Mental health therapy, or just Therapy, is the process of developing effective ways to solve a problem or make a change in life. This change is typically the result of conversations between a therapist and a client. It may also involve other activities like reading, writing, worksheets, art, mindfulness, play, and more!

Therapy often looks different for each person, couple, or family. In general, therapy involves the therapist and client(s) engaging in conversations to discuss life, personal history related to your goals, and progressions or insights on your way to meeting your goals.

People go to therapy for different reasons. In general, therapists can provide support, help teach coping and problem-solving skills, provide education about emotional processes, and more. Therapists that have specialized trainings in certain areas may be able to offer unique services like play therapy, substance use counseling, sex therapy, and more.

Counselor is a broad term for a person who acts as an advisor to another person. Anyone can call themselves counselor. Historically, psychotherapy was developed as a type of medical intervention for problems related to the psyche. In order to maintain its legitimacy and promote this new approach in a scientific method, mental health was treated like many medical illness. This means that when a problem was identified, a diagnosis was made, and a treatment method was prescribed. This began the field of psychology. As the profession grew, medical doctors who specialized in psychological issues became known as psychiatrists.

Psychiatrists are able to prescribe and manage medications due to their training as medical doctors.

Psychologists on the other hand, found that research indicated that many issues could also be resolved by talking about the problem and imposing certain emotional or behavioral interventions to correct these problems. Psychologists are now often associated with research, specifically the study of the brain and mental processes, and with clinical assessments for mental health diagnoses.

Therapists became more separated due to the clinical focus of their work. Many therapists work from a more humanistic approach rather than the medical approach that psychology was founded on. This means that therapists often put their client before the client's presenting issues, treating the person rather than focusing on the problem. Over time, some therapists began to view people within the many contexts of their life. Understanding people as parts of a larger system gave rise to systemic therapy practices. The therapists who began working from this 'systems' perspective first focused on family systems and became known as Marriage and Family Therapists.

In order to practice mental health therapy as a psychologist, counselor, or marriage and family therapist, a person must receive a Master's degree and obtain licensure from a state accreditation board. All professionally trained clinicians should have an active license displayed to let you, as a client, know that you are working with a licensed professional in good standing with their accreditation board.

Most typical therapy sessions last for 50-60 minutes, although in some cases the duration may be shortened or extended. This time is typically chosen because of the way many insurance companies pay for therapy sessions. It is typically easier to negotiate the length of session when a person pays out-of-pocket for services. Session frequency can also vary, occurring weekly, every two weeks, monthly, or based on client needs.

TLDR: Therapy is confidential and, with very few exceptions, no one is allowed to access information about your healthcare.

Therapy is meant to be a confidential and safe experience for clients. All clients have a right to privacy and confidentiality. Clients may be asked to allow the therapist to share information with specific people or entities to assist in treatment. In this case, the client will be asked to sign a Release of Information (ROI) agreement specifying what information may be shared, how often, with whom, and how long this sharing of information may continue. Some therapists participate in clinical supervision which can allow the therapist to process client cases with more experienced therapists. When this happens, the therapist's clinical supervisor and any other therapist participating in that supervision are bound by the same rules of confidentiality that your therapist must follow.

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Minors participating in therapy will be given as much confidentiality as is appropriate, however, an adult guardian does have the right to request and receive all mental health information. Guardians are often encouraged not to request these records without cause in order to afford the same confidentiality and safety within therapy that an adult would experience. Exceptions for minors would include disclosure of health and/or safety issues. In these cases, minors are often first encouraged to disclose these things to their guardians themselves, with the support of the therapist.

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As mandatory reporters, there are limits to confidentiality that are in place to protect clients and others. If a therapist suspects that a child or dependent adult is in a situation where they are being abused, the therapist is required to report this to the proper authorities. Similarly, if a therapist suspects that a person is in danger of imminent physical harm, whether harm to self or harm to others, the therapist has a duty to report this to appropriate intervention authorities and/or warn others who may be in danger.

In the event that a person's mental health record is of interest in legal proceedings, a client may request disclosure of their information to appropriate legal professionals. With out the client's expressed consent for the release of records, those records must not be shared. However, there is an exception in the case of a court order or subpoena for records signed by a judge. In this case, the therapist is compelled to release the requested information. Similarly, if a therapist is subpoenaed to provide testimony, they must comply and answer questions honestly, but only to the extent that they are qualified to speak about.

Telehealth, or teletherapy, is a term that refers to a therapy session that happens remotely with the assistance of technology, often conducted via a video call. This method of therapy service has been quickly popularized due to the COVID-19 pandemic that made in-office therapy therapy sessions more risky.

Clients interested in telehealth services should:

1. Confirm that their chosen therapy clinic offers these services

2. Have a device that allows them to participate, such as a computer, tablet, or smartphone that can connect to the internet

3. Have a reliable internet connection

4. Meet from a confidential space that they can be in during the session (someplace they will not be overheard or interrupted)

Common devices for participating in video calls for telehealth include internet capable desktop computers, laptops, tablets, and smart phones that have webcams or front facing cameras. Clients may be asked to download an app or other software to facilitate the video call and the therapist will often provide a web link to a virtual meeting room that is prepared for the session. During the time of the telehealth session, the therapist and the client will both open the virtual meeting room to conduct the session.

Many clients find that therapy is most helpful when they have clearly defined goals and the motivation to take the steps to meet those goals. For some people these goals are more measurable or tangible like reducing the frequency, duration, or severity of particular behaviors. For other clients, goals might be harder to measure, such as developing more self-awareness, better communication skills, or more confidence. Clients who are prepared to work on their goals outside of therapy and treat therapy as a tool to guide the process of change rather than a one-stop solution often see more satisfactory and longer lasting results.

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Another way to get the most out of therapy is to strive to have open and honest communication with your therapist. Many people grow up being told that we shouldn't share our problems with others. Clients who can overcome this barrier to vulnerability and share their thoughts, feelings, and emotions honestly with their therapist will often have a better chance of achieving their goals. An important aspect of communication with the therapist is to feel comfortable telling the therapist if they feel that the model or approach being used is not working for them. Most therapists have a preferred method that they work from, but are trained in others that may be more effective for the client.

The COVID-19 pandemic changed a lot of things. While many aspects of therapy, such as the purpose and processes of therapy remained largely unchanged, how therapy is conducted and the content of sessions have evolved in some ways.

Many therapists, along with the rest of the world, learned about the provision of telehealth services in a very short time. Suddenly, many people who had limited access to therapists in their geographic area found that they could see someone who might better fit their needs from across the state! While the circumstances around why this sudden accessibility arose were catastrophic, the impact on the profession has led to many therapists continuing to offer telehealth services as an alternative to in-person sessions. Some drawbacks to telehealth do include that some people do not have confidential spaces to meet from, do not have reliable internet, or find it difficult to allow themselves to release inhibitions with a therapist while sitting in their own home.