Counseling and Therapy

Mental health and wellness is something all humans need to take care of. After all, each of us has a brain that impacts our feelings and emotions. Sometimes we need specialized treatment to help take care of our health needs. Think for example, if someone experienced a physical wound. Sometimes they may be able to care for this at home, and other times they may need to see a doctor.  The same goes for emotional needs. At times we are able to care of ourselves and at other times, the help of a mental health professional is needed. It can be hard to cope with all of the changes that happen during your teenage years. If you’re having trouble dealing with certain situations or emotions, you might find counseling to be a helpful way of sorting things out.

Why should I go to counseling?

If you’re thinking about whether counseling could be helpful to you, here are some questions to ask yourself:

• Do you ever feel really sad, frustrated, or lonely?
• Do you feel especially angry, annoyed, or out-of-control?
• Do you feel very anxious, worried, or guilty?
• Have you experienced some major problems at home, at school, or in your neighborhood?
• Have you noticed some changes in the way you sleep, eat, or think and feel about life?
• Is it hard for you to talk about these feelings with your family or friends?
• Are these feelings having a bad effect on your life-are they making your schoolwork and your relationships with family and friends hard?

If you answered YES to any of these questions, it may be a good idea for you to talk with a counselor (also known as a therapist). A counselor or therapist is an adult who has special training to help people sort through their feelings and problems. Teens and young adults go to counseling for many reasons.

Counseling can help you to understand your feelings and problems and learn how to deal with them in your everyday life. You can expect that whatever you and your counselor discuss will remain confidential. Confidential means that the therapist cannot tell anyone, not even your parents, about what the two of you talk about without your permission. The exception to this rule is that if the counselor feels that you are in danger of hurting yourself or someone else, or if you are being abused or neglected, he/she is obligated by law to break confidentiality in order to keep you safe.

How do I find a counselor?

Many professionals can help you find a counselor. You can ask your health care provider for a referral in your clinic or neighborhood. You can also ask your guidance counselor at school to refer you to a counselor who deals with mental health issues. Sometimes counselors meet with students at school. You can also ask a teacher, youth advisor, clergy person, or parent or guardian to help you find a counselor. You may also want to check out mental health agencies in your area. Your insurance company has lists of counselors covered by your plan. The counselor’s specialties are sometimes listed, so you can chose someone who works with teens (adolescents) or young adults and has skills you would like them to have.

What types of counselors are there?

When you are referred for counseling, you may be referred to a psychiatrist, psychologist, social worker, psychiatric nurse practitioner, or licensed mental health counselor. All of these professionals are also referred to as therapists and are trained to understand feelings and behaviors and know ways to help people through difficult times. There are counselors in all the following disciplines who work with teenagers and young adults:

• Psychiatrist- a medical doctor (M.D.) who has graduated from medical school, with extra training in psychiatry. Some psychiatrists only prescribe medications but some also provide therapy.
• Psychologist- has graduated from college and graduate school and has the degree Ph.D., Psy.D., or Ed.D (may vary according to what kind of graduate school they went to). A psychologist provides counseling and can also do special testing to understand certain problems such as learning disabilities.
• Social Worker- a therapist who has graduated from college and graduate school, where they studied counseling. A social worker has the degree M.S.W. and the certification LCSW or LICSW (this may vary in different states or countries). They provide individual and family counseling and often have a special understanding of how families work.
• Psychiatric Nurse Practitioners (NP) – are nurses who have a master’s degree and a special certificate to specialize in mental health issues and counseling. They are able to prescribe medications that can help with depression, anxiety and other problems.
• Licensed Mental health counselor (LMHC) – has graduated from college and graduate school and is a licensed therapist who has special advanced training in counseling. Mental health counselors are often individual therapists or marriage and family counselors.
• Pastoral Counselors – many clergy people of all religions have had advanced training in counseling and some have additional degrees in counseling.

What will happen when I decide to talk with a counselor?

Before you make an appointment with a specific counselor, you or your parents should check with the “behavioral medicine” office of your health insurance. Most insurance cards have a number to call for Behavioral Health (BH). In the U.S., most insurance policies must offer insurance for therapy, but the policies and what is covered varies between insurance companies. Be sure to ask about possible mental health deductibles and your co-pay, and how many sessions will be covered.

What should I expect from counseling?

When you start talking with a counselor you should expect to meet with one person who will get to know you pretty well. Sometimes you will talk about serious things and sometimes less important things: this is how you begin to build a relationship with your counselor. Most counselors understand that it takes a lot of courage to go into counseling and often takes time to get used to talking and sharing with a counselor! It can be hard to tell on the first session if you feel comfortable enough with your counselor to talk about things that are important to you. Try to give the counselor a chance. If after a few visits you still don’t feel okay about talking with the counselor, you should tell the person who referred you to your therapist. Most likely you will have a chance to choose another counselor. This is fine! Since you will be talking about sensitive issues, you deserve to feel totally safe and comfortable with the counselor you choose.

What kinds of questions will the therapist/counselor ask me?

At the first visit, the counselor may ask you many questions about your life and how you’ve been feeling during the past year. He/she may want you to bring your parent(s) or guardian(s) with you on the first visit. The type of help you are offered by your counselor will depend on what you tell them and the kind of relationship that you develop. Teenagers sometimes bring their family members or other significant people to some of their counseling sessions to help improve communication in those relationships. Other times, teens may want the time all alone with their therapist to explore feelings without their parents.

How long does counseling usually last?

Counseling lasts different periods of time for different people. Your counselor will work with you to decide how the sessions will fit into your schedule. You might meet with your counselor once a week for as little as 30 minutes or as long as 60 minutes. Sometimes you might choose to meet with your counselor more often (2 or more days per week) or less often. You may continue meeting with your counselor for a longer amount of time. You, your parents, and your counselor should be aware of how many sessions your health insurance will cover and if you need another referral. Many counselors are willing to work out special arrangements for continuing counseling after a patient has used up their insurance for the year.

What else can I do?

Besides going to counseling, there are many activities you can do on your own to try to work through difficult feelings and solve problems. You might want to try talking with a parent, good friend, or another adult in your life. You might try writing down your feelings in a journal or diary. Other things to try are relaxation exercises, listening to music, watching a good movie, or exercising. Also try getting involved in an activity that you are good at such as a sport, drama, music, dancing, or hobbies (such as writing or reading). The combination of doing activities you like to do and talking with a counselor will help to improve how you are feeling and make your everyday life much easier.

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Our health guides are developed through a systematic, rigorous process to ensure accuracy, reliability, and trustworthiness. Written and reviewed by experienced healthcare clinicians from Boston Children's Hospital, a Harvard Medical School teaching hospital and consistently ranked as a top hospital by Newsweek and U.S. News & World Report, these guides combine clinical expertise, specialized knowledge, and evidence-based medicine. We also incorporate research and best practices from authoritative sources such as the CDC, NIH, PubMed, top medical journals, and UpToDate.com. Clinical specialists and subject matter experts review and edit each guide, reinforcing our commitment to high-quality, factual, scientifically accurate health information for young people.