Why do I need a therapist? 

Working with a therapist to learn and optimize coping strategies during times of stress is essential to the treatment of your symptoms of anxiety and depression. Psychotherapy is so much more than just talking to someone about your problems or feelings. It is about equipping you with tools to help you recognize things that activate your anxiety and low mood and discover ways to ease your anxious and/or depressive thoughts. Changing your thoughts can lead to changed behaviors and emotions. Therapy does not change your problems, situation, the people around you, or what they do. Rather, it can change your own reactions to stressful situations and people and teach you to problem-solve.  

What is the difference between a psychologist, therapist, and a counselor?

Psychologists, therapists, and counselors can provide similar services to patients in teaching them to identify what activates their emotions and manage their reactions to them. While some may refer to all of these professionals as “therapists,” there are some differences to be aware of. They have different levels of training, licensing requirements, and may have differing skill sets that fit your needs better than others. Psychologists usually have the highest level of training and can administer neuropsychological testing, diagnose both educational and some psychiatric conditions, and make recommendations based on these diagnoses. Therapists often choose a field of specialization such as anxiety, depression, PTSD, etc although many are trained in multiple areas, and use specific therapy techniques to address these conditions. Therapists generally offer longer-term care and help deal with long-standing psychiatric conditions. Counselors also choose a field of specialization although they too are comfortable managing a variety of specific conditions. They tend to offer short-term care to help you get through a tough situation or season of life.  

Can a psychologist, therapist, or counselor prescribe medications?

Only medical doctors, nurse practitioners, or physician assistants can prescribe medications, but your psychologist, therapist, or counselor may recommend a trial of medication if they feel that it will be helpful. They will refer you to either your primary care provider or psychiatrist to start and manage medications.  

Do psychiatrists provide therapy or counseling? 

Psychiatrists are medical doctors who specialize in treating psychiatric conditions. Some will provide therapy, but many focus on medication management and work closely with therapists as a team to provide comprehensive care to their patients. 

How do I find a therapist?

There are different approaches such as checking with your insurance to see who your “in-network” providers are or using online search engines to find someone who will fit your needs the best. Examples of popular sites include psychologytoday.com and findcbt.org. Your doctor may also have some references of local psychologists, therapists, and counselors. 

What if I do not feel comfortable talking to a stranger about my problems? 

No one likes to feel vulnerable and talk about their struggles with others, but hiding them will not solve these issues. Since bottling them inside has not helped, it makes sense to give the alternative a try, even if it feels awkward and embarrassing at first. You can start with more general issues and then work your way up to discussing more personal matters gradually.  

I have seen therapists before and they were never helpful. Why should I see another one? 

It can be frustrating when you try something that is supposed to help and it does not seem to make a difference. However, not all therapists are equal and your previous therapists were not likely the best fit for you. Also, consider honestly whether you truly invested in the previous therapy relationships as you could have as discussed below. Remember, this is a relationship, which means both parties have to do their part for it to flourish. 

What do I need to do during therapy? 

• Be as honest as you can, even those things that make you feel embarrassed, ashamed, or afraid. The point of therapy is not to judge you or “grade” your behavior or past. The goal is to move forward and that is not possible without first dealing with the baggage you carry within. The more honest you are with yourself and your therapist, the more freely you can let go of your past mistakes and current fears.  
• If your therapist recommends a specific technique, give it a shot even if it sounds cheesy or feels unnatural at first. You might be pleasantly surprised by how helpful certain exercises can be. You will never know if something will help you if you do not give it a chance. If you give them an honest try a few times but do not find them to be helpful, let your therapist know! You will not hurt their feelings. It is their job to help you find strategies that work for YOU, which may differ for what works for others. If a technique does not work, it does not mean that something is wrong with you – it likely is not the best strategy for you. Your therapist should then teach you another one until you find something that is actually helpful.  
• Do not be shy about requesting help with specific situations or difficulties – ex. your difficulty talking to your classmates because you worry about not having anything interesting to say or what they will think of what you say. Your therapist can help tackle your unique challenges – role playing, helping you develop a list of topics you can use when you run of things to say, ways to ask open-ended questions that will invite others to talk as well, etc. If you do not ask, you cannot get help! 

How do I know that the therapist is right for me?  

After the first few sessions of learning your story, your therapist will help you to develop treatment goals and map out ways to achieve these goals. Below are some points to consider as you assess whether your current therapist is a good fit for you:  

• Therapy Style: Some therapists are more active in recommending techniques and even give homework while others tend to be a quiet guiding force, helping you to discover techniques on your own. Neither is right or wrong, better or worse. The important thing is that you feel comfortable with their therapy style. 
• Comfort and Trust: Just like any relationship, a therapeutic relationship between a therapist and patient takes time to grow in comfort and trust. We recommend you have an open mind and patience as you enter into this relationship. Keep in mind that the goal of this relationship is not a friendship and definitely not a romantic relationship and boundaries need to be mutually respected. If you find that you are not feeling connected to your therapist after at least 4-5 sessions, it is reasonable to find someone else with whom you feel more comfortable. Do not be discouraged if this happens. Human beings don’t always “gel” perfectly together. The most important thing is that you find someone who fits your needs and can help you the best at this time. 
• Expertise in Your Issues: While most therapists and counselors are trained to treat a variety of issues, not all will be equally good at addressing every need. If you struggle with more specific challenges including trauma, abuse, obsessive-compulsive tendencies, or familial conflict, etc, finding someone who has training and experience in these areas will be helpful. Do not be afraid to ask how comfortable your therapist is at treating your specific challenges.  
• Progress: As you continue your regular sessions, it is important to frequently assess the progress being made. It may not be as evident to you as those around you especially in the beginning, so it is important to get feedback from those who are around you as well. If you and those around you do not observe any progress, it is okay to give that feedback to your therapist. They may need to consider a different approach. Beware of “blaming” your therapist for limited progress. While these sessions are there to guide you, the bulk of the work will still depend on you. Your mood or anxiety will not magically improve if you are not fully investing in the work YOU need to do – attending therapy sessions regularly, being honest and open with your therapist, engaging in developing coping strategies, and practicing these tools.  
• Availability: Many therapists are very busy making availability challenging at times. It is important to ask how often they can see you. We generally recommend seeing your therapist at least once a week until you feel stable in your mood and anxiety. If you are open to telehealth visits, availability will likely be higher.  

How often should I see a therapist?

If you find your mood and anxiety level to fluctuate frequently, it will be best to see your therapist at least once weekly, more often if you are often struggling with self-harm thoughts. As your mood stabilizes and anxiety decreases, you can stretch out the interval as recommended by your therapist. 

How long do I need to see a therapist for?

You do not have to see a therapist forever – just until you feel comfortable with the tools you have gained. This means giving therapy a fair shot (at least a few consecutive weeks). There is no definitive requirement – it will be dependent on your need. Some patients like to check in once in a while for a refresher or when going through a tough time.