Therapy
What is Therapy and How Does it Work?
In the simplest terms, therapy offers a safe environment for you to discuss anything that might be bothering you or keeping you from living a full life. Therapists listen to the goals that you want to achieve through therapy and then create a plan for helping you achieve those goals. They don’t give you answers or solve your problems, but rather aim to give you the skills, knowledge, and confidence to achieve your goals on your own. Therapy can be short or long term, depending on your needs, goals, and financial circumstances. It should always be safe and confidential.
Who Can Benefit From Therapy?
Therapy is for everyone. You don’t need to have experienced a trauma or be in crisis to benefit from therapy. You also don’t need to have a mental health diagnosis. All you need is a desire to both get help navigating challenging circumstances and feelings and to seek support with somebody who has the skills and knowledge to help you
Why Might Survivors of Sexual Violence, in Particular, Benefit from Therapy?
Survivors have been through trauma, and the symptoms of trauma can be disruptive and painful for survivors to live with. Therapy can be a powerful tool for survivors in healing from trauma and PTSD, regaining a sense of control over their lives and bodies, and moving towards health and wholeness.
How Can I Find the Right Therapist? What Should I Look For?
Finding the right therapist for you is important. Therapists are people, just like you, and you may prefer certain personalities, genders, or styles of interaction. Some therapists may be direct and guide sessions more, while others may be more low key and let you take the lead. The bottom line is that you need to feel comfortable with your therapist and to have enough trust to feel able to talk about anything. The success of your therapeutic experience will depend on these feelings of comfort and trust. A good therapist will not be upset if you express that it isn’t a good fit; in fact, therapists themselves want you to feel a connection, as they understand how important that is to your healing journey. That said, there are times when your need for therapy may feel more pressing, and in those cases, it may be more important for you to start working with a “good enough” therapist rather than waiting for a perfect fit.
One very helpful resource for finding a therapist is the Psychology Today Providers List. It includes location, type of provider, and insurance information.
What is Trauma Informed Therapy?
Some types of therapy address the particular needs of trauma survivors. Trauma is complex, and therapy that does not take that into account may fail to offer survivors the help that they truly need. Counselors and therapists who are knowledgeable about trauma have a full understanding of how social, biological, and environmental factors play a role in the lives of their clients following trauma. It is a good idea for survivors of sexual violence to ask a potential therapist directly if they are able to provide trauma informed therapy.
What are the different types of therapist/counselor? What do their titles mean?
Psychological Associates have a Masters degree. They have less education than some other professionals, but are still qualified through provincial colleges.
Psychologists have a Doctoral degree (Ph.D or Psy.D). They have studied psychology specifically, typically done research in their area of choice, and are able to give testing to clients and individuals. Typically psychologists are unable to prescribe medication, though some are also medically trained and thus certified to do so.
Psychotherapists are mental health professionals who specialize in talk therapy. Typically, they deal with less severe issues.
A clinical social worker can provide therapy and mental health treatment. They focus on helping individuals cope with their daily lives and the issues within them. Like other social workers, they can connect clients to services and support that might help them, but also are licensed to provide therapy and mental health treatment.
These professionals provide therapy in specific areas (family therapy, sex therapy etc). Clients typically seek them out to advise in big life decisions or help solve problems.
A pastoral counselor provides guidance in life and difficult circumstances through a spiritual lense.
Psychiatrists are medical doctors who went to medical school and specialize in psychiatry. They are able to prescribe medications to manage mental illness, but don’t generally do talk therapy or therapy in general. A psychiatrist may be a member of a mental health team of providers and work in cooperation with a therapist or counselor.
A Psychiatric Nurse Practitioner is an advanced practice Registered Nurse who specializes in the care of mental illness. Psychiatric NP’s can diagnose, plan treatment and prescribe medication.
What are some styles of therapy that I might encounter?
CBT is a very commonly used form of behavioral therapy that can be used to help with a broad range of emotional and mental health challenges. It aims to identify and reshape thoughts and behaviors, improve emotion regulation, and help develop healthier coping habits and strategies.
CBT generally follows these steps:
- Identify concerns and conditions in your life that are troubling you.
- Realize and understand the negative thoughts, emotions or beliefs that you may have about these issues
- Identify the negative or inaccurate thought patterns
- Reshape your negative thinking into more helpful thinking
DBT is a therapy originally designed for the treatment of BPD (Borderline Personality Disorder) but is also used in treating PTSD as well as mood disorders, suicidal ideation, and improving behaviours leading to self-harm and/or substance use/abuse. It is a skills-based therapy that includes both individual and group work. Clients learn to accept that their experiences and behaviours are valid but also that they have to make positive changes in their lives to work towards managing their emotions. They learn to tolerate distress and to be more effective in their relationships.
Crisis counseling is brief counseling intended to minimize the immediate stress of your experience. The counselor will assess, make a plan and then treat you. Unlike in therapy, these sessions will be very specific to an event or experience. You might seek out crisis counseling to help regain equilibrium following an episode of symptoms that you feel unable to manage or when you do not have a therapy session planned soon enough to manage your symptoms. Crisis counseling may need to be followed by a longer term therapeutic plan.
EMDR is typically used to treat PTSD. PTSD results from traumatic experiences that cause distress in the present because they are inadequately processed as memory. This memory contains all the physical and emotional sensations, as well as thoughts about the experience at the time of the event. When the memory is triggered in the present, all these event-sensitive feelings of the memory come rushing to the present
EMDR is used to change how these memories are stored in the brain by following an 8 step structure. The basic process is to ask an individual to recall traumatic images while creating sensory inputs like side to side eye movements or tapping. This therapy helps the brain to reprocess the traumatic memory and therefore to facilitate emotional and mental healing from trauma.
Some characteristics of EMDR include:
- History taking
- Preparing the client to handle emotional distress
- Identifying target memories and images, as well as related emotions and body sensations
- Focusing on vivid images while engaging in bilateral stimulation and noticing the emotions or sensations that arise
- Thinking of a positive belief
- Evaluating progress
What are Some Reasons People Don’t Seek out Therapy?
It’s too expensive
Therapy can be expensive. While there are certainly private therapists who are not part of any insurance or provincial health care network, other providers may be at least partially covered. Many clinics and therapists offer sliding scales and are willing to figure out payment options in some situations. It can be hard to keep looking for affordable care when you are living with the aftereffects of trauma. This is a place where loved ones can help with doing the research to help find affordable providers. The important thing is not to give up.
Therapy is stigmatized or makes us feel vulnerable
It is natural to feel vulnerable when talking to someone else about our problems. We may worry about how others perceive us if they discover that we are seeking therapy, and may also internalize the stigma. We may ask ourselves why we can’t just get over it. It’s important to remember that trauma is, unfortunately, an experience shared by millions of people around the globe, and seeking psychological help is far more common than you might think. Seeing a therapist or counselor doesn’t mean that something is wrong with us or that we are incapable of solving our own issues. In fact, seeking out help is an important step in taking care of ourselves.