Pursuing Psychotherapy I

What is Psychotherapy?

So you think you might need therapy. Now what? This series will help guide you through the process. Become an educated consumer and learn what the field has to offer and how to get the right kind of help.

We’ll start off with the assumption that there are different reasons individuals may want to pursue therapy. Some looking into therapy are struggling with emotions that are not helping them live the life they want, while others might have reasons other than ineffective emotions for their pursuit of therapy. It follows then, that not everyone needs the same therapy. There is a hierarchy to this which I will explain as follows: 

• There are those that need therapy, meaning these people have big ineffective emotions that are getting in the way of their day to day functioning. They need help now. The good news is that there is help! Fast and efficient treatments are (Baruch Hashem!) available and successful at treating so many problems that need intervention. 

• Then there are those who want therapy. These people have big emotions that are not getting in the way per se of their actual functioning, but their quality of life is affected.

• Finally, there are those who might want therapy because they would like to grow and gain insight into oneself and better understand his/her experiences. In this case, therapy isn't a need - it’s mainly enhancing quality of life more than anything else. 

Now to go backwards: For the last category of therapy seekers, any kind of therapist can be helpful. There are many insight oriented therapists that can provide that. 

However, for the other categories, it’s important to get the right kind of help! The first step is knowing that you are not looking for insight, you are looking for treatment and solutions. 

If you (or your friend) are in either of these categories, the therapy you are looking for should include: 

1. Intake (2-4 sessions)

The goal of an intake session is for the therapist to learn pertinent information about your background and the presenting problem.

2. Conceptualization of the problem and diagnosis

Once the therapist knows how the problem presents and the context by which it occurs, they should provide a conceptual framework representing a theory behind why the problem exists and through what mechanisms it’s maintained. In most cases, this will also include a diagnosis.

3. Treatment plan

With a conceptualization in place, the therapist is able to construct a robust treatment plan. The treatment plan demonstrates how therapy will solve the presenting problem based on the conceptualization.

4. Assessment

To ensure that treatment is working, the therapist should assess your progress at regular intervals. Generally, this is done via widely-accepted written assessments that can often be administered quickly in session or at home, and they provide clear measurements of outcome.

The advantage of regular, measurable assessments, is that they can direct treatment quickly and efficiently. If, after a fair amount of time, there has been no improvement or positive change, the therapist should use that information to change the treatment plan in a way that will best serve your needs.

Most importantly, once you've established that your therapy meets these criteria, the therapy should help you:

• Reach treatment goals

• Maintain treatment goals and titration of treatment 

• Graduate! 

Yes, therapy should end. Problems should get solved, and the changes should be sustained over time. 

Having this understanding in mind will help you in choosing the right therapist and treatment to get you to where you want and need to be.