The Word on Talk Therapy

We all need someone to talk with now and then. At times, friends and family will do. But, if you’re struggling with strong emotions, a troubled relationship, depression, or other mental health issues, a sympathetic ear may not be enough. You may need to try psychotherapy, or “talk therapy” with a mental health professional.

Talk therapy helps people gain insight into and resolve their problems through verbal exchanges with the therapist. This is sometimes combined with "homework" assignments between sessions.

What therapists do

Depending on your goals and the therapist’s approach, he or she may ask about your childhood, your relationships, or your thoughts and feelings, according to the American Psychological Association. Early on, you’ll do most of the talking. These conversations help your therapist help you:

• Define what you hope to accomplish, such as overcoming a phobia or coping with a loss, and make a plan for doing it

• Learn more about your situation and how to deal with it

• Identify triggers that cause symptoms such as anxiety

• Kick unhealthy coping habits, such as alcohol or drug use

• Deal better with crises

“Mood disorders and anxiety disorders respond well to psychotherapy,” says John Markowitz, M.D., a psychiatric specialist in New York City. “And, for a lot of conditions, medication and psychotherapy together seem to be better than either by itself.”

Talk therapy also may help with physical symptoms, such as pain, fatigue, and nausea. 

Ask your health care provider about psychotherapy if:

• You feel overwhelmingly sad or helpless

• Your emotions get in the way of your daily life

• Your actions are harming yourself or others

• You feel anxious but don’t know why

• You’re having difficulty coping with a medical condition

• A stressful event such as a death in the family or a divorce has occurred, and you’re having trouble dealing with it

Some symptoms commonly seen with emotional distress—fatigue, sleeplessness, a change in appetite, or weight loss—also are signs of medical problems. That’s why you should always see your doctor first to determine what’s causing these symptoms.

Finding a therapist

Ask your health care provider and loved ones for recommendations. You can also try your state psychological association; call the American Psychological Association's consumer information line, 800-964-2000, to find your state organization. Another source is your local mental health association, whose number can be found in the phone book.  Sometimes, a therapist who has been helpful for a friend or family member may be appropriate.

Once you have a name, gather as much information as you can about that therapist so that you can make an informed decision.  Try to learn about his or her background and approach and whether they are licensed and credited by their professional association. Find out whether your insurance covers the sessions, too. If the therapist seems like a good match, set up a meeting.

Then, during the first session, ask yourself if you feel at ease with this person You should feel free to discuss any feelings of discomfort with your therapist,” says Dr. Markowitz.

Your role in therapy

“In general, the more active and involved you are, the better therapy is likely to go,” says Dr. Markowitz.

• Think about what you want to discuss ahead of time and try to establish goals with your therapist.

• Attend all scheduled sessions, and be on time.

• Be open to sharing your thoughts and feelings; confirm with your therapist that your sessions are confidential.

• Continue medical treatment, including medication.  And keep your therapist informed about any changes in these, as well as possible side effects.

• Let your therapist know if you feel that you’re not making progress or getting what you want from the sessions.

• Review your progress with your therapist.