By Gina Newsome Duncan, M.D.
Medical treatments and therapies can take on many different forms in order to accomplish healing. Most involve some sort of physical interaction between a patient and a healthcare provider as occurs in physical therapy, surgery, and in prescribing medication.
Psychotherapy can be defined as a treatment in which healing of emotional distress is accomplished through the verbal interaction between a patient and a professional psychotherapist.
Psychotherapy can take on many different forms and is practiced by different types of mental health professionals including psychiatrists, psychologists, and social workers.
Upsetting life events like the death of a loved one, medical illness, trauma, job and marital stress, depression and anxiety can all be effectively addressed in psychotherapy. Research shows that psychotherapy is linked to positive changes in the brain and body. Most patients who receive psychotherapy experience symptom relief and are better able to function in their lives. Other benefits include fewer sick days, job stability, fewer medical problems, and improved relationships.
There are many different therapy styles and techniques including Psychodynamic Psychotherapy, Cognitive Behavioral Therapy (CBT), Group Therapy, and Couples Therapy, among others. The type and length of therapy will usually depend on the patient’s circumstances or preference and on the therapist’s training.
For example, let’s imagine that a 37 year old woman* with no history of psychiatric problems begins experiencing significant anxiety and panic attacks. She is referred by her family physician to a psychiatrist to begin psychotherapy. The therapy would likely consist of weekly meetings in the psychiatrist’s office that would last for 45 minutes each. During those sessions, the psychiatrist would gather a history from the patient and use this information to help develop goals for the therapy. The history may uncover, for example, that the patient has two young children, is arguing frequently with her husband, and is facing potential layoffs on her job. Depending on the type of therapy the psychiatrist practices, the patient’s concerns may be addressed differently.
In a psychodynamic approach, the psychiatrist may encourage the patient to talk freely about “whatever comes to mind.” This would include her present-day stresses as well as previous experiences from her past that may be impacting how she is coping. For many of us, unresolved issues from our past cause us to repeat unhealthy patterns, particularly in our relationships. It may be revealed that the patient’s parents divorced when she was young, and that she fears the same could happen to her. By talking through these fears with the therapist, she may be able to find effective ways to address them and prevent them from building up into debilitating anxiety.
A CBT therapist, on the other hand, would be more focused in the “here and now”, actively helping the patient to identify the pattern of negative thinking that is behind her anxiety. Examples of negative thoughts are: “I’m a failure” or “I’m unlovable.” The therapist would then teach the patient new skills to help her change her thinking and behavior.
If the patient’s symptoms are severe, medication may be prescribed. If interested, she and her husband may also be referred to a couples’ therapist.
Finding a Psychotherapist
Since the primary tool in psychotherapy is the relationship between the therapist and the patient, finding a therapist with whom you feel comfortable is crucial. Good sources of referrals include family physicians, local psychiatric societies, medical schools, community health centers, and your health insurance carrier.
For persons of color and ethnic minorities, finding a psychotherapist can present a unique set of challenges. The mental health field is making strides to build a workforce that looks more like the population we serve. However, minorities are overrepresented in mental health disparities, and underrepresented in the field. Language barriers can prevent even the most well-meaning therapist from being able to provide effective care. For people in different faith communities, there may be the concern that a therapist would try to talk them out of their belief system or “brainwash” them into a different way of thinking.
Do you have to go to someone who is of the same background as you in order to have a good therapy experience? The answer is no. However, it is important that you find a culturally competent provider.
Here are some things to keep in mind when looking for a psychotherapist:
• The therapist should be empathic, allowing you time to talk, actively listening to you, and making a sincere effort to understand where you’re coming from.
• Bad signs: If you feel easily dismissed, judged, or stereotyped. Or if the therapist seems reluctant to engage you.
Finally, it’s good to keep an open mind. We are all part of the human family; good and bad therapists come in all colors! You may find that talking to someone of a different background enables you to open up more fully.
You should be up front about what you are hoping to gain from the therapy. For example, if your faith is important to you and you feel it is relevant to your therapy work, do not be afraid to say so. The therapist should not try to change or judge you for your beliefs.
* not based on a real person