Therapy 101 with Laura Green
Updated: Jun 4, 2020
Season 3: MENTAL HEALTH
Episode 3: Therapy 101 with Therapist Laura Green
Studio ATAO’s Community Skillshare is a virtual learning series that tackles specific, actionable and pertinent topics with subject matter experts. Each season (1-4 episodes) is centered on one main topic and is paired with a thorough resources document (such as this one) with additional information and relevant links. Community Skillshares take place on Studio ATAO’s IG Live and we will announce upcoming episodes via our Instagram.
This particular resources document was compiled by Studio ATAO’s core team for our Skillshare with Licensed Professional Mental Health Counselor Laura Green, MEd. Laura’s work is rooted in understanding and improving the mental health and wellbeing of individuals in the food and drinks industry, particularly through responsible education and thorough examination of the culture of the industry.
We hope Laura’s Skillshare Session and this resource document will be a useful guide for those interested in learning more about therapy and how it can help . Please feel free to share this resource widely with anyone who you think may need it.
This is a living, evolving document and is not exhaustive of all resources. If you have suggestions on how we can better improve this document, we would love to hear from you at firstname.lastname@example.org.
If you are enjoying the series and want to help support our team at Studio ATAO, you can become a monthly patron of ours at Patreon or send us a one-time gift via GiveLively. We sincerely thank you for your generosity and support.
Table of Contents
Video of Community Skillshare Episode 4
An Overview of Mental Health Therapy: What It Is, What Kinds of Therapist Are Available, What Styles of Therapy Exist
Establishing A Healthy Therapist / Client Relationship: What to Look For, Assessing In Session Dynamics, Understanding Client Rights
Getting Started On Your Mental Health Therapy Search
An Overview of Mental Health Therapy
What is mental health therapy?
What we usually refer to as “therapy” is also known as psychotherapy or “talk therapy”, where an individual, couple, or group meet with a licensed therapist to work through various issues they may be facing.
From the American Psychological Association:
“Grounded in dialogue, [psychotherapy] provides a supportive environment that allows you to talk openly with someone who’s objective, neutral and nonjudgmental. You and your psychologist will work together to identify and change the thought and behavior patterns that are keeping you from feeling your best.”
The main goals of therapy are to help you navigate through (and hopefully resolve) the problems that brought you into therapy while also developing positive coping techniques to help you address future issues that may arise.
How do I know if I should go to therapy?
Everyone goes to therapy for different reasons. You may be dealing with a specific issue, such as the passing of a loved one or divorce, or struggling with chronic issues such as depression or anxiety. From the American Psychological Association, therapy may be a good idea for you if you are experiencing the following:
You feel an overwhelming, prolonged sense of helplessness and sadness.
Your problems don't seem to get better despite your efforts and help from family and friends.
You find it difficult to concentrate on work assignments or to carry out other everyday activities.
You worry excessively, expect the worst or are constantly on edge.
Your actions, such as drinking too much alcohol, using drugs or being aggressive, are harming you or others.
If you are looking for professional support to face any issue big or small, therapy could be a good place to begin that journey.
What are the different types of therapists available?
There’s different types of therapists that operate under separate licenses and specialize in different styles of therapy. Every state has slightly different types of licenses, so it can be hard to pin down what exactly your therapist “should” have -- for example, Laura is an MEd (Masters of Education), but someone in a different state may receive an MS (Masters of Science) or MA (Masters of Arts) for the exact same course curriculum. An LPC (Licensed Professional Counselor) in Texas is equivalent to an LCPC (Licensed Clinical Professional Counselor) in Illinois, but that academic curriculum actually exceeds the qualifications and clinical training for a PhD in Counseling Psychology in the United Kingdom.
It’s difficult to generalize all of these terms effectively, but here’s some terminology to help familiarize you with different types of mental health practitioners and what they can (and cannot) provide you. Note that the term “counselor” and “therapist” are generally seen as interchangeable, though “counseling” can sometimes be used to refer to treatment of more acute issues while “therapy” is for broader, chronic issues.
Psychology: The science behind human thoughts, emotions and behavior.
Psychotherapist: An umbrella term for professionals with proper training to treat individuals using psychotherapy.
Psychologist: A practitioner who is trained in psychology, typically with a doctoral degree such as Ph.D, Psy.D, Ed.D. They can diagnose and treat various mental health disorders and provide psychological counseling, but cannot provide medication unless they specifically have a license to do so.
Clinical Psychologist: A specialized psychologist who is more likely to use more assessments and instruments within their treatment (e.g. personality tests), and experiment with new therapeutic techniques more so than counselors or clinical social workers.
Licensed Marriage & Family Therapist: A licensed therapist, typically with a LMFT (Licensed Marriage and Family Therapist) that specializes in common problems arising in families and married couples. They are able to diagnose various mental health disorders, provide psychological counseling (psychotherapy) but cannot provide medication.
Licensed Art Therapist: A specialty therapist who is typically licensed by the Art Therapy Credentials Board (ATCB); however some states do not license art therapy (California, for example, does not), so in these states art therapists may choose another therapist license such as LMFT (Licensed Marriage and Family Therapist). They are able to specifically provide art therapy.
Psychiatrist: A doctor of medicine (MD) or doctor of osteopathic medicine (DO) specializing in mental health. They are able to diagnose and treat mental health disorders, provide psychological counseling (psychotherapy) and prescribe medication.
Licensed Counselor: A licensed professional typically holding an LPC or LCPC degree (varying by state). They can diagnose mental health disorders, provide psychological counseling (psychotherapy), but cannot provide medication. (While they cannot prescribe medication, they will work with your prescribing doctor to monitor the results of medication.)
Social Worker: Social workers are governmental employees dedicated to helping people deal with difficult issues in their lives, which can include issues such as substance abuse, housing, unemployment and childcare.
Licensed Clinical Social Worker (LCSW): A licensed social worker who typically holds a Master’s degree in Social Work, who provides services to individuals who need mental therapy. They can diagnose mental health disorders, provide psychological counseling (psychotherapy), but cannot provide medication.
Note: While life & career coaches can be very helpful and working with one might provide benefits that feel therapeutic, they are not licensed mental health therapists and not substitutable for one. However, it is entirely appropriate to seek the help of both life coaches and mental health therapists simultaneously, if it makes sense for you.
What styles of therapy are available?
There are many types of therapy available, so it’s helpful to categorize them by their main point of focus. We’ve also included some of the more popular subsets of therapies below, but this is by no means comprehensive. While some therapists might utilize a single style of therapy in their practice, others might use a more eclectic approach and subscribe to two or more of these treatment styles (which are also referred to as “modalities”). Please see here for a fuller list from Psychology Today.
Psychoanalysis & Psychodynamic Therapy: Psychodynamic therapy, sometimes also referred to as “insight oriented therapy” focuses on understanding your unconscious thoughts and motivations and how they present in your behavior. Your therapist will help you become more self-aware of recurring patterns in your past, create space for self-examination and self-reflection, and learn better coping mechanisms for the present. In these therapy sessions, you’ll likely spend time digging into your past, as well as discussing fluid thoughts, dreams, fantasies to uncover patterns.
Relational & Interpersonal: Also referred to as relational-cultural therapy, this style of therapy focuses on developing mutually satisfying relationships with other people while understanding these relationships within the wider societal context of race, class, gender, socioeconomic standing, culture, etc. The therapist works with you to understand the interpersonal dynamics of your relationships, untangle the societal influences on those relationships, and examine the impact it has on your thinking and behavior.
Multicultural Therapy: Multicultural therapy specifically incorporates aspects of race, ethnicity, religion, gender identification, socioeconomic status, disability and other factors into your therapy sessions. This is especially pertinent for those who may identify as part of one or more marginalized groups. Therapists who practice this type of therapy emphasize individualism and have high levels of familiarity and competency addressing these aspects of identity that may be different from the majority.
Behavioral Therapies: Behavioral therapies are action-based therapies that focus on unlinking negative or problematic learned behaviors that arise due to being in difficult or challenging situations. (For example, you overindulge in alcohol when you are faced with certain stressors.) In this style of therapy, you’ll likely spend less time trying to understand your unconscious’ manifestations and instead discuss your learned patterns of emotional and physical behaviors to break that response chain to distress.
Cognitive Therapies: Cognitive therapies emphasize identifying and changing thought patterns of how we absorb, interpret, and react to the world around us. This style of therapy is similar to behavioral therapy in that it is attuned to problem-solving for the future; your therapist will help you better understand your thought process when responding to stressful or triggering events with the goal of changing where those thoughts lead and how we then respond to them with behavior.
Cognitive Behavioral Therapy (CBT): CBT focuses on identifying, then changing, your negative thoughts and subsequent behavioral patterns that arise in difficult situations. The goal of CBT is to help you understand your own autonomy over how you perceive the world and empower you to change your emotional & mental reaction, as well as your physical response to challenging or stressful interactions.
Mindfulness Based Cognitive Therapy (MBCT): MBCT uses mindfulness exercises such as meditation and breathing to address the link between how you are thinking and what you are feeling, specifically to break the chain of problematic feelings with harmful behavior.
Humanist Therapies: Humanist therapies focus on nurturing the individual’s view of themselves, learning self-acceptance, and using your own instincts to find self-fulfillment and develop healthy interpretations of the world around them. These therapy sessions will typically be less structured than those of psychodynamic, behavioral or cognitive and focus more on your current lived experiences and how you see yourself. You are able to shift the conversation in however way it feels natural, and the therapist will offer unconditional positive regard alongside you.
Narrative Therapy: Narrative therapy is an exercise in constant reframing of your life, past present and future. Your therapist will encourage you to tell stories (events) about your life, shifting the perspective so that what may have been traumatic could serve to be more useful instead while separating your identity from your problems. Your therapist will help you pinpoint stories from your life that have shaped your identity, build your confidence that you are the expert over your own life, and that you can define your path forward from the dreams, goals, skills you already possess, independent from your problems.
Art Therapy: In art therapy, the therapist guides you to express yourself through an art form (e.g. painting, drawing, sculpture) and works with you to understand the common patterns, symbols, messages within the art forms to better understand deeper issues in your life.
Establishing A Healthy Therapist / Client Relationship
What should I look for in a therapist?
Once you’ve decided to move forward with therapy, choosing the right therapist can also be a daunting task. Deciding to be vulnerable in front of another person is a difficult, courageous ask that a good therapist will recognize and respect. Remember that whatever your own feelings towards the client/therapist relationship are, they are valid, and you deserve to have a therapist that helps you in the way you need.
After narrowing your search for therapists based on factors like location and insurance, consider what style of therapy specialty you are looking for (see section above on ‘What Styles of Therapy Are Available?’) and consider these general structures in what the therapist should offer you:
Ethical obligation: A therapist has an ethical obligation to practice within areas of their own competencies. For example, disordered eating is a particular category of problems that some therapists do not have the prerequisite experience to address and properly guide a client through, in which they should refer the client to a therapist better equipped to support that client. You can (and should) ask your therapist directly if they are prepared to address the particular issues you are seeking therapy for.
Cultural competency: There are differences between therapists having cultural empathy versus competency versus having it be a specialty -- these are escalating amounts of ability and significantly impact the therapist’s ability to offer useful guidance. Therapists who are working with individual(s) from marginalized communities need to be upfront on their level of familiarity with and experience in that particular community; this affects the therapist’s ability to understand the client’s worldview and how the client is uniquely experiencing the issues that brought them into therapy. You can (and should) ask your therapist directly what their level of familiarity is with the important aspects of your identity you want to address in your sessions.
It is not uncommon for people who are part of marginalized communities to mistrust therapy, and sadly, there is good reason to. The contemporary practice of therapy started in Europe less than 150 years ago, and its legacy continues to be eurocentric. For well over 100 years (and arguably still today), psychological research was completely dominated by white men solely studying the thoughts, emotions and behaviors of other white men. This resulted in psychological standards and norms that center the white, male, wealthy experience -- anyone who deviated from this norm was historically considered “disordered”.
Over the last 3-4 decades, clinicians and psychologists have acknowledged how profoundly harmful the foundation of therapy has been (and still is), and have introduced the concept of multiculturalism into psychological and therapeutic practice. While the field of therapy is slowly diversifying, this concept of multiculturalism was still presented through the lens of the white practitioner. Although a curriculum that includes multiculturalism is a requirement at universities, it’s often a colonized multiculturalism. In response, many clinicians, practitioners, and advocates have been working within this realm to decolonize therapy. This includes shifting cultural competency to cultural affirmation and celebration, and creating therapeutic spaces and relationships that are safe (or at least more safer than what they have been).
These are concepts and issues that you can and should certainly discuss with your therapist during therapy, even during your first session. Unfortunately, there are therapists who continue to subscribe to the eurocentric view of therapy, including those who downplay the importance of multiculturalism altogether. But there are also therapists whose work is rooted in social justice, and are actively challenging these oppressive systems rooted in a white, Christian, and patriarchal supremacy. Don’t be discouraged if you need some time to find the right therapist -- there is one out there!
If you’d like to read more about the decolonization of multicultural counseling, this piece is a great place to start.
What can I expect in my first therapy session?
The first interaction between client and therapist usually comes in the form of an intake session. This includes a few components:
Informed consent paperwork: This paperwork will inform you of all the risks and benefits of undergoing treatment with that therapist. These vary state by state. Some important things to note are:
Limitations of confidentiality. This should be discussed at length with your therapist. For example, some limitations of your client-therapist confidentiality may be if you are planning to harm yourself or someone else.
Treatment plan and schedule. Your therapist should be able to provide at least a rough guide of how they anticipate your treatment will go, and what sort of schedule they anticipate it will take. However, please note that therapy schedules do change, and you should feel able to adjust to them depending on how you are reacting and responding to therapy.
Medication. If you are seeing a psychiatrist or a therapist who is licensed to prescribe medication, it is important to discuss if you want medication to be part of your therapy process and if so, the potential benefits & risks of the medication.
Intake forms: This paperwork is therapist-specific and typically asks questions about medical history, therapy history, family history as well as the major issues you want to address in therapy. It may also ask for information about personal habits, such as drug or alcohol use. Intake forms are strictly confidential between you and the therapist, and you are not obligated to answer anything you may not want to.
Pricing & Schedule: You may have already discussed this with your therapist, but it’s a good idea to confirm session pricing and make sure your therapist’s schedule aligns properly with your own so you can see them regularly. Some therapists offer a sliding scale approach to payment, where you pay as much as you are able -- if that is the case with your therapist, discuss with them what rate would be feasible for you. In some cases, therapy is also covered by insurance (but may require some sort of co-pay), so that is another topic to clarify before the end of your intake session. Finally, if you are struggling to afford therapy, there are usually governmental sources of funding or help you can tap into locally -- a good place to start is the local Department of Mental Health.
Questions to ask of your therapist: The intake session is also for you to learn about your therapist, understand who they are, their approach to therapy, their worldview, their comfort zones, etc. Do not feel you are being intrusive by asking your therapist to also open up to you. Some questions could be:
I want to focus on ___ during our sessions, are you comfortable/familiar with that topic?
A part of my identity that is important to me is ___, do you have familiarity with and are comfortable with discussing aspects of that with me?
What are your strengths as a therapist?
What is your general approach to therapy? How does it differ from others?
Have you been in therapy?
What sort of goals would you like to set up for our time together? What does success look like to you?
What kind of homework or reading do you give your clients, if any?
How do you lead each of our sessions?
What do you believe helps people grow and improve?
How long do you anticipate we will meet for? How will you know when we can stop?
Deciding to move forward with a therapist: Remember that you are not obligated to move forward with a therapist after an initial intake session. If there is something that doesn’t feel right to you, you absolutely can walk away and try a different therapist that may be better suited for your needs. If you do want to move forward with a therapist, you can then schedule your first session with them after the intake session.
What are my rights as a client?
Privacy & Confidentiality: You have a right to be afforded privacy and confidentiality in your sessions. You have a right to have records protected by confidentiality and not be revealed to anyone without your written authorization.
Participation: You have a right to participate in developing an individual plan of treatment.
Explanation: You have a right to receive an explanation of services in accordance with the treatment plan.
Refuse or Terminate: You have a right to object to, or terminate, treatment proposed by your therapist.
Review of Records: You have a right to have access to your therapist’s records of you.
Proper Treatment: You have a right to receive clinically appropriate care and treatment that is suited to their needs and skillfully, safely, and humanely administered with full respect for their dignity and personal integrity.
Non-Discriminatory: You have a right to be treated in a manner which is ethical and free of discriminatory practices.
Culturally Relevant: You have a right to be treated by a therapist who is not only sensitive to your cultural background, but also affirmative and celebratory.
Escalation: You have a right to be free to report grievances regarding services or staff to a supervisor. (More of an issue if you’re being seen in a clinic or hospital.) If your therapist does not have a supervisor (e.g. they are their own supervisor or working in a private practice), you have the right to escalate any mistreatment to their licensing boards.
Informed Results: You have a right to be informed of expected results of all therapies prescribed, including their possible adverse effects (especially in the case of medications). You have a right to request that another clinician review the individual treatment plan for a second opinion.
What should I look for in my in-session therapy dynamics?
The therapeutic alliance, or bond you form with your therapist, is the most important aspect of your therapy relationship. A healthy alliance means both you and your therapist trust one another to collaboratively explore and work through difficult scenarios. This develops over time, and is the result of a therapist truly being attuned to your needs, actively listening, anticipating obstacles, and helping you keep the momentum of your therapy even outside of their office.
You and your therapist can build and strengthen your therapeutic alliance through challenges faced during therapy sessions, such as when you two disagree or if either party expresses hurt or pain inflicted by the other. In fact, the therapeutic alliance can be even more effective and impactful than the treatment style being used, so building it effectively and authentically is crucial.
As your sessions progress, here are some topics to take note of and potentially discuss with your therapist about the therapeutic process:
Power Dynamics: The therapeutic relationship between you and a therapist is inherently unbalanced in terms of power. You invest the therapist with power, with the intention of the therapist using said power to help you empower yourself. This power imbalance can impede therapy when societal power dynamics, such as race, socioeconomic background, sexual orientation, etc. are not taken into consideration, and the power imbalance can become exploitative when practitioners who are members of a dominant culture devalue the client's own values and perceptions.
It is vital that therapists acknowledge and explore the power dynamics of their relationship with you, and educate themselves about the cultures of people they are likely to counsel. When privilege and societal conditioning enters into the client-therapist relationship, this inhibits and undermines the therapeutic alliance. This power imbalance is unavoidable and especially damaging when ignored, so it’s best to talk about it openly. Recognize you are well within your rights to discuss this power dynamic within sessions with your therapist.
If you are interested in reading more about this, here is a great piece to start on.
Setting boundaries: Boundaries can be challenging in therapy since the work demands a tremendous amount of vulnerability. You may feel emotionally exposed in therapy, so the natural inclination to balance this vulnerability is to ask more vulnerability of the therapist. (This is also largely where the inherent power imbalance comes from in therapy). However, the therapist’s focus should be on helping you -- so while some therapists will self-disclose, others may not. This boundary is essential as a form of protection not only for the client, but for the therapist.
Setting boundaries also applies to time -- when the therapist is available to you (and when it is not) is very important and should be discussed in session.
You are well within your rights to set boundaries with your therapist. Ethically, therapists work at your pace. As the client, if you are not ready to talk about something or a certain subject is off limits, that boundary should be respected. You might find those boundaries changing as therapy progresses and the therapeutic bond strengthens, but all of that is on your own terms.
Communicating needs: It’s vital to remember that therapy is for you, the client, and it’s essential that your needs are being met. If you feel like you’re not getting much out of the therapeutic experience, you’re not feeling heard and seen, or you’re not feeling safe within therapy, you are well within your rights to communicate that to your therapist. If your needs continue to not be met, it’s appropriate to terminate the therapeutic relationship and ask for a referral elsewhere.
Constructively "calling out" (or better "calling in"): It’s important to realize that therapists are people too, which means they can certainly make mistakes and may need change to grow and evolve. You as a client are well within their rights to address mistakes made by the therapist however in whichever way makes you feel comfortable. While “calling out” refers to a public-facing statement, “calling in” is a private way to discuss any issues you are experiencing with the other individual.
Mistakes made by a therapist can be incredibly painful and might leave you feeling angry, distrustful, and/or abandoned. It's important to not suppress your feelings, and express them honestly to your therapist so they can process the mistake, the feelings that stemmed from it, and develop a way to move forward with you that will be both safe and effective for your treatment.
What if it doesn’t work out?
Sometimes, you and your therapist are not a fit. Knowing when to walk away and ask for a referral is a huge sign of success, as it means you understand and are prioritizing your own needs. Some potential signs that leaving your current therapist relationship is a good idea is when:
You don’t feel heard or understood
You are not meeting the goals you set out on your therapy journey
You feel judged
You feel discouraged
You feel controlled
You’re not connecting with your therapist
You feel coerced into certain action(s) by your therapist
You feel unsure and/or confused by your sessions
You don’t feel you are growing as a person
You don’t trust your therapist
Your feel more stressed, anxious, or sad after your sessions
If you do want to walk away from a therapist relationship, try to do so as soon as you can, and do so directly. You can end the relationship in whichever medium feels safe to you and ask for a referral (if you want) or begin your search independently.
Getting Started On Your Mental Health Search
Please refer to our How to Get Started Getting Help FAQ for additional questions on starting the process of therapy.
Psychology Today, Open Path, Anxiety & Depression Association of America, GoodTherapy are general sites that allow you to filter by factors such as insurance coverage, type of therapy, issues they specialize in. Psychology Today and Open Path specifically have sliding scale searches to help you find a therapist at a price point that works for you.
Sites such as Therapy for Latinx, Therapy for Black Girls, Ayana Therapy, Inclusive Therapists offer a specialized list of therapists attuned to specific factors around race and intersectional identity
If you are may be looking for alternatives to the traditional in-person sessions, some other therapy offerings include:
Virtual Therapy (or “Tele-Therapy”): Connecting with a licensed therapist virtually (e.g. my video chat or my phone) so you can have sessions in a space that you choose.
Text Therapy: Chatting via text with a licensed therapist, usually through a mobile app service. You are able to text your therapist whenever you feel like, or schedule times for a “live” text session.
Instagram “Therapy”: Some licensed therapists may have their own Instagram accounts and post information, resources, quotes, etc. related to therapy and mental health on their accounts. While you may find these to be uplifting and useful, please note this does not replace traditional therapy.
Additional Mental Health Resources
Helplines, Hotlines, Text & Chat Lines
National Suicide Prevention Hotline operates 24/7 at 800-273-8255. It is also available in Spanish and for the deaf or hard of hearing.
National Domestic Violence Hotline operates 24/7 at 1-800-799-7233. If you cannot speak safely, you can text LOVEIS to 22522 or log in online for a confidential chat. All services are available in Spanish.
California Warm Line operates 24/7 at 1-855-845-7415 for non-emergency mental and emotional support for California residents.
Teen Line operates 6-10pm PST at (800) TLC-TEEN or via text ("TEEN" to 839863).
The National Eating Disorders Association (NEDA) helpline operates Monday - Thursday 11am to 9pm ET, Friday 11am to 5pm ET. Online chat is available Monday - Thursday 9am to 9pm ET, Friday 9am to 5pm ET.
Los Angeles Department of Mental Health Access Line operates 24/7 at (800) 854-7771
New York City’s NYC Well Hotline operates 24/7 at 1-888-NYC-WELL or via text (WELL to 65173)
Crisis Text Line operates 24/7, text HOME to 741741
Chat & Support Groups
Supportiv: A free, 24/7, anonymous online peer support network chat group.
Bridge Club: An online and in-group support network for women and non-binary individuals interested in sobriety.
Project Return: A peer-to-peer support network for the greater Los Angeles area.
National Alliance on Mental Illness (NAMI) NYC Metro Support Groups: Social and support groups in the great NYC area.
Online Resources & Directories
Help When You Need It: An online directory to find local listings of services (both private and public) such as domestic violence assistance, mental health services and more.
Psychology Today: A online media site and licensed therapist directory.
Calm: A mobile phone app offering select free meditations, sleep stories, movement exercises and music that can be soothing during this stressful time.
Coa: An online class network offering free classes to manage through COVID-19, led by therapists.
Affordable Therapy Options
Southern California: Southern California Counseling Center
Nationwide: Open Path Collective
Donate & Support
If you’ve enjoyed this Skillshare episode and want to give back to the community, we are raising money for Laura’s chosen charity Support Staff! You can donate via their page here.
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