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Psychotherapists & Psychotherapy

By Stella Cuomo, LCSW

What is psychotherapy?

Psychotherapy is a practice field for life outside of the therapy room and a journey you do not embark alone. The relationship between a therapist and a client is something to be cherished and is first and foremost a container to safely explore your unique human experience. Psychotherapy is a non-judgmental, compassionate, and brave space to process and make sense of life events and give them meaning, heal psychological pain, learn tools to maneuver life’s stressors and trauma-responses and a method to explore who you are individually, in your relationships and the environments you are a part of. 

What do psychotherapists do? 

Psychotherapists can work from various modalities or approaches. A modality can be described as the mode of meeting (e.g. individual, couples of family therapy) and the mode of intervention that the therapist uses with their clients. If a psychotherapist feels that you need interventions that they are not trained in, they may seek consultation or supervision from other colleagues to best help you or help you find a therapist or resource that may best suit your needs. With that said, you should know that confidentiality is of utmost importance when a therapist consults with their colleagues. Therapists leave out your identifying information in this process unless the therapist obtains written consent from the client stating that revealing identifying information is okay. 

What are interventions?

A therapist will usually use more than intervention. These include evidence-based practices and psychological theories that help form their unique treatment plans for you. Some examples of commonly used evidence-based practices are Motivational Interviewing (MI), Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy (DBT), Acceptance Commitment Therapy (ACT), Mindfulness-based Stress Reduction (MBSR), Mindfulness-based cognitive therapy (MBCT), Trauma-focused Cognitive Behavioral Therapy (TF-CBT) and Exposure and Response Prevention (ERP). Some therapists are more psychodynamic or psychoanalytic, which are forms of depth psychology and are intended to explore the origins of behavior and unconscious drives and motives that are creating maladaptive patterns in present-day. Some theories from this modality are attachment theories, object relations, self-psychology, existential theories, relational theories, archetypal theories, sandplay and dream work. There are some therapists that specialize in specific interventions like eye movement desensitization and reprocessing (EMDR) for Post-traumatic Stress Disorder (PTSD) or neurofeedback for PTSD, Attention Deficit Hyperactivity Disorder (ADHD) and anxiety disorders. Some therapists use a combination of evidence-based practices, psychodynamic theories and have certifications in certain interventions. Your therapist will use their expertise in the way that works best for you and, again, if it is not a right match, they will refer you to a more appropriate resource. 

Types of psychotherapists

Psychotherapists can be psychiatrists (i.e.. MD), psychologists (i.e. psychological assistants, PhD, PsyD), counselors (e.g. LPCA, LPCC, LMHC), marriage family therapists (e.g. AMFT, LMFT) and social workers (e.g. ASW, LCSW). I know, it is a bunch of acronyms and, believe it or not, there are more because they vary from state to state. If you are curious about psychotherapist credentials, you can either ask a therapist in your state or do an internet search to find your state’s psychotherapist licensing board for counselors, marriage family therapists and social workers to understand how they vary. It is worth mentioning that many psychiatrists do not provide psychotherapy and mostly provide psychiatric medication management as this is their training as medical doctors. Psychologists, counselors and social workers require either assistantships, associate registrations or licenses to practice psychotherapy. These are acquired through their governing board in the state they practice. An unlicensed therapist has an assistantship or associate registration and needs a supervisor to oversee their work. The supervisor is not in the room with the client and their psychotherapist, but the pre-licensed psychotherapist will meet with their supervisor on a weekly basis to ensure that they are receiving proper training and direction for optimal client care. 

These are just some examples of why you might consider going to psychotherapy: 

  • Mental illness. These are issues that are disrupting your human functioning, such as diagnosed mood, anxiety, personality and addictive disorders.  
  • Maintaining and building relationships
  • Communication issues
  • Grief 
  • Impulsivity
  • Anger management 
  • Lost identity
  • Sexual issues 
  • Exploring sexuality and gender identity
  • Low self-esteem and confidence
  • Adapting to life’s changes
  • Building perspective and clarity
  • Finding meaning in your human experiences
  • Sobriety maintenance

Psychotherapy is not for everyone and that is okay. It will only be beneficial if you are open and willing to participate in the process. It is important to know that you might not feel amazing after every psychotherapy session because things that are discussed can bring out painful emotions and new realizations about yourself and others. Although painful, working through these emotions is part of the therapeutic experience and it can be powerful and transformative. With that said, other resources might work better for you, such as life coaching, sober coaching, hypnotherapy, speech therapy and/or Traditional Chinese Medicine like acupuncture. Understanding what these resources can do for you first before choosing psychotherapy can help you choose which trajectory to go on. The mode of healing that works best for you is up to you to decide.  

Why is it an important resource for other professionals to know about and collaborate with?

Collaborating with client’s other resources is always helpful for comprehensive care. Like I said earlier, the client must give written consent or sign a release of information (ROI) form for us to communicate with these resources. This gives us the opportunity to gain a broader perspective on how the client is functioning and progressing. It is important for us to see clients from various perspectives, meaning not only understanding their psychology, but their biological and social functioning. This informs us of how we need to adjust our direction with respect to treatment planning, approaches and giving appropriate referrals for quality care.