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Psychotherapy in the united states


NIMH » Psychotherapies

Overview

Psychotherapy (sometimes called “talk therapy”) is a term for a variety of treatment techniques that aim to help a person identify and change troubling emotions, thoughts, and behavior. Most psychotherapy takes place with a licensed, trained mental health professional and a patient meeting one-on-one or with other patients in a group setting.

You might seek out psychotherapy for different reasons including:

  • You might be dealing with severe or long-term stress from a job or family situation, the loss of a loved one, or relationship or family issues.
  • You might have symptoms with no physical explanation: changes in sleep or appetite, low energy, a lack of interest or pleasure in activities that you once enjoyed, persistent irritability, worry, or a sense of discouragement or hopelessness that won’t go away.
  • A health care provider may suspect or have diagnosed depression, anxiety, bipolar disorder, post-traumatic stress disorder, or other conditions or symptoms that may be interfering with your life, and recommended psychotherapy as a first treatment or to go along with medication.
  • You may be seeking treatment for a family member or child who has been diagnosed with a condition affecting mental health and for whom a health care provider has recommended treatment.

An exam by a health care provider can ensure there is nothing in your or your loved one’s overall health that would explain symptoms. This step is important because sometimes symptoms like a change in mood or trouble concentrating can be due to medical conditions.

Psychotherapies and Other Treatment Options

Psychotherapy can be an alternative to medication or can be used with other treatment options, such as medications. Choosing the right treatment plan should be based on a person's individual needs and medical situation and under a mental health professional’s care.

Even when medications relieve symptoms, psychotherapy and other interventions can help a person address specific issues. These might include self-defeating ways of thinking, fears, problems interacting with other people, or dealing with situations at home, school, or work.

Elements of Psychotherapy

A variety of different types of psychotherapies and interventions have been shown to be effective for specific disorders. For example, the treatment approach for someone who has obsessive-compulsive disorder is different for someone who has bipolar disorder. Therapists may use one primary approach or incorporate other elements depending on their training, the condition being treated, and the needs of the person receiving treatment.

Elements of psychotherapies may include:

  • Helping a person become aware of ways of thinking that may be automatic but are inaccurate and harmful (for example, someone who has a low opinion of their abilities). The therapist helps the person find ways to question these thoughts, understand how they affect emotions and behavior, and change self-defeating patterns. This approach is central to a type of psychotherapy called cognitive behavioral therapy (CBT).
  • Identifying ways to cope with stress and developing specific problem-solving strategies.
  • Examining a person’s interactions with others and offering guidance with social and communication skills.
  • Mindfulness and relaxation techniques, such as meditation and breathing exercises.
  • Exposure therapy for people with anxiety disorders. In exposure therapy, a type of CBT, a person spends brief periods in a supportive environment, learning to tolerate the distress caused by certain items, ideas, or imagined scenes cause. Over time, the fear associated with these things may dissipate.
  • Tracking emotions and behaviors to raise awareness and the impact of each on the other.
  • Supportive counseling to help a person explore troubling issues and provide emotional support.
  • Creating a safety plan to help someone who has thoughts of self-harm or suicide recognize warning signs and use coping strategies such as contacting friends, family, or emergency personnel.

Note that there are many different types of psychotherapy. Other therapies are often variations on an established approach, such as CBT. There is no formal approval process for psychotherapies like there is for the use of medications from the Food and Drug Administration.

However, for many therapies, research involving large numbers of patients has provided evidence that treatment is effective for specific disorders. These "evidence-based therapies" have been shown in research to reduce symptoms of depression, anxiety, and other disorders. NIMH's health topic pages about specific disorders list some of the evidence-based therapies for those disorders. 

What to Consider When Looking for a Therapist

Therapists have different professional backgrounds and specialties. See below for information that can help you find out about the different credentials of therapists and resources for locating therapists.

The approach a therapist uses depends on the condition being treated and the training and experience of the therapist. Also, therapists may combine and adapt elements of different approaches.

Once you’ve identified one or more possible therapists, a preliminary conversation with a therapist can help you understand how treatment will proceed and whether you feel comfortable with the therapist. Rapport and trust are important. Discussions in therapy are deeply personal, and it’s important that you feel comfortable with the therapist and have confidence in their expertise. These preliminary conversations may happen in person, by phone, or virtually. Consider trying to get answers to the following questions:

  • What are the credentials and experience of the therapist? Do they have a specialty?
  • What approach will the therapist take to help you? Do they practice a particular type of therapy? What is the rationale for the therapy and its evidence base?
  • Does the therapist have experience in diagnosing and treating the age group (for example, a child) and the specific condition for which treatment is being sought? If a child is the patient, how will parents be involved in treatment?
  • What are the goals of therapy? Does the therapist recommend a specific timeframe or number of sessions? How will progress be assessed, and what happens if you (or the therapist) feel you aren't starting to feel better?
  • Are medications an option? Is this therapist able to prescribe medications?
  • Are the meetings confidential? How is confidentiality assured? Are there limits to confidentiality?

Finding a Therapist

Many different types of professionals offer psychotherapy. Examples include psychiatrists, psychologists, social workers, counselors, and psychiatric nurses. Information on the credentials of providers is available from the National Alliance on Mental Illness. In addition, you can find resources to help find a therapist on the NIMH's Help for Mental Illnesses webpage.

Your health insurance provider may have a list of mental health professionals who participate in your plan. Other resources on the Help for Mental Illnesses webpage can help you look for reduced-cost health services. When talking with a prospective therapist, ask about treatment fees, whether the therapist participates in insurance plans, and whether there is a sliding scale for fees according to income.

The following professional organizations have directories or locators on their websites for mental health care professionals:

  • Academy of Cognitive Therapy
  • Association for Behavioral and Cognitive Therapies
  • American Academy of Child & Adolescent Psychiatry
  • American Association Board of Clinical Social Work
  • American Association for Geriatric Psychiatry
  • American Association for Marriage and Family Therapy
  • American Board of Professional Psychology
  • American Psychiatric Association
  • American Psychological Association
  • National Association of Social Workers
  • National Register of Health Service Psychologists
  • Society of Clinical Psychology
  • Psychology Today

National advocacy organizations have information on finding a mental health professional, and some have practitioner locators on their websites. Examples include:

  • Anxiety and Depression Association of America 
  • Attention Deficit Disorder Association
  • Children and Adults with Attention Deficit Hyperactivity Disorder
  • Depression and Bipolar Support Alliance 
  • International OCD Foundation
  • Mental Health America 
  • National Alliance on Mental Illness 

Note: NIMH does not evaluate the professional qualifications and competence of individual practitioners listed on these websites. These resources are provided for informational purposes only. These are not comprehensive lists and do not constitute an endorsement by NIMH, the National Institutes of Health, the U.S. Department of Health and Human Services, or the U.S. government.

University or medical school-affiliated programs may offer treatment options, including training clinics. Search on the website of local university health centers for their psychiatry or psychology departments. You can also go to your state or county government website and search for the health department for information on mental health-related programs within your state.

The goal of therapy is to gain relief from symptoms, maintain and/or improve daily functioning, and improve quality of life. If you have been in therapy for what feels like a reasonable amount of time and feel you are not getting better, talk to your therapist or look into other mental health professionals or approaches.

Digital Health Options

The telephone, internet, and mobile devices have created new opportunities to provide more readily available and accessible interventions, including in areas where mental health professionals may not be physically available. Some of these approaches involve a therapist providing help at a distance. Still, others—such as web-based programs and mobile apps—are designed to provide immediate information and feedback in the absence of a therapist. For an overview, see NIMH's Technology and the Future of Mental Health Treatment webpage.

Learn More

Free Fact Sheets

  • Children and Mental Health: Is This Just a Stage? This fact sheet presents information on children’s mental health including assessing your child’s behavior, when to seek help, first steps for parents, treatment options, and factors to consider when choosing a mental health professional. Also available en español.
  • My Mental Health: Do I Need Help? This fact sheet presents information about how to assess your mental health and determine if you need help. It provides examples of mild and severe symptoms and self-care activities, and options for professional help. Also available en español.
  • Taking Control of Your Mental Health: Tips for Talking With Your Health Care Provider: This fact sheet provides five tips to help prepare and guide you on talking to your health care provider about your mental health and getting the most out of your visit. Also available en español.
  • What is Telemental Health? This fact sheet provides information about telemental health services including potential benefits and drawbacks of this kind of care and factors to consider when looking for a provider.

Federal Resources

  • Agency for Healthcare Research and Quality: This agency offers resources and information about health care, including information on effectiveness research.
  • Behavioral Health Treatments and Services: The Substance Abuse and Mental Health Services Administration (SAMHSA) provides information about treatment options and links to treatment service locators.
  • National Library of Medicine's PubMed: To read in-depth research on therapies for mental health disorders, use the PubMed database of medical literature to search for articles by topic.

Health Hotlines

  • 988 Suicide & Crisis Lifeline: The Lifeline provides free and confidential emotional support to people in suicidal crisis or emotional distress 24 hours a day, 7 days a week, across the United States. Call or text 988 to connect with a trained crisis counselor. Support is also available via live chat at 988lifeline.org. Para ayuda en español, llame al 988.
  • Disaster Distress Hotline: People affected by any disaster or tragedy can call this helpline, sponsored by SAMHSA, to receive immediate counseling. Call or text 1-800-985-5990 to connect with a trained professional from the closest crisis counseling center within the network.
  • Veterans Crisis Line: This helpline is a free, confidential resource for Veterans of all ages and circumstances. Call 1-800-273-8255, press "1"; text 838255; or chat online to connect with 24/7 support.
  • Crisis Text Line: Text HELLO to 741741 for free and confidential support 24 hours a day throughout the U.S.
  • More NIH Information Lines

Last Reviewed: June 2021

Unless otherwise specified, NIMH information and publications are in the public domain and available for use free of charge. Citation of NIMH is appreciated. Please see our Citing NIMH Information and Publications page for more information.

Your Guide to Starting Psychological Therapy in the USA

By: Dita Margarita

There are over 500,000 psychological therapy professionals working in the United States today.

So how can you know that the therapist you are considering working with is a good one?

[Live in Britain? Read our piece on “Finding a Good Therapist in the UK“.]

What is a ‘good’ therapist?

It does depend on what you, personally, are looking for from therapy.

But in general, the elements that make up a good therapist include:

  • they have suitable training
  • they are registered with the appropriate licensing boards
  • they are using ethical standards in their work with clients
  • the type of therapy they offer suits your issues
  • there is rapport between you
  • you feel you can grow to trust them.

There is not one element in the above list that is necessarily more important than the other – don’t, for example, assume training is everything.

Although training is obviously important, the therapist with more degrees than any others will be useless to you if the two of you can’t get along. Therapy is at heart a relationship between you and your therapist.

Other things to consider when starting psychological therapy

We all are unique, and we all have our own priorities.

Remember, a good therapist is one that works for you, and that you feel able to openly explore your life and hopes with. So other things you might want to consider can be if:

  • they come from the same or similar race/ religion/ background to you
  • they experienced similar life experiences
  • they are covered by your insurance
  • they are a gender you are comfortable with
  • you can afford their fees.

The different types of licensed therapists in America

By: JD Hancock

It is entirely possible for a person to be a very helpful counsellor and not be registered (some people, for example, find their church counsellor very helpful). But it is generally deemed safer to work long-term with a psychological therapist who is licensed.

Licensing means a therapist is legally able to use a certain title. The requirements to have a license to offer psychological therapy can vary from state to state, but –

in general, licensed therapists in America are called: psychiatrists, clinical psychologists, counselors, and clinical social workers.

Do not be afraid to ask a therapist directly and clearly about their licensing and training. Remember, you are the one hiring and paying them. You have the right to ask whatever questions you deem necessary.

If you are worried about your therapist’s certification, contact the licensing board of your state and verify if your therapist is indeed listed.

Differences in Training of Each Type of Therapist

Each pathway into being a therapist will have certain educational and training requirements, which can vary slightly by state. But they are generally as follows:

Psychiatrist

After obtaining a medical degree of at least four years, a psychiatrist has finished a residency (another four years) that included psychiatric work. He or she has then passed various exams.

They are given general training in all major talk therapies, and they are the only type of therapist that can prescribe medication.

Doctor of Psychology (PsyD), Ph.D. in Psychology

By: Internet Archive Book Images

This means a therapist has finished the highest level of training possible in psychology, usually taking between four and seven years.They then spent years in supervised clinical training and passed many exams.

A PsyD can open their own private therapy practice (you must have a doctorate to do so in America) although some prefer to just work with clients without opening a practice.

The difference between a Ph.D and PSyD is that Ph.D’s usually work in research over with clients, although they too are eligible to open their own private practice.

Licensed Counsellor

Licensed Professional Counsellor (LPC), Mental Health Counsellor (LMHC or MHC), or Licensed Clinical Professional Counsellor (LCPC)

A bachelor’s degree in any subject followed by a master’s degree in counselling (another two years minimum) is the standard in America. A licensed counsellor will also have two years of full-time work under their belt, and have passed a certification exam. They tend to work in clinics, hospitals, courts, and with individuals.

Licensed Family and Marriage Therapists (LMFT)

They will have completed both a master’s degree and an internship placement. And as the name says, they focus on your marriage and your family life.

Social Workers

Licensed Master Social Worker (LMSW), Licensed Clinical Social Worker (LCSW), or Licensed Independent Clinical Social Worker (LICSW), LCSW-R.

Some social workers just take a four-year bachelor’s degree before entering an internship or entry level position in social work.

But to be licensed, they generally have to go on to finish a master’s in social work. After they finish their master’s they will also do a minimum of two years supervised clinical work as well as take a licensing exam.

They work with individuals, couples, and families and are interested in helping others with psychological wellbeing and relationships. They tend to be more affordable than other kinds of therapists. You’ll often find social workers in offices, schools and group settings like rehab centres.

LCSW-Rs have six or more years of experience, and are eligible to be covered by insurance plans.

Licensed Addiction Counsellor (LAC)

They aren’t actually considered ‘therapists’ in America, but they often work alongside others who are therapists. They have usually attained at least a bachelor’s degree, followed by at least a year of training in addictions counselling.

Licensed Creative Arts Therapists (LCAT)

They have taken a master’s degree in art, music, or dance therapy, and have passed the necessary training and exams to be licensed.

Is the therapist really trained in the sort of therapy you want to try?

It’s perfectly legal for a therapist to integrate different types of therapy without necessarily being fully certified in that type.

For example, a psychotherapist who did all their training in a psychodynamic school could integrate elements of CBT therapy without needing a CBT certification to do so.

They might be reasonably proficient in the other type of therapy.

But what this means that if you are interested in a particular type of therapy, you might want to ask if they are actually certified in it, and not just drawing from it.

The Personal Skills that are as Important as Qualifications

The right title alone does not a good therapist make. So what is required then?

A good therapist must have important personal skills that include advanced listening, ethical boundaries, and unconditional positive regard.

Learn all about the personal skills required in a good therapist by signing up to our blog now so you’ll know when we post our connected piece, “The Personal Skills to Look For in a Therapist”.

Have a question about finding a good therapist we didn’t answer? Ask in the public comment box below.

If you need the help of a psychologist in the USA: what you need to know

Why do we need psychotherapists and psychologists? What you need to know if you need the help of a psychologist in the USA. Qualification of doctors, prices and general questions. We analyze in this article.

Psychology is being popularized as much as possible in the USA. If somewhere depression is seen as failure and weakness, then in America psychologists work great with it. Therefore, turning to a psychologist in the United States does not mean admitting that you are sick. nine0009

It is customary in America to address a psychologist with any "sneeze". The child at school does not show interest in the subject - he is sent to the school counselor. The couple cannot make any decision - they go to family therapy.

In 2020, the number of visits to psychologists in the United States increased by 20%. For the year, more than $ 230 billion has already been spent on the treatment of depression in America. By the way, in Russia, about $290 billion is spent on the entire Compulsory Medical Insurance Fund. The number of complaints of depression in America is steadily increasing year by year. And the problem of depression is becoming “younger” – because more and more often teenagers turn to psychologists. nine0009

Specialist level

The profession of psychologist is very in demand in the American labor market, but you should not be afraid of bad specialists. Becoming a psychologist in the United States is quite difficult and very expensive. It is almost the same as the training of doctors. You can't become a psychologist in the US just by getting a bachelor's degree. Even with a master's degree, you can get a maximum job as a psychologist's assistant.

An American psychologist is a research scientist who holds a doctorate in either philosophy (Ph.D.) or psychology (Psy.D). If translated into the Russian system, only a candidate of sciences can work as a psychologist. In addition to a degree, a psychologist must have a couple of years of work experience. For example, to work as a psychotherapist, you need to spend 8 to 10 years on preparation. nine0009

25% of psychologists in the US work in their own private clinics. 10% of psychologists work in state institutions (hospitals, schools, social support institutions, prisons, etc.). The rest work in private medical clinics, nursing homes, medical offices, family support services. As well as in university departments and laboratories. Most psychologists are consultants. Consultant psychologists have at least a master's degree and a year of practice as an assistant. nine0009

Profiles of counseling psychologists:
  • School counseling psychologists
    They test the abilities, interests, talents and personal characteristics of schoolchildren. They also organize career guidance sessions and interact with teachers to overcome learning difficulties.
  • Rehabilitation consultants work with people with disabilities to integrate them into society. They also have the functions of overcoming social and psychological problems. nine0035
  • Mental Health Counselors care for patients with drug, alcohol and other addictions.
  • Family counselors - use psychotherapeutic methods to resolve family conflicts. And also the right interaction in the family, understanding and acceptance of each other.
  • Gerontological consultants for helping the elderly. Mainly in the awareness and acceptance of a new way of life, where there is a place for age-related diseases. As well as difficulties with the lack of professional activity and self-realization. nine0035

The work of a psychologist in the US is focused on the mental health of a person, so services are usually included in health insurance . When purchasing an insurance package, you need to study which specialists are included and which are not.

How much do psychologists cost?

An appointment with a psychologist costs between $20 and $250 per hour. Its cost depends on the insurance and the clinic.

Cheaper solution - group therapy, couples therapy, and anger management - up to $100 per session. Family therapy, individual, cognitive-behavioral (behavioral), work with depression, etc. - from $ 70 per session. nine0009

The cost of the service (if it is not included in the insurance) is determined by the qualification of the specialist. If the appointment of a counseling psychologist (counselor) usually costs from 20 to 150 dollars, then a session of a psychiatrist is more expensive - up to 200 dollars. Unlike a counseling psychologist, a psychiatrist can write a prescription for a drug at a pharmacy.

The most expensive are psychotherapists, as their services cost up to 300 per session. As a rule, therapy involves numerous sessions over a long period of time. nine0009

Free psychological help

Psychological services can be free of charge, such as in clinics. Students often consult under the supervision of a licensed psychologist.

Another popular way to get psychological help in America for free is through support groups. People come to class with similar problems.

Crisis and suicide prevention hotlines are also free. This is especially important in crisis situations when a person has experienced some kind of trauma (violence, loss of a loved one). Or if you have thoughts of suicide, you can call the hotline and talk to a professional psychologist. If the immigrant does not speak English, then an interpreter is provided. nine0009

Modern mental health tools include smartphone apps like Talkspace.

Services of psychologists of various categories are available to every resident of the United States, often included in insurance. Therefore, they are not afraid of them, and they consider the help of a psychologist in the USA as an opportunity for further personal development.

Why everyone in the USA goes to psychotherapists – and we need to (says a Belarusian from America)

Evgeny Kamenko, a Minsk resident, has been living and working in California for about half a year. He works diligently and diligently, and sometimes goes to his doctor Russell, whose psychological pain prompted the Belarusian to write this text. nine0008

HOW I MET THE NOISE CONTROL OFFICER

– At 5:00 am on a Saturday in the parking lot of the cleaners' office next door, a generator blared. Shouted with taste. Began to terrorize a residential building. I had to tear my eyes and google a potential solution to the problem.

Noise control officer - this is an official position in the city administration - was surprisingly prompt in response. After the officer, the administration of my residential complex began to stir. The company that manages the office building across the street was equally enthusiastic. nine0009

The general answer of all comrades came down to one thing: “Dear, sorry, sorry. We are put here so that nothing affects the quality of your life in our city. We will stop the work of the generator in the future and end your suffering.”

In the USA, the quality of life is primarily psychological comfort. The boundaries of the vast inner world of an individual little person are protected here. Especially when it comes to the intervention of other people.

But one thing is external stimuli, and another is your own problems in the head, which can suddenly cover everyone, always and everywhere. nine0009

HOW SMALL TALK HELPS YOUR PSYCHE

I sit on the medical center couch and dangle my leg. I'm waiting for my GP, Dr. Russell, to prescribe fish oil for my cholesterol. At the same time, I fill out standard patient questionnaires. The first step is a psychological questionnaire.

Do you have trouble sleeping? Thoughts of suicide? Decline in mood, impotence and lethargy? The questionnaire is as simple as a baby's smile. On the questionnaire there is a copyright icon and the names of some respected people in the world of psychiatry. All this makes me laugh culturally: in what other reality can cholesterol meet with suicide? nine0009

When asked why the hell, the smiling Dr. Russell will answer: “Everyone always suffers. This is fine".

Suffering is the same convention of our boring life as rain or credit rates. Dr. Russell, always cheerful and talkative, also suffers. Almost every reception he pours into my ears a story about his hard days in the vegan sect. On the one hand, the doctor's suffering is the cruel attitude of man towards innocent animals. On the other hand, a voluminous menu in a Brazilian steakhouse that muffles the pain. nine0009

Dr. Russell tried to become a pescatarian, but it didn't work out. And once a month, secretly from his friends, he sprinkles pepper on a fried steak, and then suffers. I bleat something in the style of "one time not a meat eater", and the doctor smiles.

This whole story is a kind of small talk, the most popular colloquial genre in the States. A little fun while the nurse is typing data into the computer. While the barista pours coffee. As the bus pulls up to the stop. While a passer-by at the crossroads is picking at the homeless dog. It's a nice jumble of words. Momentary and non-binding social interaction of people. nine0009

Most likely, Dr. Russell's suffering is much wider than going to a steakhouse, but he certainly won't discuss it with me. Personal trauma in America is taken outside of conversation. American citizens experience their emotional crises in partnership with a doctor - a specially trained brainwashing specialist. Mental anguish is outsourced to professionals.

DO AMERICANS REALLY LIE ON PSYCHOTHERAPIST'S COUCHES?

Couch beds in the psychotherapist's office, known from American cinema, are not part of the comic plot. This is a routine that Americans enjoy with great pleasure. After all, who else can tell about the sore and find the root of the problem, if it is not customary to discuss such issues with friends? nine0009

The same Dr. Russell, in case of emergency, has an hour scheduled when he will sit on the couch and throw out to his psychotherapist a stream of accumulated - sometimes belated - emotions. But the rest of the time he will continue to sincerely smile at people, managing not to strain anyone.

In the meantime, it can cover anyone and at the most inopportune moment. In 2015, when the Crimean sanctions shook our eastern neighbors and kicked our vessel of stability like a ricochet, a psychotherapist I knew, a man with regalia and a luminary in general, complained that the stream had noticeably become impoverished. The crisis changed lives. Businessmen were drowning in problems, and there was no time for healing therapy. Moscow elite prostitutes especially reduced their visits - they had rates in Russian rubles and hopelessness. nine0009

But there was still a queue for his comfortable bed in the paid psychotherapy room. There was an idyllic atmosphere of crumpled hope in the queue. Those standing there were able to realize that the problems are not in the dollar, the boss, the weather, but have long been in the head. The brain reacted, as it often happens, the last. That is, he switched off and made me look for help, which we are not particularly used to looking for.

HOW PSYCHOTHERAPY REALLY WORKS IN THE USA

We are culturally entwined with sarcasm about empty talkers and the fear that behavioral problems are psychiatry to run after when the roof is gone. In this case, it’s better to bashfully go through problems alone and think that the principle of “help yourself” will work this time as well. Or invite friends to solve the issue. nine0009

An important principle of the post-collective Belarusian reality is to share suffering with one's neighbor. Find a loyal audience for your drama. Friends, of course, will show sympathy at first, but after a while they will give up. Everyone suffers - why the hell do others have a bunch of your problems, and your sour mine?

In the US, psychological help is included in the standard medical kit. Americans run to psychotherapists like vacationers run to the beach at a seaside resort. That is, with joy and in happy anticipation. nine0009

The same Dr. Russell, during a routine examination, can stop a critical condition, and most importantly, get rid of idiocy. What we call "crazy". The critical state is the desire to lay hands on oneself. Going crazy is, for example, arguing with your wife on your nerves, picking up a package of accumulated capital in hysterics, leaving for the station, drinking yourself unconscious with mysterious strangers, losing money, and then appearing in all national media asking for help in finding the lost family assets. The first causes fear in us, the second - laughter. In the US, both are phenomena of the same order. Both seriously affect the quality of life and require assistance. nine0009

The task of the therapist is to look at and help the person realize problems that they might not have thought about. Local doctors consider psychological suffering akin to a cold. This phenomenon is temporary, easily corrected (albeit for a long time), and a person returns to a comfortable life more imperceptibly than a cough is treated.

It is the therapist who prescribes drugs and does so with great enthusiasm. According to statistics, 1 in 6 Americans is on antidepressants and throws pills like Tic-Tacs. nine0009

After prescribing pills, an adviser is connected. The counselor talks to the person about problems in therapy sessions and helps to cope with situational crises when the disorder is caused by some kind of life trouble. Psychiatrists come only in clinical cases, when talking no longer helps.

DOES IT REALLY HELP THEM?

Depending on which side to look at. If from the side of various organizations, then very much. In addition to official visits to the doctor, there are a large number of clubs - anonymous alcoholics, former drug addicts, single women or men, gays, immigrants, where all members support each other in difficult life situations. They will not give you a pill, but they will help you cope with the fear of communication during the struggle with yourself. nine0009

But when viewed from the Coronado Bridge, everything is relative. The bridge connects the peninsula of the same name with the center of San Diego. The peninsula has a lively resort town, expensive hotels, beautiful beaches and a large military base. The bridge is one of the two roads to the peninsula, the shortest. Since 1969, the Coronado Bridge has been not only a symbol of the city's skyline, but also of death.

Regularly once a month, some desperate person jumps down from the bridge to drown his life and his sorrows in the waters of the bay. Automobile bridge. There is no sidewalk and no railings. People who have made up their minds do not have the opportunity to take a walk for the last few minutes, hold on to the fence, and talk to the promptly called psychologists. Their fate is to slow down in the lane, open the car door and fly into oblivion. nine0009

Together with their brakes, life slows down in the city. The bridge is closed to traffic. Parents cannot pick up their children from school. Employees of the military base can not get to the place of duty. The ambulances are on their way. A personal tragedy becomes socially dangerous.

In the district library, the local Caltrans (California's equivalent of Minsktrans) is holding an exhibition of restrictive structures, because cheap plates with emergency numbers do nothing to improve the situation. Citizens look at the experience of San Francisco, Melbourne and other cities, read reports on the effectiveness of such measures, vote and hope to solve the jumping problem forever. By the way, it would be nice to offer this practice to our dispensaries. Probably, everyone who happened to be there for personal reasons left these places with one desire. Rather lay hands on yourself. And vodka. nine0009

How everyone wants to solve their problems is a personal matter. But one personal in the US should not interfere with another. And the local system of psychological assistance helps to return a healthy person to normal social relations with other people.

Naturally, not everything is perfect in the USA. Suicides kill themselves. Seething emotions kill other people if a weapon suddenly appears in their hands. Some categories of citizens refuse medical care, and then in transport they talk to themselves with enthusiasm. nine0009

Dr. Russell notices the question hanging in the air: “You came running to treat cholesterol. For us, it is no different from depression. Both of these are easy to fix. But it's important to want it."

Dr. Russell smiles. I'm smiling. Most Americans want. All pis.

Reprint of CityDog.

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