Psychotherapy

Why Seek Psychotherapy and Who Seeks it?

Psychotherapy is usually sought when an individual is experiencing significant subjective emotional and cognitive distress and impairment in their relational or achievement-, school-, and/or work-related functioning. Psychotherapy may also be sought by others in the individual's life who are concerned for the individual or are affected significantly by the client's distress or behavior. This latter motivation is often the case for children and adolescents who are referred for psychotherapy. At younger ages, psychotherapy typically is initiated by a parent, teacher, or health provider and involves extensive collaborative work with parents and often schools. Adolescents will sometimes self-initiate a request for psychotherapy when they understand it as a potential resource.

A child or adolescent may begin psychotherapy for a variety of reasons, including:

• Experiencing or witnessing abuse, assault, or trauma
• Adjusting to a loss (illness or death in the family, family divorce or restructuring, ending of a significant relationship)
• Adjusting to a chronic medical condition
• Experiencing relational difficulties
• Expressing suicidal ideation or following up after a suicidal attempt

Also, the effects of unrealistic or unhealthy parental or school expectations; living with parental psychopathology or drug and alcohol abuse; social and emotional adjustment to a neurodevelopmental disorder (language and learning disabilities); and prejudice or harassment related to racism, homophobia, or sexism may be reasons treatment is sought. Lastly, psychotherapy is often initiated when a single or coexisting mental disorders (mood, anxiety, conduct, or control disorders) are diagnosed.

Psychotherapy versus Counseling: Is There a Meaningful Difference?

A debate exists on whether psychotherapy and counseling differ in terms of process and outcome. Rather than enter into a controversy, some professionals simply choose not to make a distinction, while others contend that it is impossible to differentiate the two. Still others maintain that there are significant differences, typically based on theoretical orientation and depth of treatment. The “difference” group views counseling as a learning-oriented process with the goal of helping clients to learn or acquire new skills that will enable them to cope and adjust to life situations. In contrast, psychotherapy is viewed as a process in which the therapist assists the client in altering his or her thoughts, perceptions, emotions, relationships, and behavior, and possibly reorganizing or affecting the development of personality. The terms are often interchangeable in contemporary practice, possibly leaving the consumer perplexed. For clarification, it is suggested that the client or parents of the client clarify with the practitioner the nature of the services to be provided, including theoretical orientation, process, and expected outcome of treatment, and which “term” might be more accurate or comfortable. In general, schools seem most comfortable with the term counseling; schools typically offer guidance counseling, crisis counseling, developmental guidance, and career guidance.

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