What is Psychotherapy?

Psychotherapy (or therapy) includes any type of treatment for psychological, emotional, or behavioral problems in which a trained professional meets with an individual or several people to help deal with the issue. This includes work with:

	the symptoms of a mental illness		relationship difficulties
	low self esteem or negative self image		behavioral problems
	mood problems		stresses of everyday life
	phobias and fears		substance abuse
	communication problems		to facilitate personal development

What Is the Different Between Therapy and Counseling?

It's hard to distinguish between "therapy" and "counseling." Many people think of counseling as less intensive, however, and more focused toward advice, direction setting, and issues that don't require in-depth analysis, soul searching, or personal change.

Therapy, on the other hand, is often seen at the other end of the same spectrum, focusing more on a deeper understanding of the issues and on personality factors, history, emotions, thoughts, and behaviors.

Who Practices Therapy? First it's important to know that anyone can claim to be a therapist or set up a therapy practice. But, most states have professional boards that license therapists and counselors who meet their requirements. In addition, most insurance companies that pay for therapy will only reimburse professionally licensed therapists. Therapy is most typically practiced by psychiatrists, psychologists, and social workers.

	Psychiatrists: A psychiatrist is a medical doctor (MD) trained in psychiatry, which is that branch of medicine that diagnoses and treats mental disorders. Although some psychiatrists are trained in psychotherapy, many aren't and consequently don't practice therapy. In fact, many psychiatrists treat patients strictly with medications for mental illnesses, as well as treating substance abuse.
	Psychologists: Psychology is the study of mind and behavior. Most psychologists are trained at the doctorate level, holding a Ph.D. (doctor of philosophy), Psy.D. (doctor of psychology), or Ed.D. (doctor of education). Psychologists are not medical doctors and cannot prescribe medications; like many psychiatrists, however, not every psychologist is trained in psychotherapy and many don't practice therapy. Most psychologists who do practice therapy are clinical, counseling, or educational psychologists.
	Social Workers: In the United States, most therapy is provided by social workers. Although social work practice is broad, clinical social workers are trained in and practice therapy. In most states, in order to become a licensed social worker, one must have an MSW (master's in social work), receive a specified amount of professional supervision, and pass an examination.
	Forms of Psychotherapy: Therapy is most typically associated with the treatment of an individual, but therapy is also commonly provided to families, married and other couples, and groups.

How to Find a Therapist

Remember that anyone can call themselves a therapist. But, professional therapists typically:

	Hold a relevant master's degree or doctorate.
	Are licensed through their state.
	Are credentialed by a professional organization.
	Belong to a professional organization.

There are any number of ways to find a therapist, through:

	a family health care provider
	referral programs of professional mental health organizations
	the yellow pages
	a community mental health center
	your insurance company's list of participating therapists
	the recommendations of other patients
	Employee Assistance Programs

How to Pick a Therapist

Not every therapist has the time available or willingness to meet, but talking to a therapist before beginning therapy is a useful way to ensure the best possible fit. Asking therapists about their approach and whether they have ever dealt with this kind of issue before is another useful way to assess fit.

Just as important as the therapist's qualifications and experience is personal fit and comfort. Is this a therapist who's manner, attitude, and style meshes with your own?

Therapist Ethics

All professional therapists are bound to a code of professional ethics. Therapy is confidential, and cases cannot be discussed with anyone outside without the explicit and signed permission of the patient.

Professional therapists do not cross boundaries. Even though they may be personally engaging and friendly in the therapeutic relationship, they do not engage in relationships outside of the therapy. These include friendships, as well as business, romantic, and sexual relationships.

Self Help and Therapy

In the end, self help and therapy go hand in hand. Self help doesn't mean never seeking help from others or working with a professional, any more than home schooling means ignoring published and accepted curricula or avoiding the use of professional tutors.

Self help is about taking charge of your own well being, being a responsible and informed consumer of services, and accepting responsibility for choices made, interventions taken, and decisions to take one path instead over another. There are many times that therapy or counseling is exactly what's needed in any effective program of self help.

References:

Bugental, J. F. T. (1992). "The Art of the Psychotherapist." New York: W. W. Norton. 1992

Byrne, R. H. (1994). "Becoming a Master Counselor." Pacific Grove, CA: Brooks/Cole.

Rosenhan, D. L., & Seligman, M. E. P. (1995). "Abnormal Psychology." New York: W. W. Norton

Storr, A. (1990). "The Art of Psychotherapy." New York: Routledge.

For additional information, please read Dr. Gail Bernstein's excellent article How To Choose A Therapist.

11/09/99

Phil Rich, EdD, MSW, DCSW is the author of "Understanding, Assessing, and Rehabilitating Juvenile Sexual Offenders," the eight books in "The Healing Journey" series of self help journaling books, and two books in the "Therapy Homework Planner," series, all of which are published by John Wiley & Sons. He is the Clinical Director of the Stetson School, a long-term residential treatment program for sexually reactive children and juvenile sexual offenders.