Frequently Asked Questions
What is the difference between a Psychiatrist, Clinical Psychologist and Counselor?
These are all terms to designate mental heath professionals. However, these differences in titles also indicate differences in qualifications and roles.
A Psychiatrist is a doctor who has attended medical school and done a residency in psychiatry. In India, psychiatrists and other medical doctors are the only professionals who can prescribe psychiatric medications.
A Clinical Psychologist is a mental health professional holding an M.Phil degree in Clinical Psychology from an institute recognized by the Rehabilitation Council of India (RCI) and regsitered in the Central Rehabilitation Register (every legitimate Clinical Psychologist must have a CRR Number). As per the RCI Act, he/ she can conduct independent psychological evaluation, testing, psychotherapy, psychoanalysis, hypnosis, biofeedback and behavioral modification for the purpose of prevention and treatment of mild to severe psychological conditions. Currently, the qualification of Ph.D Clinical Psychology is not recognized by RCI as a valid one for registration in the CRR as it a research qualification and has little emphasis on clinical practice.
A Counselor generally holds an M.A degree in counseling or counseling psychology. Most of them focus on mild to moderate common life issues.
As a client, you have the right to ask to be informed about your consultant's educational qualifications and licensing. Practicing in private/ Government/ Non- Government as Clinical Psychologists or Counselors without RCI registration is an offence under section 13(3) of RCI Act no. 34 of 1992. All countries have independent norms for practicing professionals. Registration/ license from other countries may not be applicable in India.
These are all terms to designate mental heath professionals. However, these differences in titles also indicate differences in qualifications and roles.
A Psychiatrist is a doctor who has attended medical school and done a residency in psychiatry. In India, psychiatrists and other medical doctors are the only professionals who can prescribe psychiatric medications.
A Clinical Psychologist is a mental health professional holding an M.Phil degree in Clinical Psychology from an institute recognized by the Rehabilitation Council of India (RCI) and regsitered in the Central Rehabilitation Register (every legitimate Clinical Psychologist must have a CRR Number). As per the RCI Act, he/ she can conduct independent psychological evaluation, testing, psychotherapy, psychoanalysis, hypnosis, biofeedback and behavioral modification for the purpose of prevention and treatment of mild to severe psychological conditions. Currently, the qualification of Ph.D Clinical Psychology is not recognized by RCI as a valid one for registration in the CRR as it a research qualification and has little emphasis on clinical practice.
A Counselor generally holds an M.A degree in counseling or counseling psychology. Most of them focus on mild to moderate common life issues.
As a client, you have the right to ask to be informed about your consultant's educational qualifications and licensing. Practicing in private/ Government/ Non- Government as Clinical Psychologists or Counselors without RCI registration is an offence under section 13(3) of RCI Act no. 34 of 1992. All countries have independent norms for practicing professionals. Registration/ license from other countries may not be applicable in India.
What can I expect from Psychotherapy?
Psychotherapy is a collaborative treatment based on the relationship between an individual and a psychologist.
For your first session, your psychologist may ask you to come in a little early to fill out paperwork if you haven’t already done so.
Don't worry that you won't know what to do once the session actually begins. It’s normal to feel a little anxious in the first few sessions. Psychologists have experience setting the tone and getting things started. They are trained to guide each session in effective ways to help you get closer to your goals. In fact, the first session might seem like a game of 20 questions.
Sitting face to face with you, your psychologist could start off by acknowledging the courage it takes to start psychotherapy. He or she may also go over logistical matters, such as fees, how to make or cancel an appointment, and confidentiality, if he or she hasn’t already done so by phone.Then the psychologist may ask a question like, “What brought you here today?” or “What made you decide to come in now rather than a month or a year ago?” It helps to identify your problem, even if you’re not sure why you have it or how to handle it. For example, you might feel angry or sad without knowing what's causing your feelings or how to stop feeling that way. It’s OK for you to say that you are not ready to talk about something just yet.Your psychologist will also want to know about your own and your family’s history of psychological problems such as depression, anxiety or similar issues. You’ll also explore how your problem is affecting your everyday life. Your psychologist will ask questions like whether you’ve noticed any changes in your sleeping habits, appetite or other behaviors. A psychologist will also want to know what kind of social support you have, so he or she will also ask about your family, friends and coworkers. Some psychological tests may be recommended by the psychologist to elicit more details about your issues. For alcohol and substance using clients, urine tests are commonly suggested.
This process may take more than one session. While guiding you through the process, your psychologist will let you set the pace when it comes to telling your story. As you gain trust in your psychologist and the process, you may be willing to share things you didn’t feel comfortable answering at first.
Once your psychologist has a full history, the two of you will work together to create a treatment plan. This collaborative goal-setting is important, because both of you need to be invested in achieving your goals. Your psychologist may write down the goals and read them back to you, so you’re both clear about what you’ll be working on. Some psychologists even create a treatment contract that lays out the purpose of treatment, its expected duration and goals, with both the individual’s and psychologist’s responsibilities outlined.
At the end of your first session, the psychologist may also have suggestions for immediate action. If you’re depressed, for example, the psychologist might suggest seeing a physician to rule out any underlying medical conditions, such as a thyroid disorder. If you have chronic pain, you may need physical therapy, medication and help for insomnia as well as psychotherapy.
By the end of the first few sessions, you should have a new understanding of your problem, a game plan and a new sense of hope.
What should you ask yourself before seeking psychotherapy?
When you're ready to select a psychologist, think about the following points:
What factors should you consider before making an appointment?
You'll need to think about the best time of day and week to see your psychologist. Factors to consider include:
Should I worry about confidentiality?
Psychologists consider maintaining your privacy extremely important. It is a part of their professional code of ethics. More importantly, it is a condition of their professional license. Psychologists who violate patient confidentiality risk losing their ability to practice psychology in the future.
To make your psychotherapy as effective as possible, you need to be open and honest about your most private thoughts and behaviors. That can be nerve-wracking, but you don't have to worry about your psychologist sharing your secrets with anyone except in the most extreme situations. If you reveal that you plan to hurt yourself or others, for example, your psychologist is duty-bound to report that to authorities for your own protection and the safety of others. Psychologists must also report abuse, exploitation or neglect of children, the elderly or people with disabilities. Your psychologist may also have to provide some information in court cases.
Of course, you can always give your psychologist written permission to share all or part of your discussions with your physician, teachers or anyone else if you desire.
Psychologists take confidentiality so seriously that they may not even acknowledge that they know you if they bump into you at the supermarket or anywhere else. And it’s OK for you to not say hello either. Your psychologist won’t feel bad; he or she will understand that you’re protecting your privacy.
Is medication effective?
There are some psychological conditions, such as severe depression, bipolar disorder or schizophrenia, where medication is clearly warranted. But many other cases are less clear-cut.
Evidence suggests that in many cases, medication doesn't always work. In a 2010 study in the Journal of the American Medical Association, for instance, researchers reviewed previous research on the effectiveness of antidepressants. They found that antidepressants did help people with severe cases of depression. For mild to moderate depression, however, the medication wasn't any more effective than a placebo.
What's more, medications don't help you develop the skills you need to deal with life's problems. Once you stop taking medication, your problems often remain or come back. In contrast, psychotherapy will teach you new problem-solving strategies that will also help you cope with future problems.
Do I need medication?
If you can function relatively well — meaning you can function well at work or school and have healthy relationships with family and friends — the answer is probably no. Psychotherapy alone can be very effective. Or you might just need a more balanced lifestyle — one that combines work, exercise and social interactions.
Medication can be useful in some situations, however. Sometimes, people need medication to get to a point where they're able to engage in psychotherapy. Medication can also help those with serious mental health disorders. For some conditions, combining psychotherapy and medication works best.
How can I get medication if I need it?
If you need medication, your psychologist will work with your primary care provider or a psychiatrist to ensure a coordinated approach to treatment that is in your best interest.
How effective is psychotherapy?
Hundreds of studies have found that psychotherapy helps people make positive changes in their lives.
Reviews of these studies show that about 75 percent of people who enter psychotherapy show some benefit. Other reviews have found that the average person who engages in psychotherapy is better off by the end of treatment than 80 percent of those who don’t receive treatment at all.
How does psychotherapy work?
Successful treatment is the result of three factors working together:
While some issues and problems respond best to a particular style of therapy, what remains critical and important is the therapeutic alliance and relationship with your psychologist.
How long should psychotherapy take?
How long psychotherapy takes depends on several factors: the type of problem or disorder, the patient's characteristics and history, the patient's goals, what's going on in the patient's life outside psychotherapy and how fast the patient is able to make progress.
Some people feel relief after only a single session of psychotherapy. Meeting with a psychologist can give a new perspective, help them see situations differently and offer relief from pain. Most people find some benefit after a few sessions, especially if they’re working on a single, well-defined problem and didn’t wait too long before seeking help.
If you've been suffering from extreme anxiety, for example, you might feel better simply because you're taking action — a sign of hope that things will change. Your psychologist might also offer a fresh perspective early in your treatment that gives you a new understanding of your problem. And even if your problem doesn't go away after a few sessions, you may feel confident that you're already making progress and learning new coping skills that will serve you well in the future.
Other people and situations take longer — maybe a year or two — to benefit from psychotherapy. They may have experienced serious traumas, have multiple problems or just be unclear about what’s making them unhappy. It's important to stick with psychotherapy long enough to give it a chance to work.
People with serious mental illness or other significant life changes may need ongoing psychotherapy. Regular sessions can provide the support they need to maintain their day-to-day functioning.
Others continue psychotherapy even after they solve the problems that brought them there initially. That's because they continue to experience new insights, improved well-being and better functioning.
How do I know when I'm ready to stop?
Psychotherapy isn’t a lifetime commitment.
You and your psychologist will decide together when you are ready to end psychotherapy. One day, you’ll realize you’re no longer going to bed and waking up worrying about the problem that brought you to psychotherapy. Or you will get positive feedback from others. For a child who was having trouble in school, a teacher might report that the child is no longer disruptive and is making progress both academically and socially. Together you and your psychologist will assess whether you’ve achieved the goals you established at the beginning of the process.
What happens after psychotherapy ends?
You probably visit your physician for periodic check-ups. You can do the same with your psychologist. You might want to meet with your psychologist again a couple of weeks or a month after psychotherapy ends just to report how you’re doing. If all is well, you can wrap things up at that follow-up session.
And don’t think of psychotherapy as having a beginning, middle and end. You can solve one problem, then face a new situation in your life and feel the skills you learned during your last course of treatment need a little tweaking. Just contact your psychologist again. After all, he or she already knows your story.
Of course, you don't have to wait for a crisis to see your psychologist again. You might just need a "booster" session to reinforce what you learned last time. Think of it as a mental health tune-up.
Source: APA, 2013
Psychotherapy is a collaborative treatment based on the relationship between an individual and a psychologist.
For your first session, your psychologist may ask you to come in a little early to fill out paperwork if you haven’t already done so.
Don't worry that you won't know what to do once the session actually begins. It’s normal to feel a little anxious in the first few sessions. Psychologists have experience setting the tone and getting things started. They are trained to guide each session in effective ways to help you get closer to your goals. In fact, the first session might seem like a game of 20 questions.
Sitting face to face with you, your psychologist could start off by acknowledging the courage it takes to start psychotherapy. He or she may also go over logistical matters, such as fees, how to make or cancel an appointment, and confidentiality, if he or she hasn’t already done so by phone.Then the psychologist may ask a question like, “What brought you here today?” or “What made you decide to come in now rather than a month or a year ago?” It helps to identify your problem, even if you’re not sure why you have it or how to handle it. For example, you might feel angry or sad without knowing what's causing your feelings or how to stop feeling that way. It’s OK for you to say that you are not ready to talk about something just yet.Your psychologist will also want to know about your own and your family’s history of psychological problems such as depression, anxiety or similar issues. You’ll also explore how your problem is affecting your everyday life. Your psychologist will ask questions like whether you’ve noticed any changes in your sleeping habits, appetite or other behaviors. A psychologist will also want to know what kind of social support you have, so he or she will also ask about your family, friends and coworkers. Some psychological tests may be recommended by the psychologist to elicit more details about your issues. For alcohol and substance using clients, urine tests are commonly suggested.
This process may take more than one session. While guiding you through the process, your psychologist will let you set the pace when it comes to telling your story. As you gain trust in your psychologist and the process, you may be willing to share things you didn’t feel comfortable answering at first.
Once your psychologist has a full history, the two of you will work together to create a treatment plan. This collaborative goal-setting is important, because both of you need to be invested in achieving your goals. Your psychologist may write down the goals and read them back to you, so you’re both clear about what you’ll be working on. Some psychologists even create a treatment contract that lays out the purpose of treatment, its expected duration and goals, with both the individual’s and psychologist’s responsibilities outlined.
At the end of your first session, the psychologist may also have suggestions for immediate action. If you’re depressed, for example, the psychologist might suggest seeing a physician to rule out any underlying medical conditions, such as a thyroid disorder. If you have chronic pain, you may need physical therapy, medication and help for insomnia as well as psychotherapy.
By the end of the first few sessions, you should have a new understanding of your problem, a game plan and a new sense of hope.
What should you ask yourself before seeking psychotherapy?
When you're ready to select a psychologist, think about the following points:
- Do you want to do psychotherapy by yourself, with your partner or spouse, or with your children?
- What are your main goals for psychotherapy?
- If you'll be paying out of pocket, how much can you afford?
- How far are you willing to drive?
- What days and times would be convenient?
What factors should you consider before making an appointment?
You'll need to think about the best time of day and week to see your psychologist. Factors to consider include:
- Your best time of day. Whether you're a morning person or a night owl, know when you're at your best and schedule your appointment accordingly.
- Work. If you have to take time off from work, ask your human resources department if you can use sick leave for your psychotherapy sessions. You might also want to schedule your first appointment later in the day so you don't have to go back to work afterward. If you have an upsetting topic to discuss, you may be tired, emotionally spent, puffy-eyed or distracted after your first session.
- Family responsibilities. Unless your children are participating in treatment, it's usually not a good idea to bring them along. Choose a time when you will have child care available.
- Other commitments. A psychotherapy session typically lasts 45 to 50 minutes. Try to schedule your session at a time when you won't have to rush to your next appointment afterward. Worrying about being late to your next commitment will distract you from your psychotherapy session.
Should I worry about confidentiality?
Psychologists consider maintaining your privacy extremely important. It is a part of their professional code of ethics. More importantly, it is a condition of their professional license. Psychologists who violate patient confidentiality risk losing their ability to practice psychology in the future.
To make your psychotherapy as effective as possible, you need to be open and honest about your most private thoughts and behaviors. That can be nerve-wracking, but you don't have to worry about your psychologist sharing your secrets with anyone except in the most extreme situations. If you reveal that you plan to hurt yourself or others, for example, your psychologist is duty-bound to report that to authorities for your own protection and the safety of others. Psychologists must also report abuse, exploitation or neglect of children, the elderly or people with disabilities. Your psychologist may also have to provide some information in court cases.
Of course, you can always give your psychologist written permission to share all or part of your discussions with your physician, teachers or anyone else if you desire.
Psychologists take confidentiality so seriously that they may not even acknowledge that they know you if they bump into you at the supermarket or anywhere else. And it’s OK for you to not say hello either. Your psychologist won’t feel bad; he or she will understand that you’re protecting your privacy.
Is medication effective?
There are some psychological conditions, such as severe depression, bipolar disorder or schizophrenia, where medication is clearly warranted. But many other cases are less clear-cut.
Evidence suggests that in many cases, medication doesn't always work. In a 2010 study in the Journal of the American Medical Association, for instance, researchers reviewed previous research on the effectiveness of antidepressants. They found that antidepressants did help people with severe cases of depression. For mild to moderate depression, however, the medication wasn't any more effective than a placebo.
What's more, medications don't help you develop the skills you need to deal with life's problems. Once you stop taking medication, your problems often remain or come back. In contrast, psychotherapy will teach you new problem-solving strategies that will also help you cope with future problems.
Do I need medication?
If you can function relatively well — meaning you can function well at work or school and have healthy relationships with family and friends — the answer is probably no. Psychotherapy alone can be very effective. Or you might just need a more balanced lifestyle — one that combines work, exercise and social interactions.
Medication can be useful in some situations, however. Sometimes, people need medication to get to a point where they're able to engage in psychotherapy. Medication can also help those with serious mental health disorders. For some conditions, combining psychotherapy and medication works best.
How can I get medication if I need it?
If you need medication, your psychologist will work with your primary care provider or a psychiatrist to ensure a coordinated approach to treatment that is in your best interest.
How effective is psychotherapy?
Hundreds of studies have found that psychotherapy helps people make positive changes in their lives.
Reviews of these studies show that about 75 percent of people who enter psychotherapy show some benefit. Other reviews have found that the average person who engages in psychotherapy is better off by the end of treatment than 80 percent of those who don’t receive treatment at all.
How does psychotherapy work?
Successful treatment is the result of three factors working together:
- Evidence-based treatment that is appropriate for your problem.
- The psychologist's clinical expertise.
- Your characteristics, values, culture and preferences.
While some issues and problems respond best to a particular style of therapy, what remains critical and important is the therapeutic alliance and relationship with your psychologist.
How long should psychotherapy take?
How long psychotherapy takes depends on several factors: the type of problem or disorder, the patient's characteristics and history, the patient's goals, what's going on in the patient's life outside psychotherapy and how fast the patient is able to make progress.
Some people feel relief after only a single session of psychotherapy. Meeting with a psychologist can give a new perspective, help them see situations differently and offer relief from pain. Most people find some benefit after a few sessions, especially if they’re working on a single, well-defined problem and didn’t wait too long before seeking help.
If you've been suffering from extreme anxiety, for example, you might feel better simply because you're taking action — a sign of hope that things will change. Your psychologist might also offer a fresh perspective early in your treatment that gives you a new understanding of your problem. And even if your problem doesn't go away after a few sessions, you may feel confident that you're already making progress and learning new coping skills that will serve you well in the future.
Other people and situations take longer — maybe a year or two — to benefit from psychotherapy. They may have experienced serious traumas, have multiple problems or just be unclear about what’s making them unhappy. It's important to stick with psychotherapy long enough to give it a chance to work.
People with serious mental illness or other significant life changes may need ongoing psychotherapy. Regular sessions can provide the support they need to maintain their day-to-day functioning.
Others continue psychotherapy even after they solve the problems that brought them there initially. That's because they continue to experience new insights, improved well-being and better functioning.
How do I know when I'm ready to stop?
Psychotherapy isn’t a lifetime commitment.
You and your psychologist will decide together when you are ready to end psychotherapy. One day, you’ll realize you’re no longer going to bed and waking up worrying about the problem that brought you to psychotherapy. Or you will get positive feedback from others. For a child who was having trouble in school, a teacher might report that the child is no longer disruptive and is making progress both academically and socially. Together you and your psychologist will assess whether you’ve achieved the goals you established at the beginning of the process.
What happens after psychotherapy ends?
You probably visit your physician for periodic check-ups. You can do the same with your psychologist. You might want to meet with your psychologist again a couple of weeks or a month after psychotherapy ends just to report how you’re doing. If all is well, you can wrap things up at that follow-up session.
And don’t think of psychotherapy as having a beginning, middle and end. You can solve one problem, then face a new situation in your life and feel the skills you learned during your last course of treatment need a little tweaking. Just contact your psychologist again. After all, he or she already knows your story.
Of course, you don't have to wait for a crisis to see your psychologist again. You might just need a "booster" session to reinforce what you learned last time. Think of it as a mental health tune-up.
Source: APA, 2013