By JasonR86 133 Comments
So I'm therapist, everyone, and am biased in a lot of ways. That said, I do think that I have something to offer to people who wonder what the mental health service field is like, what it is to be a client, how I would like a client to view themselves, and so on. So I thought I might make a short FAQ about what I do. Remember, I'M BIASED, and not every person in my position will agree with what I said. But fuck those guys and gals. Also if you guys want to ask me some questions go ahead and I'll try my best.
What's a mental health diagnosis?
A mental health diagnosis is a label created to describe a list of symptoms which all signify an underlying problem. There are two primary types; Axis I and Axis II diagnoses. An axis I diagnosis is usually a short term problem. Axis II is reserved for more long term, persistent problems (this is where personality disorders go). Every assessment that leads to a diagnosis, whether the diagnosis is Axis I or II, is supposed to be a snapshot in time. This is why they can change and why some people think they have 5-10 disorders. People most likely don't have 5-10 disorders. They've had 5-10 different diagnoses at different times in their lives. Here are all the disorders I can diagnosis. There are also v-codes I can diagnosis which are sort of adjuncts to other diagnoses.
What's a case formulation?
A case formulation is where a therapist's theoretical perspective meets the mental health diagnosis. A theoretical perspective is how a therapist views the development of psychological problems, personality, and, without sounding too whimsical, the world at large. Every theory has things in common. But each has their own take on things as well. There's all sorts of lists out there on the different theories but no complete one that I can link to. Just google 'psychological theoretical perspectives' and read a few of the articles if you're interested. So a case formulation is when the diagnosis and symptoms associated with that diagnosis is described and treated from the theoretical perspective of the therapist (hence, symptoms meet theory to create a case formulation).
Why's this shit so dry?
Because this shit's science son!
What does therapy look like?
This all depends on the case formulation and the therapist. Most therapist will say that the relationship between the client and therapist is key. Some therapist will give homework to be done between sessions (not me). Some will say that the therapy sessions are a safe setting to prepare for the rest of the client's life both in how to interact with others, through the therapist, and through the client making decisions (that's more like it!). For kids it can be based on play therapy (basically a child's play represents innermost emotions, their perspectives on the past, and how they interact with others). It all depends.
Who needs therapy?
Whoever wants to have it.
Who shouldn't be in therapy?
People who don't want to be there, especially if they are forced, and people who simply want to be fixed without putting in the effort to work alongside the therapist to reach a common goal.
What's the goal of therapy?
Is it shitty if I say 'it depends' again? Because it does. It depends on what the client wants. But rest assured, there needs be an ending to therapy (this is a contentious thing among therapist though depending on the diagnosis). I would add that I the goal of therapy is that the client would no longer require therapy anymore. That they would be so well off and self-assured that therapy would no longer be a necessity.
What do you think about medication for psychological treatment?
I think my view is way less important then the client's. If they client wants medication then I need to find a way to meet that request. That said, I worry that medication will become a crutch. That people won't reach that goal I mentioned above (being fully self-reliant) and instead will think that they are only as healthy as they have medications. But I do know that there are people who require medication and will need to take it all their life. I just don't think there's as many people out there as there are currently. But I'm biased so there's that.
Are therapist as perfect as they seem in session?
Not even remotely.
Is it ok to show strong emotion in session?
It's preferred. Most of the time (there are some exceptions).
What do you do with client's who lie?
Client's don't have to necessarily tell me the truth. I'm not a cop. And, at times, the way speech is delivered is more important than the content. Also, it's really easy to tell when people lie. Trust me.
Can I ask you more questions in the comments below?
Yep. Go ahead. Ask away.
Can I tell you that you're full of shit and that therapy is bullshit and you suck and nener nener?
You can do that too. If you want. You jerk.