Unraveling therapy - Getting the help you need

By Dr. Batya Ludman · Published December 18, 2015

Psychologist, psychotherapist, psychiatrist, coach, counselor, social worker, rabbi or friend. Whom should you talk with if you’re distressed? Do they all do the same thing? How do you even know if you should see someone? These are just some of the questions people ask when they're dealing with more than they can handle but don't know where to turn for help. In these difficult times, finding the right therapist becomes even more important.

When should you see someone?

At various times during your life, with the stress of increasing demands made upon you, you may need help dealing with problems that seem beyond your control. You may consider entering therapy when you’re in crisis, at a turning point in your life, or when you have difficult decisions to make. You may be struggling with a job, family, parenting, marital or other relationship issues, may have experienced a traumatic loss, may be coping with various stressors, have anger management issues, be facing eating or sleep problems, be adjusting to life changes such as having made Aliyah, or may be having panic or anxiety attacks around the current security situation.

These difficulties may affect you cognitively, physically, behaviorally and emotionally, and can affect your self-esteem, personal, social and professional life and leave you feeling frustrated, angry, sad and overwhelmed. You may feel depressed because of challenging life issues, be dealing with a loss or chronic illness, have difficulty in getting along with others, or have difficulty in concentrating, making decisions, sleeping or carrying out your daily activities. Sometimes, you may just want to hear someone else's opinion or want assistance in changing direction, getting focused and motivated, and moving forward.

Whether a recent issue or a longstanding problem, the goal is to untangle your concerns and help you lessen your distress quickly so you can begin to feel better. It's at times like these, when it’s difficult to handle these challenges on your own, or when you can't or don't want to talk to your friends and family, that you may find it beneficial to seek help. Taking this first step, recognizing that you need assistance, and sharing your burden, allows you to begin your journey towards improved health and healing.

Your mind and body usually work well together to help you sort out your various issues and heal naturally over time. Occasionally, you may just need a bit of guidance in learning how to listen to the cues, and it is this fine tuning that a competent and experienced mental health professional can provide to help facilitate the work you need to do in order to feel better. Counseling or "talk therapy", is a very personal matter and it’s important that you feel comfortable with your therapist and the therapeutic process.

Whom do you see?

You may be confused by the many types of people offering their services. A psychologist typically provides various modalities of talk therapy whereas a psychiatrist is a medical doctor and often prescribes medication, though some also do psychotherapy. Often we work together when a client would benefit from both psychotherapy and medication. I can't stress enough the importance of ensuring that your care provider has the appropriate credentials, because anyone (including the neighborhood bartender, taxi driver or your hairdresser) can call themselves by similar sounding names such as therapist, or psychotherapist, These "titles" are often misleading and imply education, training, and credentials when in fact little or none may have been obtained.

A recent letter in the health column addressed a woman‘s concern about the unethical, inappropriate and unprofessional behavior of the psychotherapist/ marriage counsellor that she and her husband had found through an Internet advertisement. In a reply by the Health Ministry’s chief psychologist, they were told that a mechanism for dealing with this exists only if the therapist is a licensed psychologist. In Canada, where I sat on the Provincial Board of Examiners in Psychology, we often received complaints about unethical conduct. Fortunately, most of the complaints were not about psychologists, but rather “psychotherapists”. Unfortunately, as was later pointed out in an excellent letter to the editor, there are no restrictions on who can call themselves a therapist, psychotherapist, coach or counsellor, and the lay person often doesn‘t know the difference or even realize that there is one. After all, psychologist, psychiatrist and psychotherapist all sound the same, and all claim to provide similar services. While some are highly trained in their professions, others have no or minimal qualifications and are not accountable to anyone.

The Health Ministry only licenses psychologists, and physicians (including specialists in psychiatry). In other words 'psychologist', and 'psychiatrist' are protected titles: only someone actually licensed, registered and qualified in a specific area can work in that field and call themselves by these professional titles.

Sadly, precisely when you are vulnerable and uncertain where to turn, it is easy to be taken advantage of. Beware of the many "professionals" touting the "courses" they have taken and "credentials" they have earned, and their promises, testimonials and flashy advertising.

While in certain circumstances it may be helpful to talk with a friend (or family member), although meaning well, they often lack the skills and tools to help you deal with your issues at a deeper level and help you move forward in a safe, non-judgmental manner. Since you will continue to interact with them, having shared intimate details of your private life may put a strain on your relationship.

It’s also important to ensure that the person you see has expertise with the specific issues or situation for which you seek help. In addition to having the right professional degree, are they trained in, for example, bereavement counseling, marital therapy, or court based work? How much experience have they had and do they often see clients with your issues? Don't hesitate to ask these questions as it will help you choose the right person for you.

Your therapist's specific treatment orientation is often less relevant than his or her ability to successfully use a variety of techniques and therapeutic modalities that work and are appropriate to your issues. So whether it’s cognitive behavior therapy (CBT), other solution-focused techniques, somatic therapy or more psychodynamic psychotherapy, for example, your therapist should be able to explain to you how he or she hopes to work with you and why. While you may very well feel uncomfortable with certain issues, your ability to feel comfortable with your therapist will help determine your level of trust and the ability to work through things together. What works best for one person may not be helpful for another. Good treatment should be individualized to suit your personal needs.

Working actively in an open, honest and caring partnership with your therapist, you'll gain insight, greater understanding of your issues and work to find ways to successfully resolve them. You need to feel comfortable, respected and understood as you express your concerns and in return, feel that you can trust this professional and work well together.

How do I find a therapist?

You can access help through either the public or private system. If you go publically through your health fund, for example, fees are usually lower. Disadvantages may include a limited choice as to whom you can see, the number of sessions you may be allowed, the hours available and the waiting time for an initial visit.

You may also have supplemental health insurance that provides coverage for the private system. Make sure your professional is the appropriate one, and ensure that he or she is covered by your policy, if applicable.

Finding a therapist through a friend or family member, clergy, school counselor or your physician can be helpful. While word of mouth is nice, what works for one person may not work well for another and you may need to talk with more than one person before finding the right person. Don’t compromise! You may be able to find names via listings such as those found on the United States Embassy and Nefesh B'Nefesh websites or olim organizations that often offer lists of English speaking therapists. Finally, the internet has become a useful source for enabling you to search and match geographical location and philosophy of practice with your “must haves”.

Therapy is a process: your feelings towards the therapist, therapy and how you view the issues that initially brought you to therapy will change with time. It may take a session or two to determine if this therapist is right for you. Are they compassionate, a good listener, and can they help you with your problem? It takes time to build a supportive and trusting relationship where you can work together to establish and achieve your goals.

Therapy offers you the opportunity to grow as you begin a journey of self-discovery. I wish you luck and success as you move forward and hope that the process has been made clearer.

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