Here are some common reasons people come in for therapy:
- Trouble in relationships. marriage, friendships, coworkers.
- Life transitions. Adolescence, marriage, change of career, divorce, empty nest, retirement — each of these phases poses unique challenges.
- Anxiety. Many life transitions are tough on the nerves.
- Depression. Sometimes we don’t even realize we are depressed. If you are suffering from apathy, difficulty with sleep or sleeping too much, feeling blue, irritable, or lack of motivation that lasts for more than a few days you may be suffering from depression.
- Lack of direction. Sometimes people find that they are unhappy about where they are in their lives, confused how they got where they are. Psychotherapy is excellent at addressing such questions in a thoughtful, respectful manner that offers an opportunity for growth.
Find a therapist that you are comfortable talking with. You want to have a sense that this is a person with whom you can develop a trusting, respectful relationship. It needs to be a good fit. A recommendation from a good friend can be helpful.
Therapists have many different ways of working. Some focus on behavior. Some focus on thoughts. Many focus on emotional experience. Still others focus on relationships, conflicts, identity issues. Most therapists probably focus on all of these areas, but to differing degrees. It’s a matter of emphasis.
A variety of professionals do psychotherapy. Should you see a Marriage and Family Therapist, Clinical Social Worker, Psychiatrist, Drug and Alcohol Counselor, Psychologist?
More on this later.
How can I choose a therapist when there are so many different kinds? Just to start, there are a bewildering number of professional degrees associated with therapists — L.C.S.W., M.D., M.F.T., Ph.D., Psy.D. to name a few. More on the different degrees and what they mean in part two
There are many different ways of practicing individual psychotherapy. Regardless of the degree of training a psychotherapist has, they tend to fall in a couple of broad groupings in terms of how they think about cases and work with their clients. Each of these broad groups include many different varieties.
Behavioral Therapy. Broadly defined, these therapies focus on behavior. In fact, the early behaviorists thought that since we can never know exactly what goes on in the brain (they called it “the black box”) that thoughts and feelings are unimportant. We should only work with observable behaviors. Behavioral therapy can be very effective for discrete behaviors such as phobias and bad habits. A behavioral analysis can be very effective in isolating causes of behaviors in children.
Cognitive-Behavioral Therapy. At some point the hard-nosed scientists were joined by some people who decided thoughts at least might be relevant. Cognitive-Behavioral Therapy, also known as CBT, tends to focus on how our beliefs influence our thoughts, and how certain thoughts can really distort our view of the world in ways that make us unhappy. In CBT thoughts are often actively discussed, challenged, and slowly modified. Therapy often includes homework.
Psychodynamic Therapy. This type of therapy focuses on formative experiences, inner conflicts, and character structure. Its roots are in psychoanalytic therapy, but it incorporates more than just Freudian psychoanalysis. Jungian Analysis, Adlerian Psychoanalysis, and other “depth psychologies” are drawn upon in psychodynamic therapy. Psychodynamic therapies tend to be sensitive to issues of identity, patterns of family interactions, and questions about what it means to be in relationship with others.
Research supports the idea that different therapies are effective in different areas. Overall, the largest study done concluded that no one therapy was more effective than any other, despite many claims to the contrary.
My own belief is that “goodness of fit” is probably more important than what kind of therapy is being practiced. It is important that you feel comfortable and confident in your therapist’s abilities.
I have a year’s experience at Santa Anita Family Service in Monrovia, a community mental health setting, seeing low-fee and court-mandated clients. I also co-led groups in anger management, domestic violence, and pain management.
A year at Las Encinas Hospital in Pasadena was invaluable in fine tuning my clinical radar.
Currently I am doing a post-doctoral fellowship at the Wright Institute, a sliding-scale fee clinic near the Museum of Tolerance on Pico Blvd. I also did an internship at WILA last year, both years included intensive training seminars and case conferences.
I recently began seeing people at Rose City Counseling, on Colorado Blvd. near the Paseo. This will be the home of my practice starting in October.
And of course, there’s my education, but that’s another post altogether!
What are you considering getting help with? Do you have a phobia? Depressed? Are you worried that your child has ADHD? Feeling overwhelmed? Perhaps you have a sexual problem.
Depression. While depression can be effectively treated in a number of ways, certain problems are best treated by someone that specializes in that area. Lots of insight-oriented psychotherapy, while valuable in many respects, probably would not do much for your phobia.
ADHD. This is way over-diagnosed, and while you want someone with expertise, you want to be careful that you don’t find someone who specializes in diagnosing ADHD. Unfortunately, this is not uncommon. A behavioral analysis might be in order. Or a family session. In cases where the behavior does not vary markedly between settings, a neuropsychological evaluation can be very effective. This provides valuable data about possible sources of the atttention deficit. An attention deficit is a symptom, with a variety of possible causes. Once the cause is narrowed down, a sound treatment plan can be developed.
Sexual difficulties. These can be largely psychological, the product of longstanding anxieties. Or they may reflect some aspect of a relationship. Sometimes we are simply ignorant about our bodies. Couples therapy can be an excellent way to address aspects of your relationship. But sometimes we might want to consult with a certified sex therapist.
So, it’s not just a matter of finding a good match. That is important, but it does not guarantee that you’ll be getting the treatment you need. You may need to find a therapist with expertise in a particular problem. A good therapist will refer out to a more qualified practitioner when necessary.