6 Questions About Psychotherapy, Answered

During times of change—whether positive or negative—reaching out to a counselor or therapist can give you the perspective and coping tools you need to keep moving forward.

“Therapy provides a space that’s there just for you,” says UNC Health psychiatrist Nadia Charguia, MD. “It gives you a chance to seek support and process your ideas about what things are meaningful and important to you.”

We talked with her about some of the most common questions people have about psychotherapy.

Isn’t therapy only for people with serious mental illness?

No, Dr. Charguia says. Therapy can benefit anyone wanting a deeper understanding of self or situations, or someone struggling with emotions, relationships or behaviors. Of course, psychiatrists and other mental health professionals treat people with mental disorders, including depression, anxiety, schizophrenia, major depressive disorder, bipolar disorder, post-traumatic stress disorder and obsessive-compulsive disorder.

But you don’t need a diagnosis to benefit from working with a mental health professional. Therapy can help people who are dealing with changes in their lives to discover the root of their fears or angst and learn ways to cope with the changes.

“Unfortunately, there is often a negative stigma that is associated with seeking mental health services,” she says. “As we see more examples of the impact that stress, depression and a changing world have on us as a society, though, more people are starting to see the value of therapy.”

Why not just talk things over with a friend?

Friends, partners and family members can offer valuable support during difficult times, Dr. Charguia says, but people may not open up completely to those with whom they have an ongoing relationship.

“We might not tell them everything that’s bothering us for fear of hurting their feelings or having them judge us,” she says. “The beauty of therapy is that it’s a safe, impartial, unbiased place. You owe nothing to anybody but yourself.”

Additionally, she says, a mental health care professional has been trained to function as a guide to help you understand yourself better and create the life you want.

“They don’t just give you advice,” she says. “A lot of people can give you advice. But therapists are trained to help bring about understanding and change.”

When might people benefit from therapy?

“We often seek therapy when we want something to be different or recognize that something needs to change, but we may not recognize how to bring about that change,” Dr. Charguia says. “We also may think about seeking therapy when we’re struggling with major life changes or anticipated life changes.”

Some examples might be:

  • A death or illness in the family
  • Divorce
  • Children going through a change, such as starting kindergarten, or leaving home for college
  • Overwhelming or new responsibilities at work
  • Job loss

“All the stressors that have added up during the past few years—COVID-19, quarantines, political and racial unrest, war—are enough to cause an unimaginable level of stress that can feel overwhelming to manage,” she says.

Of course, not all stress is caused by catastrophe. Some joyful changes cause stress, too, and therapy can help at these times as well:

  • Marriage
  • New baby
  • Blending families
  • Graduation
  • A new job
  • Retirement

A therapist can help you uncover your own insights into your life’s challenges and help you find ways to cope with your situation. Therapy can also give you tools to help your loved ones, including your children, particularly if they are struggling and not in therapy themselves.

How do you start therapy?

If you have a good relationship with your primary care provider, start there, Dr. Charguia says. “They may be able to help you understand what kind of help would be useful and may even suggest specific therapists they are familiar with.”

If you know someone who has been in therapy, you could ask them for a recommendation or ask how they found their therapist. Search your healthcare system’s database of mental health care providers or use the Psychology Today “find a therapist” tool.

What’s the difference between types of mental health care providers?

“Therapy” is a general term that can be delivered by several types of mental health professionals:

  • A psychiatrist is a medical doctor (MD) who diagnoses mental health conditions, prescribes medications and then monitors the person on medication to keep track of progress and address side effects. Many psychiatrists also provide therapy in their practice.
  • A psychologist usually has a doctoral degree in clinical psychology or a related field (PhD or PsyD). They are trained to evaluate a person’s mental health and provide individual and group therapy.
  • Therapists and counselors usually have a master’s degree and are trained to evaluate a person’s mental health. They have been trained in therapeutic techniques that may vary, depending on the training program. They can help reduce symptoms and help people develop coping skills.
  • Clinical social workers also have a master’s degree. They can evaluate a person’s mental health and use various therapeutic techniques to help them. They are also trained in case management and advocacy services.

“What’s important is that you find someone who is right for you,” she says. “Rapport is important. You should have someone you feel safe with and who has a strong therapeutic background.”

She suggests giving yourself more than one session with a new therapist. You may need three or more sessions to move past any initial discomfort and determine if you feel “therapeutically connected” with your provider. If at that time it does not feel like a good therapeutic fit, you can try with another person.

Why would I try group therapy?

Group therapy, sometimes called “support groups,” brings people together who are dealing with a shared problem—addiction (self or family), divorce, grief, post-traumatic stress disorder and others.

“Group therapy has a significant role in helping people work through shared concerns, needs or experiences,” she says. “There’s a lot of value and validation in being able to recognize you’re not alone in the struggles you are having. And it is a place to share how one copes and works through struggles in order to move forward.”

Family counseling can help couples and families improve relationships and interactions, and address stressful situations that affect the entire family, including drug or alcohol abuse, financial problems and mental illness.

If you need help facing changes or challenges, talk to your primary care provider about finding a therapist. If you don’t have a doctor, find one near you.