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Home Articles The therapist and the client: demystifying psychotherapy

The therapist and the client: demystifying psychotherapy

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Written by Franco Espeleta Santos, M.A., MFTI (Intern Reg. #IMF 61114)   

The psychotherapist and the client: demistifying therapy
Related Issues in Mental Health:
Problems can come from all segments of our lives. The stress for many can become so debilitating that the mind eventually pays the price.

Mental illness is a pretty lonely place to be.  The demons that reside and runs wild within the sufferer's mind gives no rest especially for those afflicted with more serious forms of mental illness, e.g., panic disorder, schizophrenia, bipolar disorder, major depressive disorder, etc.

First things first:  what is mental illness?  "Mental illness" or being "mentally ill" is an unfortunate labeling of an otherwise containable affliction.  The mere mention of "mental illness" brings to mind horror films of people in hospitals purposelessly drifting, caught in their own dream-state realities while unconscious or oblivious to their surroundings.  Some are seen in movies muttering incomprehensible words, others shackled, while others laying naked on cement floors.  As a result of this Hollywood-induced imagery, a stigma against mental illness has developed and continue to pervade social consciousness.

Today we know that a small part of what we call mental illness is considered "serious mental illness" -- approximately 6% to 8% of the population -- and treatment for these types of mental illness is not as horrific as those portrayed in films.  Because of the number and effectiveness of today's antipsychotic medication, many of those suffering from serious mental illness are able to go back to the community and hold meaningful roles, e.g., job, school, marriage.  The majority of what falls under the category of "mental illness," however, suffer from difficulties in everyday living or interpersonal relationship.  Of these, the different forms of depression, parent-child conflict, difficulty controlling anger, conflict in interspousal relationships, anxiety, some forms of posttraumatic stress disorder come to mind.

Psychotherapy is aimed at easing the client's pain and anguish.  In its simplest form, psychotherapy is a one-on-one relationship between the psychotherapist and the client wherein both parties initially discuss the client's history and history of the client's presenting problem.  Thereafter, the psychotherapist and client engage in identifying events that trigger the negative feelings and resulting behavior.  As the therapy progresses, the psychotherapist and the client identify alternative meanings to previously perceived negative events and formulate positive behavior to deal with the client's stressors.

The foundation of therapy's success is three layered with each layer not more important than the other.  They are:

  • The establishment of trust in the client-psychotherapist relationship.  The psychotherapist is expected to provide an environment where the client can feel safe;
  • The client's willingness to participate in therapy:  with trust established, the client can only progress to the extent that the client is willing to explore deep hidden, oftentimes misunderstood, thoughts; and
  • Follow through by the client with agreed upon interventions outside of sessions.

The majority of what falls under the category of "mental illness" can be viewed as difficulties in everyday living or interpersonal relationship.  Of these, the different forms of depression, parent-child conflict, difficulty controlling anger, conflict in interspousal relationships, anxiety, some forms of posttraumatic stress disorder come to mind.
While the above may seem overly simplistic, the actual practice can be complicated.  Many clients come with preconceived notion of therapy and differing levels of willingness to trust.  Many have  well ingrained defense mechanisms that prior to therapy have served to keep "others" out and protect the client's sense of well being.  Given these barriers, at times, the first and second levels as stated above can take weeks or, as is mostly the case, even months to establish.  This is especially true when the client has been forced to therapy by family members, e.g., teens and adolescents, the spouse who feel nothing is wrong in the marriage, or the seriously mentally ill who feels persecuted.  Additionally, clients also come with well ingrained set of behavior or habit that may hamper or hinder the client from following through with agreed upon interventions.

Additional Interventions

Depending upon the severity of the client's symptoms, the psychotherapist may refer a client to a psychiatrist for antipsychotic medication as part of the treatment plan.  In that case, the treatment becomes a partnership amongst the client, the psychotherapist, and the psychiatrist to ensure that the client receive the most effective treatment.  The psychotherapist and client oftentimes explore other available community resources including continuing education and social activities to help the client develop social skills and enhance the client's ability to be employed and feel engaged and productive. 

Depending upon the presenting problem and number of family members involved, psychotherapy may take the form of individual sessions, family counseling, or group therapy.

Conclusion

The negative perception about mental illness is unfounded.  The majority of even the most serious mental illness can be controlled through medication and the sufferer able to go back to the community to lead a productive, normal life. The majority of people who suffer from mental illness suffer as a result of difficulties in everyday living or interpersonal relationship.  In both of these cases, psychotherapy can help alleviate the sufferer's pain and mental anguish.  However, the first step is to consult with a psychotherapist near you.  ClinicalPsychotherapists.com has a number of psychotherapists to choose from that are located not too far from you.  You can browse the Therapist Directory for more information.

 




franco_santos_maFranco E. Santos, M.A. is a Marriage and Family Therapist Intern (Reg. #IMF 61114).  Franco E. Santos, M.A. practices in Tarzana, California under the supervision of Jo Anne Kaplan, Ph.D.  Franco provides individual, couples, family and group psychotherapy.  For more information, Franco E. Santos can be reached by e-mail found on his website or by telephone at 818-748-5654.