Tips on how to get the most therapeutic value out of psychological therapy
You are emotionally struggling – weighed down by different feelings or profound sadness/anxiety/hopelessness.. you might have been going through a number of things that life threw at you from left, right and centre. You might have just realised how sad you have been throughout your whole life. You might have just lost someone, a relationship or a sense of self/achievement/control. And you are thinking about talking to a stranger all about it. Perhaps someone said ‘you better go and talk to a professional about it’. Maybe your GP was not happy to prescribe any medication at this point. Maybe you don’t want to take any pills.
As a therapist, I can tell you that it’s not an easy thing at all. You are letting a stranger see your inner self and your life including the parts you don’t want to think about (although not all therapy will result in digging up the past or your deepest darkest secrets). You have to verbalise how you feel, which can be the most daunting thing ever. You have the right to feel nervous and apprehensive, as well as feeling relieved (because a. you have decided to get help, b. there’s actually someone whom you can unload your internal burden without feeling guilty c. Things might change. In a good way. There’s hope.)
So, it is really, really important that you get into the right type of therapy and you get the most out of it. Based on my 8 years of experience in mental health service, I thought these tips might be helpful for people who are in need of and considering accessing psychological therapy.
1. Do tell your GP how you feel and how you might need emotional support/psychological therapy from a professional. GP may not know about all types of therapy but can point you in the right direction.
2. Not all therapy is ‘counselling’. If you say you need counselling, GP might only give you option for counselling. There are Cognitive behavioural therapy (CBT), psychodynamic therapy, systemic therapy…a variety types of therapy. Bear in mind, though, CBT is the evidence-based therapy recommended for various mood disorders (depression, anxiety, panic, PTSD, OCD, phobia all included) by the National Institute for Health and Care Excellence. You can do a little research on different types of psychological therapy.
3. You do need an assessment if you are unsure what type of therapy would be most helpful for what you are going through right now. Accessing your local IAPT service can help you with this. Their assessment will determine whether you would benefit from short-term treatment like CBT or you require more long-term/holistic treatment.
4. It really helps if you can think of what you want to achieve from the therapy e.g you want to improve your mood so that you can deal with your life stressors better, you want to reduce fear that’s been really getting in the way in your daily life, you want to resolve your feelings around your childhood. However, sometimes we are so overwhelmed we just can’t think clearly – where to start, what we need, what to focus on first. The person who assesses you might suggest one area to focus on. You might think ‘that’s not gonna be enough’ and feel hopeless/frustrated BUT remember, you need to start somewhere and the assessor is likely to be suggesting something that you can manage with a therapist’s help so try to put aside the uncomfortable feeling and see where it takes you/how it can help you.
5. At times, therapists (especially in NHS) encounter people who ask ‘are you qualified enough? Are you a psychiatrist? How old are you?’. When we are badly injured and our life feels upside down, we wouldn’t ask the consulting doctors and nurses these questions. Therapists need the same level of trust and respect and starting your assessment/therapy with scepticism is not likely to help you with being open and honest during the assessment, which is very important.
6. Just because you are going through 10 different problems, it does not mean that your treatment has to be the most complex, intense one. There are people who say ‘my problem is really complicated, I need to see a psychiatrist only’. If you are experiencing symptoms of psychosis such as visual/auditory hallucination, frequent urges to seriously harm yourself or others, or your paranoia is significantly disabling you, you may require psychiatric assessment and medication, and therefore a psychiatrist. However, try not to jump to conclusions and, again, be open-minded when you discuss your difficulties with your GP and assessor. You may only require a short-term CBT to understand the link between current difficulties and to learn to cope with them with new coping techniques (cognitive and behavioural), for example. Psychological therapy is most often delivered by psychologists and psychological therapists such as CBT therapists, psychological wellbeing practitioners and counsellors who are trained to deliver therapy.
7. Don’t be put off by the word ‘short-term’. It is not belittling your difficulties. Breaking down your difficult emotions and working through them one by one are more likely to have long-term benefit than trying to work on everything at the same time. Think of it this way – you are injured in several different places. Rather than going through a 24-hour surgery which will overwhelm your body and could be more detrimental, you get one treatment for one area, let it heal then move onto the next treatment, so have some gaps in between. You may also find that the first short-term treatment gives you what you need to manage/tackle some of the other difficulties, which can lead to great sense of independence and self efficacy.
8. Often drinking or taking drugs is used to cope with difficult emotions. However, when there’s been this self-medicating going on for some time, it can be difficult for your therapist to get a true picture of your current mental health because large amount and frequent use of alcohol/drug is very likely to have affected your mental health e.g. Exacerbated your anxiety, caused ‘extra’ factors around depression or panic etc. You are likely to be asked to engage with drug and alcohol support service first. This is not rejecting your difficulties or simplifying your difficulties as ‘substance misuse’. It’s not beneficial at all to be stuck in the middle – Therapy trying to pull you up to challenge dysfunctional thoughts while the impact of alcohol/drug is pushing you down to more dysfunctional thoughts and poorer concentration, for example. You will feel stuck, which may lead to further frustration/hopeless feeling/fear/disappointment.
9. Once you start the therapy, imagine that you have a driving instructor sitting next to you. You are still the driver. If you don’t put your foot down on that accelerator, your therapist won’t start the car for you. If you refuse to do that parallel parking although you were given and shown the knowledge and techniques that you require, your therapist will not do it for you. It is not because we refuse to help but because
We are here to help you become an independent driver, not to help you be a passenger.
Therapy is there to empower you, not to take the control away from you.
This post was written by an experienced colleague of mine – Scarlett Gallimore. To find out more click on the links below: