Psychotherapy usually means talk therapy. Who does "psychotherapy"? Why do people go to a "psychotherapist"? Exactly what happens when someone goes into "therapy"?
First the "who". There are several types of professionals who are licensed or otherwise credentialed to do therapy. Anyone licensed to do talk therapy is a psychotherapist. The term psychotherapist, however, is not regulated. There is no specific "psychotherapist" license. If you seek therapy, make sure you find out if they are licensed or credentialed. The following is a short list of the licenses in New York State.
A psychiatrist is a medical doctor and is the only one of these professionals who can prescribe medication and perform follow up monitoring. Some psychiatrists also do talk therapy. However, some psychiatrists just do the medication monitoring and refer their patients out for more in depth talk therapy. They are licensed like any other medical doctor and can take insurance.
A psychologist has a doctoral degree; either a Phd or Psy.D or Ed.D. This entitles them to be referred to as "Doctor" however they are not medical doctors. They do talk therapy and can take insurance. Most psychological testing requires a psychologist.
A Licensed Mental Health Counselor (LMHC) is a Master's degree level psychologist. They do talk therapy and can take insurance.
Social workers do talk therapy, case management and referrals. They are used in organizations in a variety of ways. They have a Masters degree in Social Work. Some are able to take insurance.
Credentialed Alcohol and Substance Abuse Counselor (CASAC) This is a NYS credential which limits an individual to alcohol and substance abuse counseling. The education requirement is to complete the required courses but there is no degree requirement. While they may work in an agency that takes insurance, they cannot take insurance as an individual practitioner.
Life coaches are not allowed to do talk therapy as they are not licensed or regulated. There are some credentials beginning to come into the marketplace. They are able to offer advice.
Why do people go to talk therapy? Everyone feels blue or sad now and again. It is normal to feel sad if you lose a job, a pet, an opportunity. Everyone feels anxious now and again and it is perfectly understandable to be nervous before a job interview, a dentist or doctor appointment, a speaking engagement. However, if you experience overwhelming sadness, and hopelessness, it may be depression. If your anxiety is happening for no apparent reason and you are finding relationships difficult or have trouble leaving the house, you may have an anxiety disorder. In both cases, if anxiety or depression rises to the level of interfering with your life or preventing you from doing things you love or your normal routine, talk therapy can help. Clients come in with a variety of presenting issues. If there is habitual behavior that you are struggling to overcome yourself, talk therapy can help. If there is something that you might be doing that is interfering with your happiness, talk therapy can help. There are issues like addiction (alcohol, drugs, gambling, sex, internet), obsessive compulsive disorder (checking, hand washing, hoarding), sexual issues (male and female), post traumatic stress disorder (recurrent thoughts and nightmares, hypervigilance), and personality disorders (borderline, narcissistic). This list is by no means complete but is provided to give you an idea of what types of issues people bring to their therapist.
How does it work? There are many types of talk therapy so this gives you the luxury to shop around until you find one you can work with. There are several "brands" of talk therapy; cognitive behavioral therapy, psychodynamic, humanistic, and gestalt to name but a few. Most psychotherapists have an eclectic approach, utilizing tools from various styles of therapy. One of the most important aspects of psychotherapy is the client/therapist relationship. Most therapists believe that establishing a good rapport with a client is essential to successful treatment.
Our lives go by so quickly and, for the most part, our perspective is colored by our emotional involvement. We are too close to our relationships with our significant other, children, friends, and acquaintances to see them from an objective, safe distance. A good therapist will mirror our behavior and relationships to us in a gentle way so we can take a look objectively. If our lives were a movie, the good therapist can slow the frames of our movie down so we can better see our lives frame by frame. With that kind of knowledge, we can begin to make the changes and choices that allows us lead a more successful, fulfilled and healthy life.
