Millions of Americans have found relief from depression and other emotional difficulties through seeing a psychologist. Even so, some people find it hard to get started or stay in therapy. This brief question-and-answer guide provides some basic information to help individuals take advantage of outpatient (non-hospital) therapy.

Why do people consider using therapy?

Therapy is a partnership between an individual and a professional such as a psychologist who is licensed and trained to help people understand their feelings and assist them with changing their behavior. According to the National Institute of Mental Health, one-third of adults in the United States experience an emotional or substance abuse problem. Nearly 25 percent of the adult population suffers at some point from depression or anxiety.

People often consider therapy, under the following circumstances:

  • They feel an overwhelming and prolonged sense of sadness and helplessness, and they lack hope in their lives. 

  • Their emotional difficulties make it hard for them to function from day to day. For example, they are unable to concentrate on assignments and their job performance suffers as a result. 

  • Their actions are harmful to themselves or to others. For instance, they drink too much alcohol and become overly aggressive. 

  • They are troubled by emotional difficulties facing family members or close friends.

What does research show about the effectiveness of therapy?

Research suggests that therapy effectively decreases patients' depression and anxiety and related symptoms — such as pain, fatigue and nausea. Therapy has also been found to increase survival time for heart surgery and cancer patients, and it can have a positive effect on the body's immune system. Research increasingly supports the idea that emotional and physical health are very closely linked and that therapy can improve a person's overall health status.

There is convincing evidence that most people who have at least several sessions of therapy are far better off than untreated individuals with emotional difficulties. One major study showed that 50 percent of patients noticeably improved after eight sessions while 75 percent of individuals in therapy improved by the end of six months. Psychotherapy with children is similar in effectiveness to therapy with adults.

How do I find a qualified psychologist for therapy?

Selecting a psychologist is a highly personal matter. A psychologist who works very well with one individual may not be a good choice for another person. There are several ways to get referrals to qualified psychologists, including the following:

  • Talk to close family members and friends for their recommendations, especially if they have had a good experience with therapy. 

  • Many state psychological associations operate referral services which put individuals in touch with licensed and competent mental health providers.

  • Ask your primary care physician (or other health professional) for a referral. Tell the doctor what's important to you in choosing a psychologist so he or she can make appropriate suggestions.

  • Inquire at your place of worship.

  • Look in the phone book or the internet for the listing of a local mental health association or community mental health center and check these sources for possible referrals.

  • Use APA's Psychologist Locator service.

Ideally, you will end up with more than one lead. Call and request the opportunity, either by phone or in person, to ask the psychologist some questions. You might want to inquire about his or her licensure and level of training, approach to therapy, participation in insurance plans and fees. Such a discussion should help you sort through your options and choose someone with whom you believe you might interact well.

If I begin therapy, how should I try to gain the most from it?

There are many approaches to outpatient therapy and various formats in which it may occur, including individual, group and family therapy. Despite the variations, all therapy is a two-way process that works especially well when patients and their psychologists communicate openly. Research has shown that the outcome of therapy is improved when the psychologist and patient agree early about what the major problems are and how therapy can help.

You and your psychologist both have responsibilities in establishing and maintaining a good working relationship. Be clear with your psychologist about your expectations and share any concerns that may arise. Therapy works best when you attend all scheduled sessions and give some forethought to what you want to discuss during each one.

How can I evaluate whether therapy is working well?

As you begin therapy, you should establish clear goals with your psychologist. Perhaps you want to overcome feelings of hopelessness associated with depression. Or maybe you would like to control a fear that disrupts your daily life. Keep in mind that certain tasks require more time to accomplish than others.

After a few sessions, it's a good sign if you feel the experience is truly a joint effort and that you and the therapist enjoy a good rapport. On the other hand, you should be open with your psychologist if you find yourself feeling "stuck" or lacking direction once you've been in therapy awhile.

There may be times when a psychologist appears cold and uninterested or doesn't seem to regard you positively. Tell your psychologist if this is the situation, or if you question other aspects of his or her approach. If you find yourself thinking about discontinuing therapy, talk with your psychologist. It might be helpful to consult another professional, provided you let your therapist know you are seeking a second opinion.

Patients often feel a wide range of emotions during therapy. Some qualms about therapy that people may have result from the difficulty of discussing painful and troubling experiences. When this happens, it can actually be a positive sign indicating that you are starting to explore your thoughts and behaviors.

You should spend time with your psychologist periodically reviewing your progress (or your concern that you are not making sufficient headway). Although there are other considerations affecting the duration of therapy, success in reaching your primary goals should be a major factor in deciding when your therapy should end.

Therapy isn't easy, but patients who are willing to work in close partnership with their psychologist often find relief from their emotional distress and begin to lead more productive and fulfilling lives.