Written by Lisa Ranzenhofer, PhD, and Nikki Pagano, LMSW.
You think you need help, but therapy is something you’ve never considered.
You’ve been to therapy and had a bad experience.
Either way, you’re not alone.
Unlike going to the doctor (which most of us have done since childhood), many of us do not consider therapy until we are teenagers or adults. In the absence of having a personal experience with therapy, we are left with our imagination, fueled by movies and TV characterizations of mental health care. Sadly, many of these depictions are by-and-large inaccurate and represent therapists as incompetent at best, unethical and harmful at worst.
Misconceptions about who goes to therapy, for what, and with whom can make the difference between making the first appointment and deciding “it’s not for me.”
Here are some common reservations we hear about going to therapy, and why it’s worth a second thought.
- My problem isn’t serious enough. While many people do attend therapy for severe mental illnesses, like schizophrenia, most individuals who seek care do so for common problems like relationship difficulties, stress/anxiety, and family issues (See Table 1 at the top of page 3). A related reservation that we have heard time and time again is “but other people have it worse.” Psychological wellbeing is not a competition. You are the only person living your life, with its particular stressors, and other people having it worse does not imply your problem does not deserve help. Part of your therapist’s job will be to evaluate what the problem is and how to address is. If your provider thinks that therapy is not essential for you, he or she will let you know.
- Isn’t therapy just paying someone to talk with me? While getting support from an additional person can be a nice benefit, therapists typically provide more than just another listening ear. Therapists of all types receive years of training in helping people increase their own internal motivation, change ingrained patterns of behavior, and alter thought processes and emotions that keep them stuck. Therapists have a specialized knowledge base in these areas that allows them to provide help in a way that non-trained individuals often cannot.
- I’ve been to therapy and it didn’t help. Reaching out for help and having a negative experience is certainly a frustrating setback. Willingness to start the process with someone new can mean the difference between continued difficulties and possible change. Different therapists and types of therapy resonate for different people and different issues. If you don’t “click” with the first person you meet with after a few sessions, it is perfectly okay to seek out alternatives! If you’re in treatment and are concerned that the therapy isn’t helping, check in with your therapist. Together, you may be able to work through whatever it is about the treatment that feels like a mismatch for your needs. He or she may be able to provide information about what to expect during the process. Some treatments take a while to work, and being prepared for that will help you stick with it.
- There is no way I can afford it. Some people have heard that therapy is only for those with endless amounts of money. Though there is typically some fee, there are several ways that therapy can be affordable. Many insurance providers offer behavioral health benefits (meaning coverage for a therapy appointment) or out-of-network reimbursement (meaning that they will pay you back, if you pay up-front and submit the bill). If your insurance benefits or resources are limited, ask therapists if they offer a sliding scale when you call to set up an initial appointment. Therapists sometimes offer sliding scales for their clients based on their ability to pay. Also, consider professional training programs in your geographic area. Psychiatry residency programs, psychology doctoral programs, and social work programs often have affiliated community clinics where trainees provide services for low or no cost, while being closely supervised by experienced professionals.
- Unless my therapist has been through it personally, they won’t understand my experience or be able to help. Therapists may or may not have been through what you are going through. Part of a therapist’s job is to provide understanding and therapeutic interventions to a wide range of people whose backgrounds may or may not be similar to their own. Even if your therapist has been through the same thing, he or she most likely will not share that. A key aspect of therapy is keeping the focus on you.
- I don’t want to be forced to take medication. Taking or not taking medication is entirely up to you, as is participating in therapy in most circumstances. Your therapist will share why they think you might benefit from a medication, and what the process of a medication evaluation and trial is likely to involve. Ultimately the decision is yours to be made with a prescribing physician (e.g., psychiatrist) or nurse practitioner.
Still not convinced? That’s okay. Just recognizing that things are not going how you want, entertaining the idea of seeking help, and maybe even talking to someone about it can be a really important first step. Therapy isn’t something you have to rush into.
If you are ready to take the next step, here are a few resources help you on your way:
Eating disorder specific:
National Eating Disorders Association – Comprehensive list of eating disorder treatment resources, including inpatient/residential, outpatient, and support groups. Search by location, diagnosis, co-occurring problems, and more.
Psychology Today – Search by a variety of factors, like location, specialty, and insurance. Focused on individual providers (rather than treatment centers or hospitals).
American Psychiatric Association – Find a psychiatrist, who is uniquely qualified to provide a medication evaluation and to understand the interrelationship between mental and physical health.
Association for Behavioral and Cognitive Therapies – Search for a cognitive behavioral therapist by location, specialty, and insurance.
Substance Abuse and Mental Health Services Administration – Find treatment facilities and programs in the United States or U.S. Territories for mental and substance use disorders. Includes all types of resources, like treatment centers and institutes.
National Alliance in Mental Illness – Find help in a crisis, as well as community-based support resources in your neighborhood.