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Fundamentals of Therapy #1: Who Goes?

Who should go to therapy?

Before addressing how clients can get the most from their therapy, we should cover some basics: who goes to therapy, how to find a therapist, and the roles/rules/boundaries of therapy. We'll start with who goes to therapy, and why.

According to Psychology Today's own 2004 survey, more than 27% of all adults (an estimated 59 million people) received mental health treatment in the two years prior. Of this group, "47% report a history of medication, but no therapy; more than a third (34%) report a history of both medication and therapy; and 19% report a history of therapy, but no medication." If my math is correct, that means somewhere around 30 million adults were in psychotherapy during that two-year period.

So who goes to therapy? A lot of us. An APA study found that 50% of Americans believe the stigma associated with therapy has decreased, which may be one reason for a rise in numbers. But why do people go?

People come to therapy to get help. The impetus for therapy is as unique and diverse as the individuals who seek it, but typically people come to find assistance they haven't found in other areas of their life. Depending on the issue and type of therapy, this help may come in the form of support, information, guidance, self-knowledge and/or the space to learn and practice new tools. Here is just a sample of the issues that may cause someone to seek therapy.

Mental Disorders: People struggling with depression, anxiety, phobias, addiction, PTSD, ADHD, etc. may seek therapy to treat the problem and/or learn healthy ways to cope. In many cases, disorders are treated medically in conjunction with therapy.

Distress: One way therapists determine the severity of an issue is to look at how much distress it causes the individual. For example, one young woman may be distressed about leaving home for college, while another is delighted. If the level of distress is prohibiting her ability to sleep, eat, study, socialize or enjoy life, therapy may be a healthy option.

Support/Coping: Loss is a common reason for people to seek therapy. Therapy can provide a safe, supportive place for people to talk about grief, adjustment to physical illness, the end of a relationship or job, abuse issues, or any change in life circumstances that cause distress. Therapists help clients learn coping skills to get them through these times.

Communication: Many people come to therapy looking for help with their relationships. Individual, couples or family therapy can address a common source of distress: poor communication and difficulty resolving conflicts. Some therapists are highly skilled at helping people communicate their needs and feelings constructively.

Self-Exploration: Some people come to therapy to gain a deeper understanding of self. They want to know why they do what they do, why they feel what they feel and determine how much control they have over those areas. Sometimes this exploration is used to determine career, relationship, and personal goals.

Again, this is just a sample of the many reasons people seek therapy. The good news is, it seems to work. According to the Psychology Today study: "A large majority (80%) of those with a history of either therapy or medication use report that their treatment was effective."

Next post: Finding a Therapist.

More from Ryan Howes PhD, ABPP
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