by Dr. Kim Dwyer
Hi. This article is just for teenagers who are thinking about seeing me for therapy. Maybe you are looking for a therapist, or maybe a parent or someone else in your life has suggested you work with a therapist. Opening up to someone new is not always easy. You may have questions about your therapist, or questions about therapy in general. You may wonder if it means you are “crazy” if you talk to a therapist. Rest assured, it doesn’t. You may have seen therapy portrayed in different ways on television or in the movies, and wonder if that is accurate. This article has some general information for you about therapy. Of course, we are happy to talk about this in person, too, and will do so at our first appointment.
Q: What is a psychotherapist anyway?
A: A psychotherapist is someone with advanced training in counseling and mental health. Mental health basically describes the health of our brain, behavior, and emotions. There are a number of professionals with training and certification to provide psychotherapy.
A psychologist is someone who has received a doctoral degree in psychology. A clinical psychologist has focused his/her education and training on assessment and treatment of mental health issues. Other professional psychotherapists have master’s degrees in a variety of areas, most frequently in marriage and family therapy, in social work, and in counseling. With slightly specialized focuses, these professionals are all trained to provide psychotherapy and to understand how to help people make changes in their lives.
Everyone has experiences of thoughts or feelings that they don’t particularly like. Everyone makes choices at times that lead to behaviors or actions that they or others do not like. When thoughts, feelings, or actions create obstacles for a person, therapy can be helpful, seeing a psychotherapist can be helpful. Just like when you have other difficulties you see a specialist in that area–for instance, seeing an orthopedist when you have a broken bone or seeing an allergist when you have a problem with allergies. Your family care doctor or pediatrician may refer you to us, or you or your parents may seek out a therapist on your own. A psychotherapist is not a medical doctor–we don’t prescribe medications, give injections, or listen to your heart beat. We rely on you (and, often, your family) to tell us what you’re experiencing.
Q: Am I the only one dealing with this? Does this mean I’m crazy?
A: No! Estimates are that approximately 1 in 5 teens (20%) have difficulties to deal with. Lots of teens work with therapists. It does not mean you are “crazy” at all.
Q: Well if that’s true, how come I don’t know anyone working with a therapist?
A: There are a couple of reasons you may not know anyone working with a therapist. First, therapy is confidential. That means that therapists do not tell others who they work with without the client’s express permission. When we work with teenagers, one of the first things we talk about is confidentiality. We talk about what information is shared with parents, and how that information will be shared. Therapy should be a safe place where you can talk about what is bothering you without worrying about hurting someone else’s feelings or being judged by others. We do everything that we can to make my office and our relationship a comfortable place for you to talk about what is bothering you and for you to learn new strategies to manage uncomfortable feelings, thoughts, and behaviors.
Another reason you may not know anyone working with a therapist is that in our culture, this is something many people keep private. You may know people who are working with therapists who have not shared that information with you. That’s ok. It doesn’t mean that they don’t trust you. It is just something they don’t want to share. Similarly, you may or may not want to share that with your friends. Whatever choice that you make, it is your choice.
Finally, some people who may benefit from therapy do not seek out therapy. This is unfortunate. If you know someone who is really suffering and could use someone to talk to, you can be a friend to them and help them seek out a trusted parent, teacher, or school counselor as a first step. Life’s problems can be big. No one has to suffer through them alone.
Q: What will we do in therapy?
A: One of the first things we will do is talk about confidentiality, what is private, and what information will be shared with parents. Generally we like teens to share with their parents themselves, so often a parent will join our appointment for the last few minutes. For teens who drive themselves to our office, sometimes we write an email together that we send to parents. Our second job will be to figure out what is going on that is causing difficulty for you. That will involve asking some questions in order to try to understand what you are experiencing. Usually once we understand what is going on, we will develop goals to work on. Goals are similar to the final destination on a map. We figure out where we want to go, and then we figure out what it will take to get there. Often, “what it takes to get there” is our main job in therapy. Usually that involves providing you with information about feelings, thoughts, and behavior, collaboratively devising strategies to change, tolerate, or regulate feelings, thoughts, and behavior, and you trying some of these out.
Q: How long does therapy last?
A: It depends. Some problems can be addressed and resolved fairly quickly, while others take longer. We can talk about this specifically as related to you. We typically see people once a week, at least initially. After several appointments we should have a fairly good idea of our goals and some sense of a time-line, and we can talk about that then.
Q: What can I expect from you? What do you expect from me?
A: You can expect us to be professional and treat you with an attitude of support, compassion, and respect. We will do our best to help you learn strategies supporting your goals. We will challenge you if we think you need to be challenged, but will always do so in a supportive fashion. As for what we expect from you, people who do best in therapy work on their goals between appointments. We will see you for forty-five minutes. There are a lot more than forty-five minutes in your week. Use those other minutes to try out what we work on. Think of it is as your own behavioral experiment. See what happens and report back. If the strategies we come up with are too difficult, tell us and we will problem solve them. If they work great, wonderful. If they don’t work great, we will come up with new ideas.
We also appreciate when patients are honest with us to the extent that they can. If we are talking about something that you are not ready to talk about, just tell us. If you make things up to change the topic or get us “off your back,” it won’t really be helpful to you in the long run. We are often tempted to avoid dealing with those things that are difficult, but it is that avoidance that makes our problems more difficult to manage.