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Addiction - anorexia/orthorexia - Trauma - depression

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What is Psychotherapy?

According to the National Institute of Mental Health, more than a quarter of American adults experience depression, anxiety, or another mental disorder in any given year. Others need help coping with a serious illness, losing weight, or stopping smoking. Still, others struggle to cope with relationship troubles, job loss, the death of a loved one, stress, substance abuse, or other issues. And these problems can often become debilitating. A psychotherapist can help you work through such problems. Through psychotherapy, I help people of all ages live happier, healthier, and more productive lives.

I apply scientifically validated procedures to help people develop healthier, more effective habits. There are several approaches to psychotherapy—including cognitive-behavioral, interpersonal, and dialectical behavioral therapy—that help individuals work through their problems.

Psychotherapy is a collaborative treatment based on the relationship between an individual and a therapist. Grounded in dialogue, it provides a supportive environment that allows you to talk openly with someone who’s objective, neutral, and nonjudgmental. You and I will work together to identify and change the thought and behavior 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

How effective is psychotherapy?

Hundreds of studies have found that psychotherapy helps people make positive changes in their lives.

Reviews of these studies show that about 75% of people who enter psychotherapy show some benefit. Other reviews have found that the average person who engages in psychotherapy is better off by the end of treatment than 80% of those who don’t receive treatment at all.

How does psychotherapy work?

Successful treatment is the result of three factors working together:

• Evidence-based treatment that is appropriate for your problem

• The psychotherapist’s clinical expertise

• Your characteristics, values, culture, and preferences

When people begin psychotherapy, they often feel that their distress is never going to end. Psychotherapy helps people understand that they can do something to improve their situation. That leads to changes that enhance healthy behavior, whether it’s improving relationships, expressing emotions better, doing better at work or school, or thinking more positively.

While some issues and problems respond best to a particular style of therapy, what remains critical and important is the therapeutic alliance and relationship between you and me.

What if psychotherapy doesn’t seem to be working?

When you began psychotherapy, your psychotherapist probably worked with you to develop goals and a rough timeline for treatment. As you go along, you should be asking yourself whether they seem to understand you, whether the treatment plan makes sense, and whether you feel like you’re making progress.

Some people begin to feel better in about 6 to 12 sessions. If you don’t start seeing signs of progress, discuss it with your psychotherapist. Your psychotherapist may initiate a conversation about what to do. If he or she doesn’t, bring it up yourself. You could ask your psychotherapist about additional or alternative treatment methods, for example. Sometimes speaking up to your psychotherapist can be very empowering, especially since your psychotherapist will be understanding and nonjudgmental instead of offended.

Keep in mind that as psychotherapy progresses, you may feel overwhelmed. You may feel more angry, sad, or confused than you did at the beginning of the process. That doesn’t mean psychotherapy isn’t working. Instead, it can be a sign that your psychotherapist is pushing you to confront difficult truths or do the hard work of making changes. In such cases, these strong emotions are a sign of growth rather than evidence of a standstill. Remember, sometimes things may feel worse before they get better.

In some cases, of course, the relationship between a patient and the psychotherapist isn’t as good as it should be. The psychotherapist should be willing to address those kinds of issues, too. If you’re worried about your psychotherapist’s diagnosis of your problems, it might be helpful to get a second opinion from another psychotherapist, as long as you let your original psychotherapist know you’re doing so.

If the situation doesn’t improve, you and your psychotherapist may decide it’s time for you to start working with a new psychotherapist. Don’t take it personally. It’s not you; it’s just a bad fit. And because the therapeutic alliance is so crucial to the effectiveness of psychotherapy, you need a good fit.

If you do decide to move on, don’t just stop coming to your first psychotherapist. Instead, tell him or her that you’re leaving and why you’re doing so. A good psychotherapist will refer you to someone else, wish you luck, and urge you not to give up on psychotherapy just because your first attempt didn’t go well. Tell your next psychotherapist what didn’t work to help ensure a better fit.

What Are CPT and DBT?

Cognitive Processing Therapy (CPT ) and Dialectical Behavioral Therapy (DBT) is a form of psychological treatment that has been demonstrated to be effective for a range of problems including depression, anxiety disorders, alcohol, and drug use problems, marital problems, eating disorders, and severe mental illness. Numerous research studies suggest that CPT and DBT lead to significant improvement in functioning and quality of life. In many studies, CBT and DBT have been demonstrated to be as effective as, or more effective than, other forms of psychological therapy or psychiatric medications.

It is important to emphasize that advances in CPT have been made on the basis of both research and clinical practice. Indeed, CPT and DBT is an approach for which there is ample scientific evidence that the methods that have been developed actually produce change. In this manner, CPT and DBT differ from many other forms of psychological treatment.

CPT and DBT are based on several core principles, including:

1. Psychological problems are based, in part, on faulty or unhelpful ways of thinking.

2. Psychological problems are based, in part, on learned patterns of unhelpful behavior.

3. People suffering from psychological problems can learn better ways of coping with them, thereby relieving their symptoms and becoming more effective in their lives.

CPT and DBT treatment usually involves efforts to change thinking and behavioral patterns. These strategies might include:

• Learning to recognize one's distortions in thinking that are creating problems, and then reevaluate them in light of reality.

• Gaining a better understanding of the behavior and motivation of others.

• Using problem-solving skills to cope with difficult situations.

• Learning to develop a greater sense of confidence in one's own abilities.

CPT and DBT treatment also usually involves efforts to change thought and behavioral patterns. These strategies might include:

• Facing one's fears instead of avoiding them.

• Using role-playing to prepare for potentially problematic interactions with others.

• Learning to calm one's mind and relax one's body.

Not all CPT and DBT based therapists will use all of these strategies. Rather, the psychotherapist and patient/client work together, in a collaborative fashion, to develop an understanding of the problem and to develop a treatment strategy.

CPT and DBT place an emphasis on helping individuals learn to be their own therapists. Through exercises in the session as well as “homework” exercises outside of sessions, patients/clients are helped to develop coping skills, whereby they can learn to change their own thinking, problematic emotions, and behavior.

CPT and DBT therapists emphasize what is going on in the person's current life, rather than what has led up to their difficulties. A certain amount of information about one's history is needed, but the focus is primarily on moving forward in time to develop more effective ways of coping with life.

Source: APA Div. 12 (Society of Clinical Psychology)