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The Decision to Begin Therapy

Reviewed by Psychology Today Staff

Most people—even those with a strong support system and no diagnosable mental illness—can benefit from therapy at some point in their lives. But the signs that therapy might be helpful aren’t always obvious. If you’re experiencing prolonged periods of anger, sadness, or anxiety; are struggling with relationship conflicts or communication problems; are coping with a specific painful event, like the death of a loved one, a breakup, or the loss of a job; or are grappling with questions of identity or self-esteem, it may be time to try either short- or long-term therapy.

How do I know whether therapy could help me?
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If you feel depressed, overwhelmed by daily life, or unable to connect with the people around you, it’s very likely that a competent therapist will be able to help you. More subtle signs that you could benefit from therapy include the realization that you’ve been overreacting to small setbacks, or a feeling of being “stuck” or mentally fatigued.

Must I have a specific problem to begin therapy? Shutterstock

It’s common for people to seek therapy with a specific issue in mind that they want to address; they may then terminate therapy when they feel they’ve done so. Others, however, enter therapy without clear goals and just a vague sense that something is “off.” Both are valid reasons to seek help.

How common is it to see a therapist?
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Attending therapy—whether individual, group, or couples—is more common than many people think. The CDC found that overall, approximately 40 percent of insured adults between the ages of 18 and 64 had seen a therapist during 2012-2013. According to the NIMH, more than 20 million adults with a mental illness in the U.S. received mental health services of some kind in 2017; a 2019 analysis concluded that 3 million additional people were being treated for depression in 2015 than in 1998.

Should I go to couples therapy with my partner or go solo?
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Couples therapy works best when both partners attend and commit to improving their relationship together. However, it’s common for therapists to see individual partners alone, in order to allow each to discuss issues that may be difficult to bridge in the partner’s presence. In cases where one partner refuses to attend couples therapy, individual sessions may still help the other partner identify their own behaviors and thought patterns that could be contributing to relationship conflicts.

What if I want to seek couples counseling but my partner does not, or vice versa?
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Many who wish to seek couples therapy find that their partner is against the idea. If the reluctant partner is unsure it will help or is worried about feeling attacked, it may be helpful for the couple to have an honest conversation about specific concerns and address common myths about couples therapy. Setting up a low-pressure phone consultation or trial session may also help the hesitant partner become comfortable with the process. In cases of extreme refusal, individual therapy may still be helpful to the other partner and to the relationship.

How do I determine whether my child needs therapy?
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Children experience tough emotions and challenging transitions, just as adults do. But it’s not always easy for parents to tell whether such difficulties reflect normal developmental challenges or more serious concerns. If your child seems “down” or not like themselves for more than two weeks, is struggling to keep up academically, is behaving violently at school or home, or is having persistent difficulties making friends, a therapist may be able to help. If your child mentions suicide or hurting themselves or others, get help right away. If you’re unsure, raise your concerns with your pediatrician.

What are the benefits of group therapy over individual therapy?
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Group therapy—in which one or more therapists work with several people at once—is typically less expensive than individual therapy. It allows patients to receive social support from other group members and see that they’re not alone in their struggles; this can be a particularly beneficial aspect of recovery when dealing with issues such as substance abuse or grief. Group therapy also encourages members to improve communication skills and learn to respect others’ experiences and perspectives, which may be useful for those who struggle in social situations.

What are the benefits of individual therapy over group therapy?
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In general, many patients find it significantly easier to bridge embarrassing or painful subjects with just one person rather than several. Individual therapy also provides more one-on-one attention, which means that patients are more likely to receive treatment that is customized to their specific needs. Confidentiality is also guaranteed in individual therapy (except in cases in which a client poses imminent danger to themselves or others); while group members are asked to keep information confidential, it’s not a guarantee that they will do so.

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