Episode 04: What It's Like to Go to Therapy
Making the decision to see someone about your mental health can be transformative. But for new patients, those first appointments may seem nerve-wracking and overwhelming. In this episode, we talk with Right Track Medical Group Treatment Coordinator Clark Hunt and Coordinator of Best Practices Taryn Cooper about what new patients can expect. Listen now below, or anywhere you get your podcasts.
EPISODE TRANSCRIPT
Welcome to South of Fine, a podcast from Right Track Medical Group, dedicated to de-stigmatizing mental health in the south through genuine conversation about the challenges that we all face every day. For more information, please visit our website, righttrackmedical.com\SouthofFine. While we hope you enjoy listening to our podcast, please remember that this is not a substitute for professional diagnosis or for the treatment of any mental health condition.
Rhes Low, Host:
Alright. Hey guys, thank you for coming back for another episode of South of Fine. Once again, I'm your host Rhes Low. I am very excited about today's episode because we're going to get a 360-degree view of what therapy looks like. We're going to look at the process of how to start therapy, the difference in the titles of mental health providers, such as what is a therapist versus a counselor. We're going to get to look at an insider view of what a therapy session looks like and so on and so forth.
I haven't done much research on this either, because I do have the benefit of asking and getting answers from two people who know this view inside and out. I'm glad to welcome back to Taryn Cooper, coordinator of best practices at Right Track Medical Group and welcome for the first time Clark Hunt, treatment coordinator for Right Track Medical Group. They are joining us from their office in Oxford, Mississippi. Clark, and Taryn, Glad to have you here.
Taryn Cooper, Coordinator of Best Practices, Right Track Medical Group:
It's good to be back.
Clark Hunt, Treatment Coordinator, Right Track Medical Group:
Thank you for having me.
Low:
Cool. All right. So, let's just get to the questions, guys. The first and biggest here is, why is there a stigma around mental health and why does it continue to prevail and keep people from seeking support?
Cooper:
Well, we tend to judge what we don't understand and there's a lot about mental health that most people I think don't understand. Especially the people who have mental health issues. They might not even understand themselves, what's going on. And so, we do tend to judge what we don't understand. And so, I think that that judgment causes us to treat people differently.
We do see that people with mental health challenges often face rejection, bullying, sometimes even discrimination. And we tend to criminalize people with mental health issues rather than getting them the mental health services that they need. And so I can understand that from a systemic perspective, a societal perspective, how mental health is something that we don't understand and therefore judge. And so, we don't necessarily want to admit that we might have a mental health challenge.
Hunt:
Yeah. And I think a lot of that misunderstanding creates fear with people as well. So, with mental health, it can be hard to grasp why someone is thinking or feeling or behaving in a particular way. So, for that person, as Taryn was saying, it can be hard to understand and then for their family members and friends, it can be very difficult to grasp what's going on. And so, I think fear fuels that stigma of people saying or thinking unhelpful things, like why is this person acting this way or what is wrong? So, not only for the family or friends thinking about what is wrong with this person, but maybe even that person wondering what is going on. It can be very confusing and difficult to grasp. I think some fear fuels that stigma as well.
And along those lines I think it's important to see mental health for what it is. Just like any other healthcare concern. And I think the more we talk about it, as we're doing today, the less of those misconceptions there are out there related to mental health.
Low:
Right. We're basically educating ourselves so we understand it more. Why is that? Why is educating ourselves about therapy an important part of eliminating that stigma, to get people in, to get professional help? I think you guys just answered that question, honestly. It's fear, right?
Hunt:
Yeah. And I think part of talking about it and gaining a better understanding of mental health, I think the focus of the conversation may shift from those things associated with stigma to the benefits of therapy. And so, when people start to understand what therapy is, then they can see the value in therapy and see the positive impact it can have on individuals, families, and society as a whole.
So, shifting that discussion from stigma to why therapy is beneficial. And I just view therapy is a very normal thing that most people, if not all could benefit from. So I think when we start to see and talk about it in that way, the question becomes why wouldn't you, instead of why would you seek therapy?
Low:
Yeah. Cool. Okay. Go ahead, Taryn.
Cooper:
Well, when nearly one in five U.S. adults live with mental illness, I think we have to be able to normalize it. We have to be able to say nearly 20% of us all struggle with some sort of mental health issue. Especially with suicide being the leading cause of death for people aged 10 to 34, this is something that we need to recognize and we need to understand. So, even if I'm personally not someone who struggles with mental health issues, I would say just educating yourself is so beneficial because chances are, you know somebody who is struggling.
And so, if we can educate ourselves, if we can attempt to understand, we might not understand exactly what that person is going through, right? Until we have a conversation with them, but we can understand in general what they might be thinking, what they might be feeling, what they might be struggling with so that we can attempt to support them in the best way that we can.
Hunt:
Yeah, absolutely. And I think part of reducing that stigma may actually encourage people for themselves or their family members to seek treatment maybe sooner rather than later. So being able to seek treatment, maybe they might not have otherwise or sooner, when symptoms may be more manageable rather than waiting until later when it may be something that's more difficult to treat or until there's some sort of crisis situation. So I do think starting mental health treatment sooner, and that early intervention piece of it can really make a lasting difference in the lives of people and their families, for the better.
Low:
Yeah. And the more we talk about this, the sooner people will be getting to you guys. I would hope. I think that's a great point to manage that before a crisis happens. All right. So yeah, that's a great set up, guys. So just basic questions here, that I know most of us don't know. What's the difference between counselors and therapists and psychologists and psychiatrists and all the different titles? And now nurse practitioners. I know that Right Track has some nurse practitioners on staff. So, you all tell me about it.
Cooper:
A counselor and a therapist are basically the same thing. Both have their master's degrees in some sort of counseling field. There are three or four different types of counselors or therapists out there. And really the only difference is between those four different kinds are the type of training that they received and a type of theoretical perspective that they might enter into the counseling session with.
A psychologist and a psychiatrist, both have their doctorate, so a little bit more education. Psychologists tend to focus more on the research side of things or testing. If you've heard of ADHD testing, psychologists can do that. And then psychiatrists, they can prescribe medication and treat you that way. Same thing with nurse practitioners, they just don't have quite the same education or level of education as a psychiatrist. But a psychiatric Nurse practitioner does have a specialty in the psych field. And so those are just the general differences, if we're talking just in general about those differences.
Low:
Gotcha. Cool. So, beyond the stigma of mental health, what do you think makes people nervous about seeing a counselor or a therapist? I guess more specific than what we've already discussed previously, which is the broad scope. If there are any specific instances that you could think of that would make people hesitant and nervous about seeing counselors or therapists? No one wants to answer that one? You all are getting nervous?
Cooper:
I just don't want to talk too much.
Hunt:
Yeah. You were looking for something more specific?
Low:
Yeah. Just off the top of your head.
Hunt:
Well, I was just thinking more of what can make people nervous about seeing a therapist is the uncertainty about what to expect, especially if they've never been to a therapist before, never had any mental health treatment. So, just not knowing the process of things and what to expect. So I think that's a really good reason for people to ask questions on the front end or even once you see a therapist, ask them questions about the process and what to expect can ease some of that nervousness maybe, and anxiety about going to a therapist and I think also it can be scary to consider what might they uncover about themselves and their situation during the process as things come to surface.
Hunt:
But it's that very insight they can bring about positive change in people's lives, but can also be a scary thing to do. I just have a lot of respect for people who are willing to confront that and have some vulnerability in doing that because it does take a lot of courage.
Low:
Yeah. Great. That's super cool. Are there any stereotypes that people have when they come in for their first session about counseling, that maybe we could dissolve?
Hunt:
You will not be judged.
Low:
That's a very good one. That is probably the most prevailing.
Cooper:
Yeah. I do think that a lot of people who maybe don't know what to expect when coming to counseling for the first time, I've had people come to the first session and think that they were just going to see me one time, like it's a one and done deal, right? Like, "I'm going to come see you, I'm going to tell you everything that's going on, you're going to tell me how to fix it." I'm doing air quotes right now, right? So they're like, "Fix me, fix the problem. Tell me what to do." And that's just not what therapy is, or counseling is. We would be absolutely no help to our clients if we just gave them what we felt like were solutions to their problems, because then they would be dependent on us and they would have to keep coming back and ask us what they should do next.
Any parent knows that isn't helpful, right? Parents know that you have to teach your kids how to slowly and independently, on their own, the older that they get, make decisions that are best for them. And they feel like are really the right decision. And so, we do the same thing in counseling where we try to encourage push, motivate, challenge our clients to take their next best steps.
Low:
Yeah. Good deal. Okay. So, let's say I want to go to therapy and I want you guys to look beyond the fact that you do this on a daily basis and give me the rundown of the steps that I would take to get into the office and what it looks like.
Hunt:
Yeah, so I'm not sure about other places, but at Right Track Medical Group, it can be as simple as picking up the phone and calling. So, if you wanted to schedule an appointment, you could call our number and ask to speak with someone on our admissions team and they could assist you with make an appointment, answer questions you may have about our services or our approach to mental health treatment. And I say that's a simple step, but not wanting to be underestimate either because I know how challenging that can be to pick up the phone and call and ask for help.
Low:
And Clark, when someone does that, do they have to go into a little bit of why they're calling in order for you to determine where they need to go or who they need to see?
Hunt:
There may be some discussion of that. Usually, we may ask what the reason is for the visit or the difficulty they're having. And at Right Track Medical Group, we have, as an outpatient, mental health clinic, have a therapist and psychiatric mental health nurse practitioners who do medication management. So, those are things that we could talk through. And we can also, at our website, that's RightTrackMedical.com, there's information on our web page about the services we provide, our approach to treatment, what to bring and what to expect in your first session, some very practical things like an ID and things maybe if you're nervous about coming, might not think of. And there's also some forms to fill out as well.
So, and even on our webpage, there's a place there, under contact, where you can actually request an appointment through the webpage. And then once that's done, someone from office will reach out to you and set up an appointment.
Low:
Is there a timeframe on how long it takes for someone to get back to you, if you fill out something online? How long does that typically take?
Hunt:
If someone was to request an appointment through our webpage, someone should respond within that day.
Low:
Okay, great. Cool.
Cooper:
Yeah, that's actually one thing I really love about Right Track Medical Group is that we don't have a waiting list and in the state of Mississippi and the country as a whole, I think this is a common issue that we have in the mental health field, is we just don't have enough mental health professionals out there to serve the needs of the community. And so people are often put on waiting lists or it takes a while to get them in for that first appointment. And so that is something I really respect about Right Track in particular.
Low:
Cool. So, once someone starts to seek out this mental health support and we get to an appointment and let's say I go to that first session and I'm not jiving with that therapist or that counselor or that psychiatrist. Do I have the option to change? To request someone new? I'm sure that doesn't happen often, but if it does, is that a possibility?
Cooper:
Yeah, I think what actually typically happens is the client will just stop coming to therapy and just ghost their therapist, right? Just cancel an appointment or not show. That is one of the biggest mistakes that I think a client could make, because typically then, they're not receiving the referrals that they might need to work with another therapist.
The best thing you can do is let your counselor know, your therapist know, that maybe you're needing something a little different. Maybe you're not the most comfortable in the session. Just being open and honest. I know that's challenging. It's very challenging to do, right? Because I think oftentimes we fear that we're going to offend or somehow hurt our counselors feelings, but we are trained as professionals. We know not everyone is going to be the best fit or we're not going to be the best fit for every single person that we see.
Cooper:
And so, if we can't recognize that maybe we can't help the client that's sitting in front of us, they definitely can feel it. They can tell something's off or they don't feel the most comfortable. And sometimes we don't feel comfortable with a counselor because they remind us of someone in our life, our family, that we have some conflict with, unresolved conflict. And so, it's not going to be helpful for me if I'm the client to work with someone who reminds me of someone else who brings negative emotions for me. And so, I think telling your counselor that you might need something else, we are trained. Ethically, it's our responsibility to give you that referral and make sure you get connected with the right counselor.
Low:
Cool. Yeah, absolutely. From just my little bit of talking to you guys, I know that you're looking out for the patient's best interest first. You're not going to take anything personally, as long as they continue, is what I hear you saying. Don't give it up. Change if you have to.
Cooper:
Right. Because we never know really why they stopped coming, if they just don't come, right? And so, if it had something to do with me not being the right fit for them, I want to make sure that I'm helping them get connected to the right person.
Low:
Yeah. And so when they come for that first session, is it a get to know you session? Or what's the inside of that look like?
Hunt:
The first session is an assessment where you do get to know the person, you get to gain a better understanding of their mental health needs and why they came into the office and some background information on them as well. And that's another good opportunity, as I said earlier, for that person to ask questions of the therapist too.
So, the therapist would get an idea of what brought you into therapy, an overview of you and your life and what's going on with you. Most likely begin with that reason of why it is you took that step to... What was the thing that prompted you to seek out treatment when you did? Maybe some problem that's going on or, for instance, "I've been depressed for the last couple of weeks," or, "I'm feeling extremely overwhelmed with worry since this COVID-19 began to happen," whatever that main reason is that, "Okay, this is why I'm presently here." And then get some history leading up to that.
For instance, if it was, "I've been feeling depressed for the last couple of weeks," have there been other episodes of depression in the past and what was going on around those times? And then, part of that overview of the person is looking at their social and developmental and educational history, a comprehensive overview of their life and may ask about symptoms that they're having such as loss of interest or worry or feeling down, whatever that may be. And then, past mental health treatment, if they've had any and how effective that was and importantly, their motivation for seeking treatment. So, what are their goals? What it is that they're wanting to get out of this process? What changes maybe they're wanting to make in their life moving forward?
Low:
And then moving forward into further sessions, if I'm in a session, is it a lot of me talking and you telling me what to do, or how does that look as you go forward? Taryn?
Cooper:
Yeah, I'll take this one. Yeah. So really, it just depends on the personality of your therapist and the client. Sometimes clients do you have a lot to say and sometimes they don't and so, the pace of the session can vary depending on what's happening in that person's life. Also, what they talk about can vary depending on what's happening in their life. Sometimes you have sessions where a client comes in for one particular thing, but as you're spending more time together, other things come up. That actually happens pretty often and so the goal that they might set for themselves in counseling initially, might not be the goal that they have throughout the counseling process.
Cooper:
Because as you're talking, as various things are coming up for the client, they might set some new goals or have some new things. Some, I would say, probably deeper goals that they didn't really even realize that they have, that they wanted to change, something that comes up for them that they want to challenge, that they didn't necessarily even know that that existed. So that does change throughout the counseling process.
Hunt:
Yeah, I think what Taryn brought up is a really good point, how whatever may be that presenting issue that people come in with and may set some goals around, as that improves and they begin to see improvement in those areas, then maybe some of these deeper issues come up. So I think another part of that is that it is a collaborative process of coming up with those goals and other things that may occur in therapy or just psycho education. Teaching coping skills, working on your thinking about things and maybe even learning how to regulate your emotions.
Cooper:
Or just identify your emotions. I think I heard a research stat that said most adults only can name off five human emotions. And those are the most basic human emotions, right? Like happiness sadness, anger, disgust, fear. I'm thinking of the movie Inside Out right now, actually —
Low:
I was like, "This is very much a cartoon." That's a good movie.
Cooper:
It is. But most adults can really only identify those five basic emotions. They have a really hard time going in more depth about what they're feeling and explaining what they're feeling with labeling and using emotional words. And so, oftentimes in therapy, we help them develop the language to describe how they're feeling, too.
Low:
And Taryn, and I'm not excluding you Clark, you can answer this as well if you'd like, I heard something about children as opposed to adults and us being able to maybe identify several emotions we're having at once and them not. Do you know where I'm going with that?
Cooper:
Yeah. It's definitely a part of emotional intelligence that we can learn and start to identify that we feel more than one thing at a time. That is something that is a part of our reality as humans with how complex we are with everything we're feeling. I might even use this language of parts where I'm like, "One part of me feels this way. And another part of me feels another way." And that language tends to resonate with a lot of people. Because we have a lot of conflicting emotions sometimes too.
Cooper:
With kids, it really just depends on how much the parent is teaching that child, depending on the age, what they're able to grasp and understand and hold on to whether or not the kid can recognize and label that emotion for themselves. That just depends on the age.
Hunt:
Even for myself as a counselor, on my refrigerator at home, I have an emotion chart. So today I feel, and then I can move it around. So even as a counselor, at my age, as an adult, sometimes that can be challenging. So, I have one myself at home.
Low:
That's cool. And that's one of the things, the tools that I think Clark, you mentioned that your mental health professional can help you with, to identify. Some of those emotions are really conflicting and you're like, "I shouldn't be feeling this way while I'm feeling this way. Can joy and sadness go together? Yeah."
Anyway, so as we move along in that process and I know this is going to be on a case by case basis, but you go and you go and you go, is there an end? Or how do you recognize an end? That's a hard question.
Cooper:
Yeah. Sometimes the end is just when the client becomes too tired to go on. I say tired, but I mean pacing is really important. And if you're really doing some hard work in counseling, there might be a need for a break after a while, depending on what you're talking about and working through. Sometimes that means the client, they feel that they've met their goal. I think we would love to be able to look at the goal and agree with our clients, that they've met that goal, that they don't have any other things that they want to work through. They feel good. We would like to typically have an ending session, right? Where we say, "Okay, if you start to feel this way again, what have you learned? What are you going to do? What are you going to do the next time you feel this way, or this happens, or this negative thinking comes back?" Or whatever the issue was that they were coming to counseling for.
Cooper:
But I do think it is important to be realistic with yourselves, as the client, and then also as a therapist or a counselor, in saying that sometimes we can want to push our clients a little bit further than they are able to go in the moment. And that's okay. We just have to recognize, "Okay. I think you need to take a break for a little while. That's fine. Get some rest. Think about what we've talked about and then come back when you're ready."
Low:
Yeah. And like you said, you all aren't judging anyone. And that's what keeps a lot of people out of there. They think they're going to be judged on what they say, which leads me to this question about if you're not good at being open. Do you have any suggestions for people, or is it just a matter of time? How does someone ever come that if you are really bad at expressing and being open? Because that's a lot of us.
Cooper:
Yeah. I don't know if it's really a good or bad thing. I think it's whether or not we've had enough good or bad experiences maybe, or proof that show us that we can be open, and people are going to hold what it is that we have to say or share with them. It's not by any means the fault of the person for feeling guarded for not wanting to be vulnerable because that person has probably had some hard experiences where they tried to be open, they tried to be vulnerable, they maybe tried to share with a parent at a young age or a friend or their spouse and they got shut down or dismissed. And so, they learned very quickly that that was something that they weren't able to do. And so, one thing we do try to do in counseling is provide that safe environment and that safe relationship for them to learn, for our clients to learn, that this is possible.
Cooper:
That they might not be able to do it with some of the people that they attempted to early on, just depends on the openness of the other person, right? Being able to listen and learn and change, but that it is possible for them. So that definitely is something I would say, I don't want to, by any means judge the person and say, "You're bad at this," or "You're good at this," because they're that way for a reason, right? We learn from people early on in our lives, whether or not we can be open.
Hunt:
Yeah. And communication is a skill, just like any other. So, learning how to communicate is something you can get more comfortable with and even better at. So, I just see it as a skill, just like you would learn any other kind of skill. And for a lot of people, it's a very challenging one.
Low:
Wow. That's great. Yeah. Really, really good stuff there. So, when you leave a session, are you always going to feel really good about yourself? Or sometimes you're going to feel pretty crappy? Can I say crappy on a podcast? If you come out of a session and you're feeling terrible, is that normal?
Hunt:
If it's every time, I would probably say that I don't know how normal that is, but I think therapy can be mentally and emotionally challenging, so yeah, I think feeling exhausted after a session can certainly happen and does. And one thing I think that may be part of this misconception as we were talking about earlier, that sometimes people may have, is that therapy takes a lot of effort. But it's also not always so heavy and sometimes there can be laughter, there can be joy, taking credit for progress made. So there may be some heavy moments and some times where it can be exhausting, but I wouldn't say that's the norm. What do you think, Taryn?
Cooper:
Yeah, I definitely don't think it's the norm to feel that way every time. But you can't expect, depending on what you're talking about, you know personally how hard some of these issues are for you that you're bringing to counseling. And I have definitely been known to let clients know if it has been a harder session. If it's been a session where maybe there were some tears or there was some intense anger or whatever they were feeling, if they felt that way strongly, well, they felt strongly about that probably because they weren't letting themselves feel it before. And so, when your body does release the emotion that it was holding onto, you do feel a sense of exhaustion or physical fatigue after. And so, I always just tell clients, go home, take a bath, go to bed early, take care of yourself, do whatever you need.
That is just as much therapy, are you implementing what you learned in therapy? As the actual session, as being able to go home and take care of yourself after that hard session. But yeah, not every session is like that. Like Clark said. I joke around with my clients all the time. You have to be able to joke around with each other. It's part of building that relationship between you and your therapist. When you have the same sense of humor or you get a joke that your client says, there's something really bonding and connecting about that. It's been funny as we've been doing more tele-health and more Zoom sessions and stuff like that with clients, I've met clients' dogs, I've met their pets, I've had tours of their bedrooms, if I'm meeting with a teenager and that's part of the session too, is just getting to have a peek into the world of the person that you're meeting with and building that relationship with them. So not every session is heavy and hard, but some definitely are.
Low:
Yeah. I bet. Cool. And you guys are super fun. I see you all the time. I think you're pretty funny and intelligent. We've talked a lot about the talking in the therapy session, that sort of thing. So what about the medication part? Are those appointments different? Is that a part of a regular appointment? How does that look, if you need to be prescribed something?
Hunt:
Going back to when Taryn was explaining the difference between different types of therapists and psychiatrists and psychiatric mental health nurse practitioners, so therapist are not going to be prescribing medications, but maybe a psychiatrist or a psychiatric mental health nurse practitioner, in a separate appointment with that provider, would then where the medication management piece comes in. But also, there is I think, good to collaborate when that's possible and being able to collaborate together with the therapist and the provider who is prescribing the medication is a good thing.
Cooper:
Well, and your counselor can help you in managing that medication, too. Some of the hardest things about medication are remembering to take it, consistently taking it right? And then scheduling those follow-up appointments so that you can get your refill or talk to your nurse practitioner or your psychiatrist about how you're feeling if you have side effects. It's hard to find the right medication that works best for you and your body, right? Depending on what the chemical imbalance is or what's happening for you. And so your therapist can help being an advocate for you in talking to those other providers as well as help keep you consistent and on schedule and accountable.
Low:
This has been quite an amazing episode and a very important episode. Thank you so much for caring and knowing your profession so well and understanding people so well through your training and through just getting to know your clients or your patients, I guess. And that's another thing, are they patients, or do we call ourselves clients or patients? Or I don't know, people?
Cooper:
They're both. Yeah, people. People is good.
Low:
Because talking to you guys, it feels like I'm talking to another person. You're open and you're honest and I don't feel like I'm being judged. And I say stupid stuff every podcast.
Cooper:
So do I. So, it's okay.
Low:
No, not to the degree that I do. Yeah. So guys, just thank you so much. Once again, Taryn, great to have you back. Your knowledge is super awesome to have. Clark, you are a welcome newbie. It was a pleasure having both of you guys. And like I said, I love the openness that both of you guys have and the care that it is highly apparent is just seeping out of both of you.
Low:
All right, guys, if you are struggling yourself or know a family member who is struggling with mental health issues, do not be afraid to reach out for help. Your mental health matters, now and always. And if you have questions about mental health, that you'd like one of our providers to answer in a future episode, please email SouthOfFine@RightTrackMedical.com. Thank you guys, Clark and Taryn, for being here with us. And I'm Rhes. I look forward to continuing this conversation with everyone in upcoming episodes of South of Fine. I'll see you guys later.
If you have questions about mental health and the COVID-19 pandemic that you'd like our providers to answer in a future episode, please email SouthOfFine@RightTrackMedical.com and if you'd like more information about Right Track Medical Group or the South of Fine podcast, please visit RightTrackMedical.com.
Thanks to our production team. Kelly Hunsberger, Caitlyn Clegg, Carolyn Hughes, Aleka Battista, and Rhes Low. Special. Thanks to Squadcast for providing superior remote interview services
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