Harvard Women’s Health Watch eases the challenge of choosing therapy

Boston , MA —Every year, one in five adults in the United States experiences a mental disorder or emotional problem serious enough to warrant treatment. Nonetheless, navigating the therapy course can be challenging. The August issue of the Harvard Women's Health Watch explores talk therapy options and offers guidance about making the decision to visit a therapist.

Psychotherapy, or talk therapy, addresses troubling symptoms and emotions using primarily psychological techniques. The two most popular forms are psychodynamic and cognitive behavioral therapy.

Psychodynamic therapy asserts that experiences and feelings that you're not consciously aware of can influence your present emotional well-being and ability to function. This type of therapy is useful in helping people to cope with the loss of a relationship, conflicts within relationships, or demands of shifting roles.

Cognitive behavioral therapy (CBT) is less focused on the underpinnings of feelings and instead emphasizes how to change the thoughts and behaviors that are causing the problems while learning productive responses to distressing circumstances. CBT can be used to alter difficult behaviors, such as smoking, procrastination, or phobias and can alleviate conditions such as depression and anxiety.

A good therapist can incorporate a multifaceted approach depending on the needs of the patient. And, as the August issue notes, the most important consideration is the rapport between patient and therapist.

Harvard Women's Health Watch defines the training of various therapy providers:

• Psychiatrists are physicians who complete at least four years of psychiatric residency after medical school. This level of training is often essential in treating serious mental illnesses where medication may be necessary.
• Clinical psychologists have doctoral level training. Psychologists receive extensive training in psychotherapy but may have less experience than a psychiatrist in handling serious mental illnesses.
• Clinical social workers have master's degree level training. While not all specialize in psychotherapy, many receive training in therapy.
• Marriage and family therapists are master's level professionals trained to help with conflicts within marriages and family.