By Daniel Buccino, MSW, ACSW, DCSW
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Introduction |
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Benefits of Antidepressants |
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Benefits of Talk Therapy |
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How Social Workers Help |
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What to Expect of Talk Therapy |
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Conclusion |
Introduction
As a social worker specializing in mental health issues, I spend most of my week working in the public mental health system, where I see firsthand how helpful our newer antidepressants and antipsychotic medications are.
Because of these medications, combined with various rehabilitation, case management, and psychotherapy services, more patients are able to enjoy a far more robust quality of life outside of hospitals than ever before.
Benefits of Antidepressants
Antidepressant medications have been lifesaving to countless patients. However, there are possible side effects and health consequences to taking any medication. Each individual situation should be weighed carefully in consultation with an experienced health care provider. And every person who is considering taking medication to treat depression should be fully informed of those potential side effects and health consequences, as well as of the potential benefits.
Antidepressants have helped millions of people but patients also should consider the option of psychotherapy to treat their depression.
Benefits of Talk Therapy
Psychotherapy, often referred to as talk therapy, can work in many cases as well or better than medications, at lower cost, with fewer side effects and more lasting benefits. For many patients, psychotherapy can be a first choice treatment option. For others, a combination of medication and psychotherapy is indicated.
All mental health providers generally are able to provide psychotherapy – social workers, counselors, nurse specialists, psychologists, and psychiatrists. Psychologists generally do more testing and psychiatrists prescribe medications.
Since most mental health services, especially for children and families, in this country are provided by social workers, it is very likely that clients will have an opportunity to work with a highly trained and qualified social worker in some treatment or counseling setting. Social workers can help people change quickly and reliably through psychotherapy or counseling.
How Social Workers Help
Social work psychotherapists, often called clinical social workers, have a full 60 credit Master’s degree with extensive coursework in the diagnosis and treatment of psychopathology. Social workers, perhaps more than other disciplines, also consider the person-in-environment most fully and the ways in which social, family, community, and other stressors impact functioning.
Clinical social workers must obtain advanced licensure in most states which requires at least two years, fulltime, supervised work experience and are required to stay current by obtaining continuing professional education each year. Many social work psychotherapists have additional advanced training in psychotherapy techniques.
One type of therapist is not necessarily likely to be better than another because all therapies and therapists work some of the time with some clients. The best predictor of a good result in therapy is the quality of the relationship that the client has with his or her therapist, not what type of therapy they practice, or what type of degree they have.
Research confirms repeatedly that psychotherapy is a safe and effective treatment for many psychiatric disorders and problems of living and is currently being extended with promise into the treatment of major mood disorders and psychosis.
Clients will generally be able to find a therapist with whom they work well, and since social workers are so prevalent in many settings, it will likely be a trained social worker. Unfortunately, many people do not believe that therapy can help them change, or are worried about the stigma of talking to a therapist. But therapy can and does help.
Unless a prospective therapy client has a very specific type of treatment in mind, which most do not, a potential therapy customer would expect to review some of what’s bringing them to treatment, what they hope to get from treatment and what better might look like, as well as the types of strategies that have helped them cope before.
What to Expect of Talk Therapy
Generally speaking, if nothing positive is happening in therapy after three to six sessions, clients should discuss this with their therapist. If no change persists, it may be time to find another therapist.
Therapy is not necessarily long term or short term – it should continue as long as it is being helpful – but we know that if it is not proving to be helpful early, it is not likely to be helpful later with this particular therapist.
Other tips for a good therapy outcome include finding a therapist who you like and feel comfortable with and whom you think understands and appreciates you and your point of view. Clients will also want to work with a therapist with whom they share goals for treatment and whose opinions and feedback they find helpful. If you are asking for something and not getting it, or if your therapist believes your problem inevitably will require years to change, you also may want to look for another one.
Conclusion
There is a time and a place for medications. A careful evaluation is essential, to assess each individual situation and to consider the possible health consequences and outcomes of medication. But it is equally as important to know that therapy works too. And sometimes it can work better and should be considered as a first line treatment option in many instances. And for other persons, a combination of medication and therapy is the best option. There is a good therapist match for every client to ensure a positive outcome. Every social worker should be able to help their clients evaluate what is right with themselves as well as what’s not working, and what the best treatment options may be. Therapy works. Change happens.
