I remember my mom asking me some time ago, with a curious look in her eyes, “So, how does therapy work? You just talk to people and then you can cure their mental disorders? ”
Psychotherapy has in recent years gained more and more interest, as people slowly get to be more aware of the importance of our mental health. However, there is still a lot of mystery surrounding the concept of “psychotherapy”, which leads to a lot of different reactions towards it: some people are curious to know more about psychotherapy, some are confused by its mysteries.
In my opinion, the mysteriousness of psychotherapy and lack of understanding towards it comes from the perpetuation of myths, as well as the media hype that surrounds it. Of course, this meant that as clinical psychologists, we have not done enough psychoeducating towards the general public. That’s why, in this article, I wanted to invite you, the audience, to join me in discovering what is psychotherapy, along with the top 3 things you didn’t know about psychotherapy.
Before Psychotherapy Begins, There is Another Step?
Whenever a client or potential client messaged us to make an appointment for a psychotherapy session, they will usually tell us about their individual concerns, such as whether they have clinical depression, or anxiety disorders, etc. But when we dig deeper and ask further about their concerns, we realize that their “diagnoses” didn’t come from a proper diagnosis formed by either psychiatrists or clinical psychologists (Note: Only these two kinds of professionals are able to provide a proper clinical diagnosis). Rather, these “diagnoses” came from their own internet research and online psychological assessments.
It’s not that difficult to find such psychological assessment tools online; in fact, we provide them on our own website here (you can click here to know more about these screening/assessment tools). But do note that the main purpose of these psychological screening tools is to help the general public understand their own mental health, and that’s why the results gained from such tests can only be used as a reference, so that everyone can seek for professional assistance or guidance when there is a need to do so.
For example: just like the recent covid-19 disease, you may perceive yourself as experiencing symptoms of “sore throat, dry coughs and breathing difficulties”. These perceived symptoms are signals for you to seek help, but they do not definitely indicate that you truly have the covid-19 disease. In order to be properly assessed and diagnosed, you still need the guidance of a professional doctor to distribute the required tests. Self-diagnosis can only lead to more feelings of anxiety and fear.
So, to go back to the topic of psychotherapy: before the professionals conduct a proper psychotherapy session, what they will do is to provide a thorough mental health assessment and diagnosis. Only when they have determined what the concern was can they provide a more personalized and suitable therapy to help you. Normally, what the clinical psychologist will do to help the client fully understand their current mental health state, and to gain an accurate assessment/diagnosis, is to combine the methods listed below:
- A mental health inventory：this form of assessment requires the client themselves to fill up the form or to rate their recent state of mind or situation (e.g. “Are you experiencing feelings of sadness? 0 – I don’t experience any feelings of sadness; 1 – I sometimes experience feelings of sadness; 2 – I am always experiencing feelings of sadness, and I can’t get out of this feeling; 3 – I feel extreme feelings of sadness, and I can’t control them.”)
- Interview：the professional will ask you a series of personal questions, in order to understand your concerns and situation
- Observation：the professional will observe your emotion, your speech, your thoughts, your attention span, etc., throughout the session
What Does The First Psychotherapy Session Look Like?
During the first psychotherapy session, the client will obtain a copy of an informed consent, and this document’s purpose is to help the client gain a basic level of understanding towards some key conditions of a psychotherapy journey, such as:
- The benefits and risks of participating in psychotherapy
- The clients’ rights to privacy, as well as some of the conditions under which their rights to privacy will be revoked
- The consultation fee of psychotherapy
- The terms and conditions of participating or canceling an appointment
After the client has fully read and agreed with the terms of the informed consent, and after they have provided their signature on the document, only then can the first psychotherapy session begin. Usually, the first psychotherapy session will be 90 minutes long. The first session is mainly to help the clinical psychologist fully understand the client’s concerns and mental health condition. You, as the client, may be required to fill up some mental health screenings, and the psychologist will also ask a series of questions, such as:
- How long have you been having these concerns?
- How have these concerns impacted your daily life, your relationships with others, your work or academic performance?
- What is your medical history?
- What does your family background, your education background, your social relationships look like? And what are some of your interests or hobbies?
Through these questions, the psychologist can then be able to fully understand and to gain a full picture of your concerns, so that they will be able to provide a proper diagnosis/assessment. If you are not comfortable to answer certain questions, feel free to communicate with the psychologist.
Before the end of the first session, the clinical psychologist will discuss with their clients, and to decide together the goals and directions of their therapy journey (after all, this is a collaborative relationship between the psychologist and the client). These goals and directions will then guide subsequent sessions, and will begin in the next session.
If you want to know more about psychotherapy, you can also click here to read our FAQ on psychotherapy.
(In general, a client will experience around 6-12 psychotherapy sessions. Of course, the amount and the frequency of sessions will depend on the severity of the client’s concerns, as well as the collaborative discussion between psychologist and client.)
So, Is Psychotherapy Just About People Talking In A Room?
Psychotherapy is an evidence-based practice that aims to help clients deal with their mental health concerns, as well as mental health disorders. To do that, it requires a large amount of scientific research in order to gain the most effective and efficient method towards therapy. A clinical psychologist uses language as a tool to help clients deal with their individual concerns, and that is why there is another common name for psychotherapy: “Talk Therapy”.
During a psychotherapy session, the primary attitude of a clinical psychologist towards their clients is to be:
- Empathetic (able to understand how others feel)
In the therapy room, the client’s thoughts and emotions are respected, and that’s why, in this safe and protective environment, they are able to fully utilize this opportunity and space to express their every thought and emotion. During their expression, they will not be criticized or judged.
Through empathy, the clinical psychologist can place oneself in their clients’ shoes, and to be able to understand or feel their concerns, so that they can explore the concerns, and the concerns within their concerns, together. The psychologist will tailor their therapy methods based on the client’s individual concerns, so that it will be more personalized, and will be able to help them get through their most pressing concerns.
For example: a person with anxiety disorders can perhaps learn about methods of relaxation, such as deep breathing methods to help relieve themselves of feelings of anxiety, and to help regulate the emotions that may give rise to their anxiety. A person with depression can perhaps learn about “behavioral activation”, to help regulate their daily activities, and to increase their feelings of happiness and joy through their own active participation in life. (These are just some of the most common examples, and the methods of therapy will be based on the client’s individual concerns)
The clients will learn during therapy to face and to understand their own thoughts, feelings, and behaviors. They will learn how to apply the skills and techniques they have learned during the psychotherapy sessions in real life. Personally, I have always believed that “psychotherapy is about the process of a person’s self-growth and skill-building, and the aim of therapy is to help clients ‘graduate’ from the ‘class of psychotherapy’, and to bring what they have learned back into their own lives, to live a life that can be called their own.”
So, to answer the question at the beginning of this article, the one my mother have asked me some time ago:
Yes, the job of a clinical psychologist does seem to be like two person just chit-chatting. That is because we are using “language” as a tool to help others. But it is never just talking. For us, or for the clients.
Translated from Gary Yap’s original article: 讲讲话就能医好心理疾病？关于”心理治疗” 你不知道的三件事
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