Saturday, July 26, 2014


One of the many reasons I love my work is that I have the honor and pleasure of seeing most of my clients get better. Do I have special skills that other mental health clinicians do not? No, my work simply mirrors the statistics on the efficacy of mental health treatment. Research shows that therapy is effective at least 80 percent of the time.

Since therapy usually helps, and no one wants to suffer, why are we our own worst enemies when it comes to getting help? Our tough inner critic tells us "you should be able to snap yourself out of this", or "you don't have it so bad, think about what Mary next door has been through", or "you need to help the kids, you're not as important." My wish for folks suffering from mental health challenges or family struggles is that they view mental health treatment as a tool that can help them move towards their future, not as a failure and a last resort.

Recently I have noticed an increase in the length of time clients are waiting to get themselves or their kids to treatment. My colleagues have shared the same observation with me. There are good reasons: financial challenges, increasingly spartan or absent insurance coverage, busy family schedules, and the still present stigma in our culture towards mental health treatment. The problem with delayed treatment is that it increases the likelihood of the development of a second mental health challenge, a substance abuse problem, and physical illness.

Not only does the client get worse if not getting help, but family members and co-workers are also sorely tested by caring for or working with a depressed, highly anxious, bi-polar or substance-involved individual. Many times the people that end up in my office have anxiety or depression that has been triggered by living or working with someone who has not sought help for their own challenges. Delays in getting help often leads to multiple family members in crisis. Jobs are lost, marriages fail, and academic careers stall.

The decision to see a therapist does not bind you to a never-ending series of weekly appointments. One of the important roles a trained therapist plays for you or your child is "assessment".  We evaluate a client's functioning in their environment: home, school, work, relationships, and community. We work with clients to collect data by interview, observation, surveys and test (psychologists) instruments. Thanks to the assessment process, clients can decide whether to enter the "therapy or treatment" phase of mental health treatment after gaining an understanding of their diagnosis and treatment options. After the assessment, I may recommend that a client meet with a psychiatrist, nutritionist, career counselor or life coach. Sometimes I work with parents to help them sort through parenting challenges without ever seeing the child.

The bottom line is that there may be much to gain by investing in a few visits. Unfortunately, waiting until you or your child are too sad to get out of bed in the morning, or your daily glass of wine has turned into a daily bottle, will likely cost more time and more money, and more importantly, needless suffering.

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