I have been thinking about the question, “What is therapy?”. This is not an easy question to answer, but it is my goal in this essay. Perhaps images of chaises longues and pleasant coloured rooms are already firmly in people’s minds from popular culture and I have no idea how to break past that.

 It’s best to think of therapy more pragmatically, so I am going to answer the question “What is therapy?” in three parts. I am going to start by defining therapy in a straightforward fashion. Then I am going to advise you on how to find out about various kinds of therapy so that you can make sense of the recommendations that a doctor or a counsellor might make. Finally, I am going to talk about free or low cost therapies that can be accessed online.

Therapy is defined as an interaction that helps a person manage difficult emotions, thoughts, and behaviours. Some therapeutic interactions can be as simple as providing education about symptoms or listening to a distressed person compassionately and without judgment. For example, it’s not uncommon when a young person first comes to see me for help that all they want to do is vent. They want to talk about their worries about their marks at school, or about a girl they like, or about how strict their mother is. Just listening, saying little and making no pronouncements or judgments might be all some people need to feel less distressed. At other times, reminding a youth that the reason their self esteem is so low is that their depression has come back can be therapeutic. Both are examples of supportive psychotherapy, but they are elements of any therapy. Reminding a person that feelings they are experiencing is a symptom of a psychiatric illness is psychoeducation, another aspect of therapy. These gentle actions may be the only intervention that some people with mental health problems can tolerate. These interventions can be helpful for life or situational crises, but more serious mental health conditions may require more elaborate therapies.

The list of more elaborate therapies can be overwhelming. From Dialectical Behaviour Therapy to Interpersonal Therapy to Family Therapy, it’s difficult to keep track of the various treatment, never mind trying to make an informed choice about the therapy when it’s recommended. If you want to know something about a variety of different therapies, this article is a good place to start. It’s succinct but clear. My one recommendation is that, before agreeing to see a particular therapist for a particular therapy, make sure that they have been formally trained in that treatment.

Finally, I wanted to mention the online therapies that are now available all over the world, and not just because they are on the world wide web. Most jurisdictions and health insurance plans now give patients access to some form of online cognitive behaviour therapy. It’s effective and inexpensive for jurisdictions to provide and convenient and usually free of cost for those using the treatment. If you’re American, this New York Times article compares three online therapy programs. Similar programs are offered by provincial health insurance plans in Canada. This website explains the programs available in the province where I live. Some of these programs were face-to-face but had to move to online treatments during the pandemic.

If you are suffering with a psychiatric illness, it can be difficult to keep track of instructions and even of important facts. If you are finding all I have said above confusing, the most important thing to remember is this: therapy is hard work, but do the work. Research has shown that participating in therapy will have more effect on your mental health than any other intervention – including medication in many cases.

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