STARTING PSYCHOTHERAPY 

WHAT IS PSYCHOTHERAPY?

In general, “psychotherapy” is similar to “counseling” or “therapy.”   “Counseling” tends to involve the counselor giving ideas and information to the client, and “therapy” is a very broad term incorporating physical, mental, or emotional areas of focus. "Psychotherapy” more specifically focuses on the mental, emotional, experiential, and even spiritual aspects of oneself, how one sees the world, and how one acts, based on those thoughts, emotions, and experiences.  

Other disciplines related to the health of the mind besides social work include psychology, general counseling, and marriage and family therapy. In addition, there is "psychiatry", (which focuses on the neuro-chemical and physical aspects of the brain’s functioning, and utilizes medications to help manage mental states and moods), and "psychoanalysis "(which is a specific method of treating mental and emotional issues, initially developed by Freud, and applied mostly by psychiatrists trained in psychoanalytic theory). Psychiatry is not psychotherapy as described above; rather psychiatrists are medical doctors who specialize in neurobiological and physiological areas of their patients' lives.  Although psychiatrists typically are concerned with helping their patients stabilize their physiology, biology, and  moods utilizing medication, some offer some psychological support as well.




CHOOSING A THERAPIST


A psychotherapist can be a Licensed Clinical Social Worker (LCSW), a Licensed Professional Counselor (LPC), some Licensed Psychologists (PhD), or a Licensed Marriage and Family Therapist (LMFT), among others. 

Licensed Clinical Social Workers are often specifically ftrained in treatment and intervention during their graduate programs.The clinical social worker looks at the client individually, addressing personal issues and concerns, and also factoring in the bigger picture (home, family, work, friends, self-care)  of a client's life.  Social workers generally have a "systems" approach.

LPCs have a MA degree focused on counseling skills.  Though in many ways similar to social workers, LPCs may have less specific training in technical diagnoses, and may focus on skill building, resource development, and and social relationships.  LMFTs are specifically trained in relational work, as the name implies.  LCSWs, LPCs, and LMFTs are all graduate level degrees (beyond the four years of college).

Many psychology (PhD) programs tend to focus on research, and tend to incorporate a "medical model" kind of value. Psychologists mainly work to help the client resolve personal issues, often with less attention to the culture, environment, and relationships. Psychologists often  specialize in areas that emphaisize testing and formal treatment measures around both physical and emotional issues.

Though the scope of practice is different, there is overlap between clinical psychologists and clinical social workers, since both do assessment and counseling.  Both are trained in diagnosis and treatment of medical and mental health issues, and both can refer to a psychiatrist  for medication needs. Both social workers and psychologists (as well as LMFTs and LPCs) have credentialing bodies with standards of practice and ethical codes.

In looking for a psychotherapist, in addition to the experience and knowledge base of the therapist, it is of the highest importance that a client feels a sense of respect and safety from the psychotherapist, 
and that there is a good intuitive feel that the client and therapist can work well together. If these elements don’t exist, a client should move on. David offers a free half hour consultation as a way for clients to get a sense of how the therapy works and how it feels.

It is of course also important that the therapist have an understanding of the issues and concerns you are working with as a client, and supports you in staying focused on those issues and concerns. A therapist should be a good listener, yet still be accessible, and a therapist should take the time to fully understand who you are and what your life circumstances are.  

Sometimes it may be wise to have an initial meeting with several possible therapists in order to find the best fit for you.


 

WHAT TO EXPECT

When you first come to the therapist’s office, you should be sure that you feel comfortable in the space. Most therapists will ask that you fill out some initial paperwork and sign a statement that you have read and understand your rights as a client (as the State of Colorado requires).  David will ask that you read over some initial information (like what you are reading on this website), and then to fill out a form with basic information about yourself (mostly demographic, with a short section on your therapy and medication history). You will also be asked to sign the Client Rights Disclosure Statement and indicate that you are informed about David’s practice and process. This information is in the “Introductory Paperwork” section .

When you meet with David, you should initially ask any questions you would like, and when you are satisfied, you can share your reasons for coming to psychotherapy. David will help with this by asking a few questions as the conversation goes along. If you have any questions at any time, please feel free to ask—in person, by phone, or by email. As therapy progresses, you should expect that you will feel heard, understood, and respected, and that the conversation will be interactive and supportive, as well as gently probing where appropriate. David has a direct style, but is sensitive to the client’s needs and comfort level as well.

Psychotherapy is usually a weekly process, continuing over several months or more. You, as the client, set the stage and determine your needs, especially around length of therapy and frequency of sessions. Normally, ending therapy is  best done when there is mutual understanding and agreement between client and therapist that ending is the best choice.  Ultimately, this decision rests with the client. If a client is choosing to end or take a break from psychotherapy, it is requested that this be addressed directly.



David A. Yeats LCSW - StillPoint Psychotherapy
Starting Psychotherapy