Note: Responses to the following questions are my own opinion and should not be construed as representative of all mental health professionals.

1.  What's the difference between a psychiatrist and a psychologist?

A psychiatrist has an MD degree (Doctor of Medicine) or DO (Doctor of Osteopathy) and has chosen to specialize in the branch of medicine that focuses on mental health issues. A psychiatrist treats patients by talking with them as well as by prescribing medication (if needed). Psychologists have one of these degrees: PhD (Doctor of Philosophy), PsyD (Doctor of Psychology), or EdD (Doctor of Education). A psychologist treats patients by talking with them but does not prescribe medication. (If medication is needed, a psychologist will refer the patient to an MD such as a psychiatrist, a family physician, or another type of MD.)

2.  What's the difference between the terms "counseling, " "therapy" and "psychotherapy"?

In one sense, there are no differences since they all imply that you talk to a mental health professional to help solve various problems in your life. In another sense, there is a significant difference. I view the term counseling to mean that a short-term and very focused approach is taken toward solving the client's problems. I view the term psychotherapy to mean that a long-term and more in-depth approach is taken. (The term therapy is simply an abbreviated version of the term psychotherapy.)

3.  What's the difference between a counselor, therapist, psychotherapist, psychologist, psychiatrist, social worker, marriage and family therapist, etc.?

At a basic level, there are no differences in that all of these mental health professionals talk to clients to help them solve their problems. At another level, there are significant differences in education and training that can impact the type of help you receive. For instance, typically the terms therapist, psychotherapist, psychologist and psychiatrist denote practitioners with a doctoral level of training, while the other terms denote practitioners with a master's level of training. But I believe that what determines how much a client resolves their problems while in treatment lies more within the client than within the therapist (such as the desire to get help and the determination to persevere until the goals of psychotherapy are met).

4.  How can simply talking about a problem fix it?

The way this commonly asked question is worded tells us a lot about the culture we live in today. We are action-oriented and usually want to know several action steps that we can take in order to solve our problems. The idea of patiently thinking or talking about a given problem seems almost ridiculous and certainly a waste of time. But truly meaningful, significant change has to begin from within and changing from within requires a shift in perspective (a paradigm shift). This in turn usually happens only after contemplating an issue for awhile and after talking to caring others and feeling the strength of their support.

5.  Will my psychologist think I'm weird, crazy or sick?

In a word, no. In fact, I think that anyone who enters psychotherapy is courageous and to be respected because they are doing something about their problems by facing and confronting them.

6.  How long will I be in treatment?

In general, a circumscribed issue with a short history will probably be dealt with fairly quickly, for example in 10 to 20 sessions. However, a non-specific issue with a long history like, "I've never really been a happy person," will probably need a much longer time period to be dealt with, say six months to several years.

7.  Will I be sent off to a mental hospital against my will?

No, this does not happen to most people. There are very few instances that would dictate hospitalization, namely, only when safety issues are a concern. Out of the general population, only a very small percentage ever need to be hospitalized for psychological reasons and even fewer are taken against their will. (Again, these few have to threaten harm to themselves or someone else.)

8.  Will I fall apart if I start talking about upsetting thoughts and feelings?

For most people, the answer is no, at least not in terms of a "nervous breakdown" or crying uncontrollably. It is certainly possible that you may cry or feel anxious or upset. But many people feel relief after letting their feelings out during a session.

9.  Am I a failure if I go to a psychologist (or am I a failure as a parent if I take my child)?

No, I do not believe this to be true. However, the answer depends upon who you listen to. Unfortunately, many in our society still view a visit to a psychologist as a sign of some inherent weakness or deficiency in the person. The good news is that many others are seeing this view as outdated and even foolish. I suggest that consulting a psychologist be viewed the same as when one visits another professional, for example, a physician. While on the one hand we could say someone has a physical weakness if they get the flu and have to visit their physician, on the other hand we could say that person is wise to seek the help of a trained professional. I believe it is the same for an emotional or behavioral problem, that is, it is wise (not weak) to seek professional help.

10.  Can't I just read a book, attend a parenting class, etc. and get the help I need?

You certainly can try that, but you may have already tried several of those methods. From my experience, most of my clients have already tried several avenues to deal with their problem by the time they come in for psychotherapy. In fact, the problem I hear over and over is that the self-help book, seminar, parenting class, etc. that was utilized was not specific enough to the client's particular situation. In psychotherapy, problems and the application of solutions to those problems can be discussed in great detail.

11.  Can't I just put my problems behind me, move on and hope for the best next time?

You can certainly try that but it often doesn't work if we are honest with ourselves. And in fact, the more we deal with life in that manner the more difficult it usually becomes to move on after each successive disappointment, frustration, or conflict. I think this is because each issue or situation that isn't dealt with appropriately accumulates with other prior unresolved issues. Then when too many issues accumulate, the overflow comes out in the form of symptoms like stress, anxiety, depression, irritability, lack of focus, stomach upset, headaches, muscle tightness, and the like. It is akin to a container that becomes too full and spills over if not monitored.

12.  How do I know if I need to see a psychologist?

One way to answer this question is to continue with the above analogy, that is, you need to see a psychologist when the container gets too full and strategies aimed at helping don't work. For example, you may find that talking to a friend or reading a self-help book doesn't change things for the better. Other indicators that you might want to a see a psychologist include: you know the problem is too big or complex to handle easily; others suggest you need to talk to someone or get help; you've tried numerous strategies over the years and have had some success with the issue but no real lasting or deep changes have occurred; or, you just don't seem to be reaching your full potential in your marriage, career, friendships, or hobbies.

13.  What can I expect in the first session?

In the first session, you will be asked to begin talking by responding to the question, "What prompted you to call a psychologist?"  From there I will seek to gain a clear understanding of what issue(s) you want to work on, how and to what extent the issue gives you difficulty or concern on a regular basis, what factors led to the development of the issue, and how we can address the issue in terms of working toward a solution. We will end the session by discussing how many sessions it is likely to take to attain your goals, as well as find a time and day each week to meet on a consistent basis.

14.  Will what I say in therapy sessions be kept private and confidential?

Generally, what you say in therapy sessions will be kept confidential. However, there are circumstances under which exceptions do exist. The following is not a complete list of exceptions to confidentiality but it does contain a few of the more common ones: 1) you are a threat to harm yourself or someone else; 2) child abuse or neglect is suspected; 3) your treatment records are requested by subpoena; or 4) to collect payment for services rendered.

15.  How can I afford psychotherapy at the rates charged if I don't have insurance coverage?

Psychotherapy is not cheap if paid for out of pocket without accessing insurance. But then, if you have struggled with a problem issue for some time and are tired of it, the importance of alleviating it becomes more and more valuable to you over time. Another thought on this issue is that we spend our money according to how much we value something, that is, we put our money where our priorities lie. So if changing the quality of your marriage, career, or any other area of your life is a high priority, then you will probably find a way to pay for psychotherapy out of pocket. 

STEVE W. PATRICK, PSY.D.
4100 Spring Valley, Suite 511
Dallas, TX 75244
972-934-1485