Do I need therapy?
By: Enrico Trentin
Therapy can help us move out of our comfort zone (familiar but not necessary as comfortable as the name suggests), and into the learning zone.
Content warning: online and in-person therapy and counselling
Why does anyone embark on therapy? Wouldn’t be easier just to figure things out on our own? What would I gain from the process? These are the types of questions that people sometimes ask when mulling over the idea of seeing a therapist. The short answer to these questions would be that people embark upon having therapy because they have tried to go it alone with dealing with their issues, and have yet to have succeeded in getting better.
Can’t I just use introspection to help myself?
Introspection is a good place to start, and the father of psychology, William James, used this method when trying to understand the human psyche. However, when trying to resolve our issues, this approach runs into difficulties fairly quickly, because we tend to engage in the same ways of thinking that have caused us the problems in the first place. It takes someone outside of our network of thinking to help us find a clearer perspective on our issues.
Can’t I just be “rational” about this?
Using our reasoning would work to some extent if we were truly rational. However, most of us, when emotionally charged, are not as “rational” as we would like to believe we are. Our mind takes shortcuts to try to understand ourselves, our dynamic relationships, and our complex society. These shortcuts are biased because we try to shoehorn the world as it is into our mold of how we believe the world is. This leads to self-fulfilling prophecies, whereby we think someone or something in a particular way, so we act accordingly, thus shaping them into what we thought they were.
For example, if we think someone is angry with us, we can either be overly nervous to the point of tip-toeing on eggshells around them or perhaps get angry with them, but either way will probably help create annoyance in the person, who will then get angry with us, thus “proving” we were right to think they were angry in the first place. We need guidance to help us take a more sustainable approach to life, including our inner life.
I understand how I need to think, but I still feel the same. How can therapy help with this?
Therapy can help us move out of our comfort zone (familiar but not necessary as comfortable as the name suggests), and into the learning zone. We can be encouraged to test out our fears and find them unwarranted. We begin to not only understand our emotions at a logical level but also at an emotional level.
Will therapy help me have more compassion for myself, and is that a good thing?
Self-compassion, as well as compassion towards others, is a key element of mental health. However, as many people would testify, it can be difficult to have compassion for ourselves. We can feel undeserving, maybe feel like it would be an unsavoury indulgence, think we will lose our motivation if we are “too” easy on ourselves, or that we cannot even access the compassion we want to offer ourselves. Through the process of experiencing our therapists’ positive regard towards ourselves, us looking at our beliefs about what the act of being kind to ourselves would both achieve and cost us, as well as learning techniques to develop self-compassion, we can begin to be kinder to ourselves, without losing our motivation, our edge.
So how do I go about getting therapy?
Face-to-face therapy, whereby the therapist and client are in the same consulting room is still popular, and, in some cases, where risk is an issue, the appropriate way to work together. If you are considering this approach, then looking at the registers for counsellors and psychotherapists. In the UK, there’s BACP, UKCP, and the BPS Register of Chartered Psychologists.
Counsellors and psychotherapists often have similar training these days, but historically psychotherapists tended to have had longer, more advanced training (such as a master’s degree), and this is still true for some schools of therapy. Most clinical and counselling psychologists have a doctoral level of training.
Online therapy via video conferencing is becoming increasingly popular, as people begin to realise that it is not just convenient, but also a very effective way of managing our emotional/psychological issues. If you need high-quality therapy, and
- don’t want to be tied down to going to a therapist’s office,
- are too busy to spend time travelling back and forth from sessions,
- prefer to have therapy from the comfort of your own home or office,
- have difficulty accessing a therapist because of your anxiety, location, or disability,
- want not the closest therapist, but the best therapist
then online therapy via video calling has gone a long way to levelling out access to therapy.
Evidence for Doing Therapy through Video Conferencing
Research has proven that this approach to therapy is at least as effective as face-to-face therapy, and in some cases, even more effective.
Research examples include:
- Wagner Birgit, Andrea B. Horn, Maercker Andreas. (2014). Internet-based versus face-to-face cognitive-behavioral intervention for depression: A randomized controlled non-inferiority trial. Journal of Affective Disorders.
- Yuen et al., (2013) Acceptance Based Behavior Therapy for Social Anxiety Disorder through Videoconferencing. Journal of Anxiety Disorders.
Client Confidentiality and Privacy
Client confidentiality and privacy is paramount in therapy, regardless of whether it is accessed through face-to-face or video-calling sessions.
Client confidentiality refers to therapists ensuring that they do not share information about you, apart from when adhering to the following exceptions:
- therapists may discuss your case with their supervisors (because it is mandatory for therapists who belong to regulatory organisations, such as the BPS, UKCP, BACP, etc., to have supervision for the purpose of ensuring therapists adhere to high standards of practice) however, therapists will do this in a way that protects your anonymity
- if you are at risk to yourself or others, and the involvement of the emergency services is required for your own and/or others safety.
When accessing therapy via video calling, it is important to ensure that you are in a private place where you are happy to receive the video-call. Although there are sometimes concerns raised about the possibility of people being able to intercept video calls, in reality this issue is extremely unlikely. Skype, FaceTime, and Zoom use end-to-end encryption. However, if you want extra peace of mind, then use a service that offers therapy video calling through Zoom (a free service that is easy to set up) because it is HIPAA-compliant (which means it should have an extremely high level of cybersecurity).
What are some services out there?
When should I not use therapy via video conferencing?
This way of accessing therapy is not generally appropriate for people who are actively suicidal. If you are a risk to you or yourself, please contact your general practitioner (GP), or may refer you to your local mental health team. In an emergency, please contact the emergency services.
Can I get therapy via text messages?
Nowadays, some therapists offer the option of having therapy via text messaging. This service normally works by clients messaging their problems/concerns, and the therapist offering a certain amount of text responses per day/week. This service can work well for some people who are looking for advice rather than therapy. It tends to be more affordable than traditional services.
Here are some of the English, subscription-based services that offer text messaging as a way that clients can engage with their therapists:
Therapy is expensive and there are a growing number of discounted options out there.
The following UK-based charities also offer free or low-cost support:
