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Talk Therapies

Talk Therapies



What is talk therapy?
How much time is involved?
Which mental health professionals use talk therapy?
What is individual psychotherapy?
What is cognitive-behavioral therapy?
What is family therapy?
What is group therapy?
How do I find a good therapist?
How much does talk therapy cost?


What is talk therapy?
For many different emotional problems, the best treatment, believe it or not, is talking. Talk therapy, also known as psychotherapy, is not exactly like talking on the phone with your friends (and not as fun), but it can help you in so many ways. In one national survey, nine out of 10 Americans said that talk therapy helped them. In a major national study, half of the patients made improvements after just eight sessions of talk therapy, and three-quarters of them made improvements after six months.

There are many different kinds of talk therapy. Each type works best with certain kinds of problems, but it is common for people to be in a couple of different talk therapies at once. For instance, if you are depressed, your mental health professional may suggest that you participate in individual psychotherapy and family therapy. If you are anxious or phobic, perhaps you will try cognitive-behavioral therapy and group therapy. In many cases, a combination of talk therapy and medication is the most effective treatment.

The purpose of talk therapy is to help you get rid of or manage painful symptoms so that you can go back to feeling like yourself again. It can help a person get over a specific problem or encourage emotional growth (if you can identify your feelings, you can accept them—and yourself). By talking with a therapist, you may begin to have a better understanding of your own thoughts and feelings. You may learn some specific ways you can help yourself—in school, at home, and with your friends. You may learn how to tolerate intense emotions like anger and frustration. You'll probably feel much better about yourself in general. You may even start to appreciate more of your own strengths and abilities.

Even though the goal of talk therapy is change, there is nothing magical about the process. Your therapist does not wave a magic wand to make you feel better. Instead, you make a commitment to change, with your therapist as a guide. It takes a lot of hard work. But it will probably last you for the rest of your life.

Here's what therapy doesn't do: it doesn't turn you into a different person. Some people are afraid that therapy will make them into a different person—others wish that it would. For instance, if you're shy, therapy will not suddenly turn you into the life of the party. But talk therapy can help you find solutions to some of your problems. back to top

How much time is involved?
The number of weeks or months you will spend in therapy depends on a lot of things: what kind of problem you have, how long you've had it, how serious it is, as well as the kind of therapy you are in, how you are responding to it, and how much health coverage you have. Because of the high costs of health care, shorter treatments have become more common in the last decade or so. Many people complete therapy in 16 or fewer sessions. But sometimes, emotional problems are very deep and can take months—or even years—to work out.

How will you know when you're finished? This can be tricky, because sometimes people want to end therapy just when it's starting to help them. The funny thing is that therapy can actually make you feel worse before it makes you feel better. And, of course, that would make anyone head for the nearest exit! The best strategy is to hang in there and remember that the awful feelings won't last forever. One thing for sure: it won't help you to run away from your problems. They'll eventually catch up with you again.

Usually, you are ready to end therapy when everyone—you, your therapist, and your parents—agrees that you are healthier and coping better with everyday life. back to top

Which mental health professionals use talk therapy?
There are all kinds of mental health professionals who use talk therapy to help their patients:
  • Psychiatrist. A psychiatrist is a medical doctor who went to college, then to medical school for four years, and then spent at least another four years training to be a psychiatrist. A psychiatrist has the letters M.D. (doctor of medicine) or D.O. (doctor of osteopathy) after his or her name. A psychiatrist knows about the body and the mind, and can diagnose problems. He or she is the only kind of therapist licensed to prescribe medications. Some psychiatrists work primarily with children and adolescents. This means that they've had yet another two years of training. (That's 26 years of school!) Some psychiatrists do therapy which they might combine with medication, others only prescribe medication and might refer you to someone else to "talk."
  • Psychologist. A psychologist is someone who has a doctoral degree in clinical, educational, or research psychology. A psychologist has spent an average of seven years of training and education after college. Look for the letters Ph.D., Ed.D, D.M.H., or Psy.D. behind the person's name. Some psychologists may have only a master's degree, also called an M.A. or M.Ed. That's usually about two years of training after college. Psychologists know how to evaluate and treat emotional problems. They also know how to give psychological tests and how to do sophisticated research about psychological problems.
  • Social worker. A social worker has earned a master's degree—or M.S.W.—at a college or university. That usually takes two years. In most states, social workers can take a test to be licensed as a clinical social worker—or L.C.S.W. Some social workers have jobs at hospitals and government agencies. They help families cope with all kinds of problems, such as abuse and poverty. Other social workers are in private practice or work at mental health centers or psychiatric hospitals. They provide counseling or psychotherapy for individuals, groups, couples, and families.
  • Psychiatric nurse. Nurses can have different kinds of training, but they all have the title registered nurse—or R.N. They may also have M.S.N., Ph.D., N.P., or C.S. after their names. Some nurses have master's or doctoral degrees. Some even having special training in child and adolescent psychiatric nursing. In most states, these specialists can provide therapy and prescribe medications. They often work closely with a psychiatrist.
Something you should know is that almost anyone can call himself or herself a psychotherapist. You don't have to have a special degree or training. All it means is that the person is practicing psychotherapy. As we've just learned, many people who practice psychotherapy do have professional degrees. But some people don't. They may call themselves counselors, pastoral counselors, or just therapists. That doesn't mean that they can't help you. It just means that you don't have as much information about their skills and training. Don't be afraid to ask questions about someone's qualifications. It's your right to know. back to top

What is individual psychotherapy?
Individual psychotherapy is a popular and usually effective kind of talk therapy. It is sometimes called psychodynamic therapy. Once or twice a week, you'll get a chance to talk with a mental health professional who listens to you and helps you explore the different thoughts and feelings you have. The meetings usually take place in the therapist's office. A session usually lasts between 45 and 50 minutes.

You may feel nervous at first about meeting with a therapist. You may think, "What am I going to say to this person I barely know?" or "What if I run out of things to say?" This is normal. It may take some time for you to feel relaxed enough—and trusting enough—to talk openly. After a while, a lot of girls realize that psychotherapy is a special time. You can ask or talk about anything you want, and you don't have to worry about being judged or criticized. The therapist's job is to listen and to help you figure out what's making your life difficult right now. Eventually, you'll probably tell your therapist things that you've never told anyone else. That can be a little scary, but don't worry. Your therapist is not allowed to tell your secrets to anyone, including your parents, unless you are in danger of hurting yourself or someone else.

You probably have seen therapists on TV and in the movies who have a couch that the patient lies on. There are still a few therapists, called psychoanalysts, who meet with people four or five times a week and sometimes have them lie on a couch. That way, a person can get to deeper issues. Most therapists, though, simply use chairs!

Sometimes, you may leave a therapy session thinking that your therapist is the most awesome person on the planet. Other times, you may storm out of a therapy session feeling angry and frustrated with your therapist. These are all normal feelings. No relationship is perfect, so you will have good times and bad times with your therapist—just as you do with all of the other people in your life. back to top

What is cognitive-behavioral therapy?
Cognitive-behavioral therapy is one of the newer types of talk therapy. It has helped many young people with certain emotional and behavioral problems, especially depression, anxiety, and phobias. A therapist who practices cognitive-behavioral therapy can help you see that the way you think about things affects how you feel. This is different from the more traditional kind of individual psychotherapy, which focuses on the causes of emotional problems.

Cognitive-behavioral psychotherapy looks at your everyday behavior and can help you change some of the negative thought patterns that you may have developed over the years. For instance, do you always expect the worst to happen to you? Do you think that because you failed one test, you'll never get another good grade? Do you ignore or put down the good things that happen to you? These are all examples of thought patterns that can make you feel depressed or anxious. Cognitive-behavioral therapy helps you turn down the volume on those self-defeating thoughts and encourages you to think more positively.

Cognitive-behavioral therapy can also help you set more realistic goals for yourself and can teach you how to be kinder to yourself. Your therapist may teach you some relaxation techniques. You may even get some homework assignments to help you practice some of the new skills you are learning.

Many young people like cognitive-behavioral therapy because it is active and deals with specific problems. The therapy sessions are also short—often one or two 20-minute sessions per week. Many people find that once they get into the habit of thinking positively, they begin to feel much better.

But keep in mind that cognitive-behavioral therapy isn't the answer to everyone's problems. In some cases, it can reduce some symptoms, but it may not get to the root of deeper problems. In other cases, cognitive-behavioral therapy can bring lasting results, especially when your symptoms are mild, when you are motivated to get help, and when your family is involved in your treatment. back to top

What is family therapy?
Family therapy is used to treat a wide range of emotional and behavioral problems, including depression, anxiety, substance abuse, eating disorders, and psychotic disorders.

Often when a teen is having these kinds of problems, the family is also having some difficulties. Perhaps your parents are fighting. Perhaps they are getting divorced or separated. Perhaps someone in your family has a physical illness or someone died recently. Perhaps your parent has a substance abuse problem or another emotional problem. Perhaps there are too many strict rules in your home—or maybe there are no rules at all. Any of these problems and stresses can rub off on the kids in the family, including you.

A family therapist's job is to bring the entire family together to talk about these problems. This can include your parents, your siblings, even your grandparents or aunts and uncles. Everyone sits in the same room, often in a circle. The therapist leads the session, which usually lasts an hour or so. The therapist's job is to make sure that everybody gets a chance to talk. Once he or she starts learning about the family's problems from each person's point of view, the therapist can begin to figure out what may be causing the problems.

The therapist will also be watching carefully to see how members of a family interact with each other. It's very common in troubled families for people to develop unhealthy ways of communicating. They may talk about each other, instead of talking directly to each other. They may take sides. They may criticize each other constantly. They may even abuse each other. Sometimes family therapy can help all the members of the family understand each other. It can give you a chance to express yourself and help your family members know what you are going through. That way, the people in your family can find better ways to deal with each other.

Some family therapists do exercises, like role playing, to help the family experiment with different ways to talk to each other. back to top

What is group therapy?
Group therapy is just that: people meeting together to talk about their problems. Group therapy takes place in schools, community centers, churches and synagogues, health clinics, mental health centers, and hospitals—as well as individual offices. Group therapy is especially helpful for people who are going through similar types of problems. For example, teens whose parents are divorced often have a lot in common. So do teens who have been physically, emotionally , or sexually abused . Groups have been known to work extremely well for people who are trying to recover from a trauma or crisis. And group therapy is a common treatment for substance abuse , including parental substance abuse . Sometimes it's a chance to learn about how you relate to other people and what they notice about you.

Groups vary in size, but most of the time, there are at least four and not more than 12 people in a group. Most groups meet once or twice a week. In a hospital or intensive treatment program, groups may meet every day. Some groups meet for just a few months—and then they're finished. Other groups are ongoing. The members of a group listen to each other's stories, and they offer each other support. In the process, they learn that they are not alone.

Most groups have a facilitator or leader. The facilitator offers support and makes sure that the group is running smoothly. One of the first things a facilitator does is set up a few rules that everyone agrees to honor. Here are a few examples:
  • Members must show up on time and stay for the entire session.
  • Members must keep what is talked about in the group completely confidential.
  • Members must take turns talking and not interrupt each other.
  • Members must treat other members with respect; no name calling or other disrespectful behavior is tolerated.
These rules may sound strict, but they are designed to make the members of the group feel safe and able to share what is on their mind. back to top

How do I find a good therapist?
There are many ways to find a good therapist, but it may take some time. It is common, in fact, for people to interview a number of therapists before they make a final decision. Even though it costs money just to interview a potential therapist, it's usually worth it. You want to make sure that you like and trust the person who is going to be helping you. This is probably a decision that you will make along with your parents or another trusted adult.

One of the best ways to find a therapist is to ask the people you already know to make suggestions. Your friends and family, your pediatrician, your guidance counselor, or your priest, minister, or rabbi are some of the people who may be able to give you names and telephone numbers.

If that doesn't work, you can call your local hospital, medical center, or community mental health center. You may also try the department of psychiatry or psychology at a nearby medical school or college. Most cities also have a local medical society or mental health association. They may be able to steer you in the right direction.

A number of national organizations refer people to mental health professionals. One such organization is the American Psychological Association. By calling 1-800-964-2000, you will be connected directly to the state or local referral service for your area. You can do the same thing by going to the Web site of the American Academy of Child and Adolescent Psychiatry at www.aacap.org. The home page will tell you how to get to the Members Directory Database, where you can find the names of licensed child and adolescent psychiatrists in your city or community.

Some people use the Yellow Pages to find a mental health professional. Usually, they look under "Mental Health Services," "Physicians," "Psychologists," or "Psychotherapists." But it's not generally a good idea to use the Yellow Pages as your only source of information. You will want to know as much as possible about a therapist before you begin treatment. It's probably a better bet to find a therapist by talking with people you already know and trust.

Once you have found the name or names of several therapists, here are a few questions that you and your parents may want to ask:
  • Are you licensed?
  • How long have you been practicing?
  • What areas do you specialize in?
  • What kind of treatment do you usually use, and why would this be effective for me?
  • How long do you think my treatment will last?
  • What are your fees?
  • Will you accept my insurance coverage?
Finally, make sure you feel comfortable with the therapist you choose. Ask yourself: Does he or she listen? Does he or she seem to understand my concerns? Is he or she nice? The two of you will be working as a team, so it's important that you get along.

Over time, you and your therapist will develop a special relationship. Even though you will be sharing very personal thoughts and feelings, it is important to remember that your relationship is not a friendship. A therapist is never allowed to socialize with a patient, and sexual relations between a patient and a therapist are strictly forbidden. back to top

How much does talk therapy cost?
The cost of talk therapy varies. A 50-minute session can cost anywhere from $50 to $150, depending on the therapist's training, years of experience, and the type of therapy he or she practices. Generally, psychiatrists and psychologists charge more than licensed social workers and other counselors. Group therapy tends to be the least expensive type of talk therapy. And cognitive-behavioral therapy is usually less expensive than individual psychotherapy.

Because talk therapy can be so costly, some mental health professionals have "sliding fee scales." This means that they do not charge you the full price for a session. Instead, they charge you a portion of the full price, depending on your family's income level. It's a good idea to ask about this option, especially if you and your parent are both involved in finding you a therapist.

You may also be able to get some help through your parent's health insurance plan. Many plans have mental health coverage, but there may be some restrictions on whom you can see and how many sessions are covered by the plan. This is something that your parents will have to find out from their employer or a customer service representative at the insurance company. back to top

Last Modified Date: 3/23/2001