Even with the best information or resources, we may still have some doubt about signing up for psychological therapy – ‘Does therapy really work (for me)?’. In enquiries and initial consultations, I help individuals clarify about their situations, expectations for change, and if therapy will act as a useful support. I strive to ensure that people can make their own decisions with clarity and more confidence. At the same time, I recognize that many also seek for professional opinions to shed light on their puzzlement and uncertainties.
Working as a professional, I often emphasize that promotion of therapy is, and should not be ‘selling a product’. The decision of whether someone needs therapy is made under my psychological formulation of a person’s conditions and needs. Here I share a few of my considering points as I make recommendations whether someone should proceed to receiving therapy or not.
When do you need therapy?
Point 1: How concerning the difficulty/problem is (severity level)
There are different issues people want help with – ranging from depression and anxiety, relationships, dealing with physical health problems, to personality difficulties/disorder, bereavement, trauma, abuse, etc.
A major concern I ask about is how much the problem has impacted on the person’s life. If the person’s daily functioning has been affected and also this has lasted for a few weeks (est. three weeks), such as inability to maintain good sleep, uncontrollable crying/anger outbursts, panic attack, or that they already acquire medication to manage their conditions, he/she would benefit from therapy. A combined medication and therapy approach is often the best way for one to regain control in functioning.
The function of therapy is not just to help the person alleviate symptoms, but also that the person would benefit from having emotional support when he/she goes through such a difficult time – no one should go through such tremendous challenge alone.
Point 2: How Immediate you Need Support with (Immediacy of needs)
Another factor I consider is how soon the person needs support. For those who suffer from a higher level of mental distress, a change to their current state is needed (as soon as possible). Examples to look out for are risk of harm to the self or the others; impact on their daily functioning; constant sense of out of control, etc. Therapy is recommend to help stabilize the person’s mental health.
Although therapy does not help solve the problem overnight, and it does take time before the effect of therapy starts to show; however nothing ever changes if no one takes action.
Point 3: Your own capacity
This refers to practicalities which affect people’s ability to invest in attending therapy. This includes financial capacity, time availability (do people have time for an hour per week/biweekly work), etc.
Furthermore, I also explore with people their mental capatiy – how much are they motivated to change? Therapy works for those who have the urgency or ‘craving’ for change and self-development. I am often very open to individuals who are pondering about receiving therapy to ‘think it through’, rather than impulsively deciding on setting the first session up and regret it later.
Point 4: How likely can you get support
Can you have someone to support you, or even listen to your problem uninterrupted?
When stuck with the own problem, our lives become a mundane routine. It is not like we do not want to look for a change, but we never feel we could. Some clients reveal they cannot find anyone to talk to. They have to put on a different face so not to cause worry or ‘unnecessary talk about them’.
Furthermore, I also discuss about whether people have his/her support network and avilable coping mechanism in place, such as social circle, family, welfare, self-help, etc. This indicates how much they may need therapy.
After going through these considering points, and ensuring that the individual decides to receive therapy, I then set up an initial session in which the person will be able to elaborate on his/her presenting issues. From there I will be able to further assess the person’s conditions (e.g. specificity of the problem) and treatment plans.