  The compatibility matrix includes many elements: personal philosophy, common experiences, gender, race, culture, etc.  While a perfect client-therapist match may not be possible, research shows that clients paired with compatible therapists are more likely to be actively engaged in, complete, and show lasting results from treatment. 

Effective mental health treatment is possible and attainable.  However, limited access to appropriate providers combined with misconceptions about psychotherapy can have the unfortunate result of turning people away from the service or spoiling their experience.  Clients can improve their outcomes with a little bit of work spent on vetting potential therapists and on self-reflection.

Resources

Richardson, P. (1997). ABC of Mental Health: Psychological Treatments. BMJ: British Medical Journal, 315(7110), 733-735. Retrieved April 19, 2020, from www.jstor.org/stable/25175745

Høglend P. (1999). Psychotherapy research: new findings and implications for training and practice. The Journal of psychotherapy practice and research, 8(4), 257–263.

American Psychological Association. (2012, January 1). Get the facts about psychotherapy. http://www.apa.org/topics/psychotherapy-myths

American Psychological Association. Understanding psychotherapy and how it works. 2016. http://www.apa.org/helpcenter/understanding-psychotherapy.aspx

Like most of the pictures on TeensParentsTeachers, the picture posted with this article is courtesy of a free download from Pixabay.com.