Frequently Asked & Unasked Questions
Do I really need therapy?
People who decide to seek out therapy are taking responsibility for their lives by accepting their situation, demonstrating self-awareness, and showing the courage to act. Everyone encounters challenges in life, and sometimes a person’s skills and knowledge can meet that challenge. Sometimes a helping hand is needed. There is no weakness in accepting reality and making a commitment to get new skills, tools, and insights to navigate current and future obstacles.
Is therapy confidential?
In general, the law protects the confidentiality of all communications between a client and psychotherapist. No information is disclosed without prior written permission from the client. However, there are some exceptions required by law to this rule. Exceptions include:
• Suspected child abuse or dependent adult or elder abuse. The therapist is required to report this to the
appropriate authorities immediately.
• If a client is threatening serious bodily harm to another person. The therapist is required to notify the police and
the person in danger.
• If a client intends to harm himself or herself. The therapist will make every effort to work with the individual to
ensure their safety and in rare cases this requires contact to family members or other service providers.
Which treatment program should come first: Mental health treatment or substance abuse treatment?
At one time, it was considered standard to expect a person to first stop using all drugs and alcohol and then to undergo mental health treatment. This is no longer the case. It is accepted across the medical and mental health community that co-occurring disorders are so deeply entwined that it is necessary to treat both issues at the same time. Though it may be necessary to attend to a client’s physical needs first in terms of providing medical detox assistance as needed, therapeutic treatment, when it commences, must focus not only on the issues that drove addiction but also on the issues created by the mental health disorder.
How can mental health issues lead to addiction?
One very common scenario occurs when a person experiences a trauma that triggers depression, anxiety, disordered eating habits, suicidal thoughts, and/or post-traumatic stress disorder (PTSD). In an attempt to manage the otherwise unmanageable symptoms associated with these disorders, many people turn to drugs and alcohol. These substances may initially serve to quell the anxiety, alleviate depression, or otherwise numb the pain caused by the mental health issue. However, over time, continued use of these substances will fail to bring the sought after relief and will instead create a new and equally intrusive problem: addiction.
What are the non-medication methods for treating mental health symptoms?
Though medications may play an important role in recovery from a mental health disorder because they aid in the management of symptoms, they are not the only option in mental healthcare. In fact, for many, they play a steadily decreasing role in recovery as they progress and grow through treatment. Each person is different and will be differently impacted by the specific mental health disorder in combination with drug or alcohol abuse and addiction, and thus different therapies and treatments will make sense in different situations.
However, in general, options may include:
• Cognitive and behavioral therapies
• Support groups
• Family therapy
• Acupuncture and acupressure
• Bodywork and massage
How is PTSD treated?
Post-traumatic stress disorder (PTSD) can occur when someone experiences or witnesses a traumatic experience. The symptoms can be avoidant (e.g., causing the person to want to avoid anything that triggers memories of the event), aggressive, or negative in nature, and intrusive on the person’s ability to function in day-to-day life. Treatment may vary based on the symptoms experienced, however, they often include some combination of medication and psychotherapy.
• Eye Movement Desensitization and Reprocessing (EMDR): Guided eye movements performed in combination with a
retelling of the trauma event can help to diminish its power and decrease the negative symptoms experienced by
• Cognitive Behavioral Therapy: This style of talk therapy helps clients to recognize the patterns they exhibit in response
to different events and situations, and assists them in altering those patterns with shifts in perspective.
• Support groups: Meeting regularly with others to share experiences and tips can be beneficial to all involved.
• Exposure therapy: Being exposed to some aspect of the trauma can help to minimize the power of the event and put
control back into the hands of the client.
Can mental illness run in the family?
Yes. Genetics play a role in the development of a mental health disorder. First, a person’s genes may make that person more likely to experience mental health symptoms like depression or anxiety or to develop a personality disorder if a parent, sibling, or grandparent also struggled with the disorder. Second, being raised in a family in which one or more members is living with an untreated mental health disorder may cause someone to learn those behaviors and be less likely to recognize the need for treatment later.
What is the best way to talk to someone about mental health issues?
It is not easy to broach the subject of mental health with someone who is clearly struggling from the negative effects of an untreated mental health disorder, with or without a co-occurring substance abuse problem. In some cases, one of the symptoms of the disorder may be that the person does not recognize the problems for what they are, but rather views others as the source of the issue. This makes it more difficult to connect the person with treatment and puts many families in a predicament when it comes to helping a loved one heal.
In dire situations – for example, when people are demonstrable threats to their own personal safety or that of others – it may be possible to enforce an involuntary treatment hold. Laws vary by state and procedures must be followed carefully.
In other situations, if there is a hope that the person will see reason and experience clarity in deciding how best to manage the problem of co-occurring disorders and proceed with treatment, then an intervention can be a helpful method to connect a loved one with treatment. Families are encouraged to:
• Handpick a few concerned, balanced family members who are all united in their goal of helping the person enroll
• Hire a professional family mediator (e.g., interventionist) to manage the event and make sure it goes as smoothly
• Enroll the person in treatment in advance to ensure that that person can immediately begin treatment after
• Remain calm, nonjudgmental, and focused solely on helping the person recognize the need for immediate treatment.
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