September is “Suicide Prevention Awareness Month,” as well as “National Self-Care Awareness Month.” One of the most important aspects of taking care of yourself is to engage in mental health care. Negative attributes and negative connotations have been put forth by family, friends, and others when it comes to mental and emotional health. Far too many of you attribute the term ‘mental’ or ‘emotional’ to one being ‘crazy’ or ‘postal.’ These terms are misconceptions, harsh, stereotypical, and they often hinder those in need of mental and emotional health treatment from seeking treatment.
Mental health disorders are associated with disorders of the mind, cognitive functioning, rationality, and all things related to the brain. Your mental health includes and encompasses your emotional health, your psychological health, your spiritual, and your social health. They are all interconnected and interrelated. Like your physical health, you should also engage in mental health checkups and treatment. Psychotherapy treatment for mental health disorders is for everyday people who have difficulty in dealing with everyday life challenges. Sometimes these challenges affect the quality of one’s mental and emotional state.
Psychotherapy sessions can help with the challenges of mental health disorders once properly diagnosed by a licensed mental health professional. There are times that psychotherapy treatment is not enough. Psychotherapy treatment in conjunction with medication maintenance with a licensed medical professional who can prescribe psychotropic medications might be necessary. This dual level of treatment is very important and effective for persons with severe, chronic, and acute mental health disorders. It is especially crucial in the treatment of suicidal individuals.
It is important that when an individual is suicidal, with a plan, that immediate treatment is rendered. Family members and friends are cautioned to not try to diagnose or treat a loved one exhibiting severe or acute mental health disorders. Getting that person to the nearest emergency room is essential for their safety, the safety of others, as well as for their life. Recent events regarding family members and friends calling law officials such as police officers to help with their loved ones having mental health episodes has brought about much mistrust. Sadly, not enough police officers have been trained in handling persons with mental health disorders, often resulting in the death of the person in need of treatment. I commend those law enforcement departments that have trained mental health teams working with them to combat the possibility of a mental health call being mishandled.
Prevention and early intervention are always the best approaches for effectively dealing with mental health disorders. Once there are signs of possible mental health disorders, it is in the best interest of the individual to seek or receive help in receiving a mental health diagnosis and mental health treatment. And if necessary and if accepted, it can be helpful for a family member to attend the first psychotherapy session with their loved one. The first psychotherapy session can be filled with concern, anxiety, and uncertainty. Having a family member or close friend can be an act of support.
As with any relationship, the way the psychotherapist starts the first session will determine the ebbs and flows of the succeeding sessions. As a matter of fact, the first psychotherapy session is the platform for building the ensuing sessions if the client returns.
The first psychotherapy session is an engagement between the licensed mental health professional and the client (and possibly his/her, spouse, family member, friend, or significant other). The psychotherapy process begins with the client (or parent if a minor) making the initial telephone call to secure a psychotherapy appointment, either by phone or through a tele-mental health process. I personally speak with all potential clients to ascertain the reason for the call, the perceived reason for psychotherapy, and to ascertain therapist/client fit.
Once the appointment is scheduled the intake process begins. The client completes the “Confidential Client Intake Form,” as well as a signed “Client Fee Agreement,” prior to entering the treatment room. If the psychotherapy treatment is a tele-mental health session, forms will have been completed and returned to the psychotherapist, prior to the scheduled first psychotherapy appointment.
Once in the treatment room or on Zoom with the psychotherapist, the process involves clarification and verification of information included on the “Confidential Client Intake Form,” information gathering, including background information, as well as the reason for the visit, his/her view about psychotherapy, expectations, and how the client sees the ‘problem’ that called for him/her to make the visit. The first psychotherapy session is a time for the psychotherapist to bond with the client to foster trust and openness.
The psychotherapist is the expert and should be able to help the new client to get through the first session without fear and without trepidation. He/she is being paid to set the tone and to guide the process of the psychotherapy session for the client. My first psychotherapy session is ninety (90) minutes. I start with conversations regarding ‘how they are doing,’ including their thoughts and feelings. I then ask the question, ‘what’s going on,’ focusing on their nonverbal behaviors, feelings, thoughts, insights, as well as gains and/or losses in the here-and-now. I interweave their thoughts and feelings about pre-therapy experiences into the session. I use open-ended questions, humor, and I also focus on nonverbal communication presented by the client. Their moments of silence are brief and reflective. And if, on those rare occasions their moments of silence extend more than a couple of minutes, I inquire about their silence, focusing on their thoughts and feelings in the here-and-now, as well as the meaning of the silence.
The feelings of my clients are always worth discussing, especially during the first session. They are personal and are not often provided a true, uninterrupted, and honest opportunity to discuss their feelings without shame, guilt, or fear of a loss of confidentiality. Conversations about their children, grandchildren, as well as vacations, trips, and leisure activities are always great topics for discussion during the first and ensuing psychotherapy sessions…they are personal.
Clients should be allowed to ask the therapist about external and general topics that might be of common knowledge about the psychotherapist (school, work, favorite foods, favorite TV/radio shows), as opposed to asking personal, internal, and private topics (marital, sexual, family, financial). Topics that can cause either transference or counter transference are not great discussion topics between a therapist and his/her client. It is important that the psychotherapist set the tone, while setting boundaries with their clients for discussing his/her life. It is important that the psychotherapist shows humanness, a sense of humor, as well as compassion and positive regard for the client.
By the end of the ninety (90) minute first psychotherapy session and after completing a “Mental Status Exam” worksheet, the experienced psychotherapist should be able to develop a diagnosis based on the DSM-V (Diagnostic Criteria Manual). However, nothing is etched in stone. The psychotherapist is responsible for developing an effective treatment plan with the client for follow-up sessions as directed by the client’s diagnosis, and to make necessary referrals if warranted.
If you or a loved one need mental health treatment, please contact either of the following:
1. Mental Health Hotline--988
2. NAMI--800-950-6264
3. SAMHSA—800-662-4357
©2023; J. Morley Productions, Inc.; P.O. Box 1745; Decatur, GA 30031; 770-808-6570; www.doctorjoyce.com
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