Understanding Psychotherapy
What is Psychotherapy?
A psychologist can help you work through such problems. Through psychotherapy, psychologists help people of all ages live happier, healthier and more productive lives.
In psychotherapy, psychologists apply scientifically validated procedures to help people develop healthier, more effective habits. There are several approaches to psychotherapy — including cognitive-behavioural, interpersonal and other kinds of talk therapy — that help individuals work through their problems.
Psychotherapy is a collaborative treatment based on the relationship between an individual and a psychologist. Grounded in dialogue, it provides a supportive environment that allows you to talk openly with someone who’s objective, neutral and nonjudgmental. You and your psychologist will work together to identify and change the thought and behaviour patterns that are keeping you from feeling your best.
By the time you’re done, you will not only have solved the problem that brought you in, but you will have learned new skills so you can better cope with whatever challenges arise in the future.
When should you consider psychotherapy?
Because of the many misconceptions about psychotherapy, you may be reluctant to try it out. Even if you know the realities instead of the myths, you may feel nervous about trying it yourself.
Overcoming that nervousness is worth it. That’s because any time your quality of life isn’t what you want it to be, psychotherapy can help.
Some people seek psychotherapy because they have felt depressed, anxious or angry for a long time. Others may want help for a chronic illness that is interfering with their emotional or physical well-being. Still others may have short-term problems they need help navigating. They may be going through a divorce, facing an empty nest, feeling overwhelmed by a new job or grieving a family member's death, for example.
Signs that you could benefit from therapy include:
- You feel an overwhelming, prolonged sense of helplessness and sadness.
- Your problems don't seem to get better despite your efforts and help from family and friends.
- You find it difficult to concentrate on work assignments or to carry out other everyday activities.
- You worry excessively, expect the worst or are constantly on edge.
- Your actions, such as drinking too much alcohol, using drugs or being aggressive, are harming you or others.
What are the different kinds of psychotherapy?
There are many different approaches to psychotherapy. Psychologists generally draw on one or more of these. Each theoretical perspective acts as a roadmap to help the psychologist understand their clients and their problems and develop solutions.
The kind of treatment you receive will depend on a variety of factors: current psychological research, your psychologist's theoretical orientation and what works best for your situation.
Your psychologist’s theoretical perspective will affect what goes on in his or her office. Psychologists who use cognitive-behavioural therapy, for example, have a practical approach to treatment. Your psychologist might ask you to tackle certain tasks designed to help you develop more effective coping skills. This approach often involves homework assignments. Your psychologist might ask you to gather more information, such as logging your reactions to a particular situation as they occur. Or your psychologist might want you to practice new skills between sessions, such as asking someone with an elevator phobia to practice pushing elevator buttons. You might also have reading assignments so you can learn more about a particular topic.
In contrast, psychoanalytic and humanistic approaches typically focus more on talking than doing. You might spend your sessions discussing your early experiences to help you and your psychologist better understand the root causes of your current problems.
Your psychologist may combine elements from several styles of psychotherapy. In fact, most therapists don’t tie themselves to any one approach. Instead, they blend elements from different approaches and tailor their treatment according to each client’s needs.
The main thing to know is whether your psychologist has expertise in the area you need help with and whether your psychologist feels he or she can help you.
Common Myths about Psychotherapy
Myth 1: Only crazy people go to psychotherapy.
Reality:
Untrue. People seek psychotherapy for a range of reasons in everyday life. Some pursue psychotherapy for treatment of depression, anxiety or substance abuse. But others want help coping with major life transitions or changing problem behaviours: the loss of a job, a divorce or the death of a loved one. Yet others need help managing and balancing the demands of parenting, work and family responsibilities, coping with medical illness, improving relationship skills or managing other stressors that can affect just about all of us. Anyone can benefit from psychotherapy to become a better problem solver.
Stigma connected to getting help for psychological or behavioural concerns used to be a strong deterrent for people. But getting help is now seen as a sign of resourcefulness. Researchers continue to find new links emphasising the value of taking care of mental health to ensure good physical health, often called the mind-body health connection. Emotional problems can show up as physical symptoms. And when we are physically ill, we may develop emotional issues.
Myth 2: Talking to family members or friends is just as effective as going to a psychologist.
Reality:
Support from family and friends you can trust is important when you're having a hard time. But a psychologist can offer much more than talking to family and friends. Psychologists have years of specialised education, training and experience that make them experts in understanding and treating complex problems. And research shows that psychotherapy is effective and helpful. The techniques a psychologist uses during psychotherapy are developed over decades of research and more than “just talking and listening.”
Psychologists can recognize behavior or thought patterns objectively, more so than those closest to you who may have stopped noticing — or maybe never noticed. A psychologist might offer remarks or observations similar to those in your existing relationships, but their help may be more effective due to their timing, focus or your trust in their neutral stance.
Plus, you can be completely honest with your psychologist without concern that anyone else will know what you revealed. The therapeutic relationship is grounded in confidentiality. (There are a few exceptions where a psychologist has a duty to inform others, such as if you threaten to harm yourself or someone else. But that’s something your psychologist will clarify with you.) In fact, people often tell their psychologists things they have never before revealed to anyone else. If your difficulties have been ongoing without any significant improvement, it may be time to seek help from a trained psychologist.
Myth 3: You can get better on your own if you just try hard enough and keep a positive attitude.
Reality:
Many people have tried to solve their problems on their own for weeks, months or even years before starting psychotherapy but have found that that it’s not enough. Deciding to start psychotherapy doesn't mean you’ve failed, just like it doesn't mean you’ve failed if you can't repair your own car. There may be a biological component to some disorders, such as depression or panic attacks, which make it incredibly difficult to heal yourself. In reality, having the courage to reach out and admit you need help is a sign of strength rather than weakness — and the first step toward feeling better.
Myth 4: Psychologists just listen to you vent, so why pay someone to listen to you complain?
Reality:
A psychologist will often begin the process of psychotherapy by asking you to describe the problem that has brought you into his or her office. But that's just psychotherapy's starting point. They will also gather relevant information on your background, as well as the history of your problems and other major areas of your life, and the ways you have tried to address the concerns. Psychotherapy is typically an interactive, collaborative process based on dialogue and the patient's active engagement in joint problem-solving.
Your psychologist may give you homework assignments so that you can practice new skills between sessions or reading assignments so that you can learn more about a particular topic. Together you and your psychologist will identify problems, set goals and monitor your progress.
Myth 5: A psychologist will just blame all your problems on your parents or your childhood experiences.
Reality:
One component of psychotherapy might entail exploring childhood experiences and significant events impacting your life. Relating information from your family background can help you and your psychologist understand your perceptions and feelings, current coping strategies, or see patterns that developed. The point of wanting you to look backward is to better understand your present and make positive changes for the future.
However, in some instances your psychologist will choose to focus mainly on the current problem or crisis that brought you into treatment and not delve into your past at all. You’ll learn how to incorporate techniques and use tools that will help change your current thoughts or behaviours contributing to your problem. Psychologists who use an eclectic style of psychotherapy will know how to guide the session to include discoveries about your past with reflections on current problematic thoughts or behaviours.
Myth 6: You’ll need to stay in psychotherapy for many years or even the rest of your life.
Reality:
Everyone moves at a different pace during psychotherapy — it’s a very individualized process. In one study for example, half of patients in psychotherapy improved after just eight sessions while 75 percent had improved by the six-month point. It’s something you and your psychologist can talk about in the initial meetings when developing a treatment plan. Your psychologist's goal is not to keep you on as a client forever but to empower you to function better on your own.
Myth 7: If I talk about or reveal my problems, someone might hear about me being in psychotherapy.
Reality:
Untrue. Remember that psychotherapy is bound by the rules of confidentiality. Only you can release your health records to an outsider. The only ones who know about your psychotherapy sessions are you, your psychologist and anyone to whom you give the written approval for your psychologist to talk (such as a physician or family member). The strict rules of confidentiality your psychologist is bound by aren't the only protection. In most places, mental health records receive an even higher level of protection than medical records.
Understanding Psychological Testing and Assessment
What is Psychological Testing and Assessment?
If you or a family member has been referred for psychological testing, you probably have some questions about what to expect. Or you may have heard about psychological testing and wonder if you or a family member should be tested. Psychological testing may sound intimidating, but it's designed to help you. In many ways, psychological testing and assessment are similar to medical tests. If a patient has physical symptoms, a primary care provider may order X-rays or blood tests to understand what's causing those symptoms. The results of the tests will help inform develop a treatment plan.
Psychological evaluations serve the same purpose. Psychologists use tests and other assessment tools to measure and observe a client's behaviour to arrive at a diagnosis and guide treatment.
Psychologists administer tests and assessments for a wide variety of reasons. Children who are experiencing difficulty in school, for example, may undergo aptitude testing or tests for learning disabilities. Tests for skills such as dexterity, reaction time and memory can help a neuropsychologist diagnose conditions such as brain injuries or dementia.
If a person is having problems at work or school, or in personal relationships, tests can help a psychologist understand whether he or she might have issues with anger management or interpersonal skills, or certain personality traits that contribute to the
problem. Other tests evaluate whether clients are experiencing emotional disorders such as anxiety or depression.
The underlying cause of a person's problems isn't always clear. For example, if a child is having trouble in school, does he or she have a reading problem such as dyslexia? An attention problem such as attention-deficit hyperactivity disorder (ADHD)? Difficulty with impulse control? Psychological tests and assessments allowa psychologist to understand the nature of the problem, and to figure out the best way to go about addressing it.
What is the difference between Testing and Assessment?
Tests and assessments are two separate but related components of a psychological evaluation. Psychologists use both types of tools to help them arrive at a diagnosis and a treatment plan.
Testing involves the use of formal tests such as questionnaires or checklists. These are often described as “norm-referenced” tests. That simply means the tests have
been standardized so that test-takers are evaluated in a similar way, no matter where they live or who administers the test. A norm-referenced test of a child's reading abilities, for example, may rank that child's ability compared to other children of similar age or grade level. Norm-referenced tests have been developed and evaluated by researchers and proven to be effective for measuring a particular trait or disorder.
A psychological assessment can include numerous components such as norm-referenced psychological tests, informal tests and surveys, interview information, school or medical records, medical evaluation and observational data. A psychologist determines what information to use based on the specific questions being asked. For example, assessments can be used to determine if a person has a learning disorder, is competent to stand trial or has a traumatic brain injury. They can also be used to determine if a person would be a good manager or how well they may work with a team.
One common assessment technique, for instance, is a clinical interview. When a psychologist speaks to a client about his or her concerns and history, they're able to observe how the client thinks, reasons and interacts with others. Assessments may also include interviewing other people who are close to the client, such as teachers, co-workers or family members. (Such interviews, however, would only be performed with written consent from the client.)
Together, testing and assessment allows a psychologist to see the full picture of a person's strengths and limitations.
Must I be seen by a Clinical Psychologist for testing and assessment?
Psychological tests are not one-size-fits-all. Psychologists pick and choose a specific set of assessments and tests for each individual client. And not just anyone can perform a psychological evaluation. Licensed clinical psychologists are expertly trained to administer assessments and tests and interpret the results. In many cases, psychologists who administer tests will then treat patients with psychotherapy. Some psychologists focus only on evaluating patients, and then refer them to other specialists for treatment after they've made a diagnosis. In either case, the testing and assessment process will help ensure that the client receives treatment that's tailored to his or her individual needs.
What should I expect?
Psychological testing isn't like taking a multiple-choice exam that you either pass or fail. Rather, psychologists use information from the various tests and assessments to reach a specific diagnosis and develop a treatment plan.
Some people are tempted to peek at the tests ahead of time. If they suspect they may have a particular problem, they may look online for a practice test of that problem. That's a bad idea, experts say. In fact, practicing ahead of time usually backfires — when you try to take the test in a certain way, the answers may be inconsistent and make you appear to have more problems than you actually do. Remember, psychological testing and assessment is nothing to fear. It's not something you need to study for. Rather, it's an opportunity for psychologists to determine the best way to help you.
* FAQ adapted from the American Psychological Association.