When an issue or symptom is causing you distress or begins to interfere with school, work, relationships or other daily activities, it may be time to seek professional help.
Mental health services vary widely by type and by levels of other supportive services (medical or psychiatric) that are offered concurrently. Where you get treatment and the additional support services you receive will depend on your current needs.
Most often, people can get the support they need through counseling. Your counselor may include others in the treatment process through family, couples or group counseling. They may also recommend other services for you, like medication, medical support, or to connect with others in recovery through a peer support group.
Treatment most often begins with a counselor or doctor asking you about your concerns and symptoms and then making a recommendation for you based on your current needs. The goals that you express to your counselor are important to help ensure that treatment fully addresses your needs.
Your first appointment is called an intake session. During this first session, your counselor will ask you questions about the problems or experiences that are bothering you. The more honest you are in talking about your experiences, the better your counselor will be able to understand your current needs and make a plan for treatment.
Your counselor’s assessment often includes questions about your symptoms – such as excessive worry, sadness, or your use of alcohol and drugs, and relationship concerns. For children, assessments often include questions about development, how your child manages change, parenting strategies that work well and those that don’t. They will also ask about a history of mental health problems in your family, your physical health, the people who support you, and where you live and work.
An assessment is completed the initial phase of treatment where your counselor or doctor asks questions about your problems or concerns. You should be as honest as you can when answering questions and discuss your concerns or preferences about treatment. You should also feel free to ask questions about the assessment or treatment process.
Your counselor will use this assessment to help identify a diagnosis. Like a medical diagnosis, a mental health diagnosis is a way to describe your symptoms and identify the kinds of treatment that will likely be the most helpful for you. Diagnoses are also used to bill insurance companies. An accurate diagnosis may help you to make sense of the symptoms you have been experiencing, and you are free to ask your counselor any questions you may have about the diagnosis.
Diagnosis of a mental health concern, like a medical diagnosis, identifies and describes characteristics of your symptoms. An accurate diagnosis may help you to make sense of your experiences, by helping to explain certain symptoms. You are free to ask your counselor any questions you may have about your diagnosis.
In this first session, you will also be asked to sign different consent forms, including to consent for treatment. Some consent forms will give your counselor permission to contact your doctor or other health care providers. Your counselor will explain each of the consent forms, but you should feel free to ask any questions about what you are signing and what kind of information will be shared. Privacy laws under the Health Insurance Portability and Accountability Act (HIPAA) control the kind of health information that can be shared and who your counselor can talk with about your treatment.
The information you share during your counseling sessions is private and confidential. This means that the information cannot be shared without your permission or consent. Your counselor should take your confidentiality very seriously, however, there are some situations in which a counselor might be required by law to break confidentiality. For example, all counselors and doctors are required to report suspected child abuse or abuse of an older person. They are also required to take steps to keep you and others safe if you appear to be at risk to harm yourself or others.
During this first session, you may also be asked about your health insurance coverage and told what you should expect to pay for treatment. You are free to ask any questions you may have about the cost of treatment, and how much will be paid by your health insurance. Learn more about your rights related to insurance coverage for mental health treatment here.
Based on results from your assessment and identified diagnosis, your counselor will develop a treatment plan. Your treatment plan helps to set a direction for therapy, outlining what issues will be worked on during counseling and helping your counselor to assess progress.
Depending on your needs, your counselor may recommend group counseling, family counseling, or couples counseling. They may also refer you for medications to help with symptoms such as anxiety, depression, excessive substance use, craving, or withdrawal. A psychiatrist, doctor, or specially trained nurse must prescribe the medications – counselors and clinical social workers are not able to prescribe medications. If medications are recommended to you, the individual prescribing them will explain to you the risks and side effects that you might expect from medication and give you an opportunity to ask questions.
Your counselor and doctor will keep record of your treatment goals, content of each therapy session, and overall progress of counseling. These records are kept secure and confidential, but you have the right to request these records at any point during treatment.
Some people find treatment quickly helps them to stabilize the symptoms they are experiencing. For others, it may take much longer. This is similar to certain physical health problems – like heart conditions or diabetes – which require some people to continue seeing a counselor or doctor or be on medication throughout their lives. Other individuals may feel that they have made enough progress to not need to continue seeing a doctor or counselor after a few sessions. And others may continue to take medication but not continue in counseling. During therapy, you can talk with your counselor or doctor about what to expect based on the established treatment plan, and about any changes to your symptoms or goals for therapy that you experience.
It is important that you talk with your doctor or the person prescribing your medication before you stop taking it. In some cases, your doctor or prescriber will recommend that you reduce your medication slowly rather than all at once. Even if you continue taking medication without counseling for a long period of time, you will need to check in with your doctor or prescriber from time to time to ensure that the medication is still working as expected.
Ending counseling may feel like a big step. Your counselor will talk with you through this process, helping to manage the transition and making referrals to any other services that might be helpful for you.
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