The price you pay for therapy

CHENNAI: The first step towards resolving a problem is to accept there’s one. The next is to seek help. If taking that proverbial first step supposedly resolves half the problem, then the next one would have you stumped.

‘Help’ within the context of mental health starts with therapy. A concept so frowned upon until a 10-15 years ago that it was unconceivable for someone to even mention it. Fast forward to 2022. The world is still coping with two-plus of pandemic-induced myriad stressors. In addition to that are the new/old diseases mushrooming everywhere, it seems everyone is in therapy. Or are they really?

Finding the right therapist is difficult, especially one who understands your issues, assists you in getting to the root of a problem, and enables you in finding answers on your own. When you add the high cost of therapy, literally, the challenge seems insurmountable.

Understanding your concern

Dr V Surendran, psychologist-oncology, Adyar Cancer Institute, says “There’s a difference in distress and severe health issues that require medical help. The demarcation is necessary. If a person suffers from clinical depression, psychiatric help is required. If stress is affecting your life, you can seek help within the circle you trust or start seeing a psychologist who can identify the issue and decide on the type of intervention required.”

But preventive mental health should also be propagated. “Why wait until it gets too complicated? There’s a need for awareness on how an individual can be affected and thus, certain behaviours can be prevented,” he added.

However, there continues to be some ambiguity about the type of intervention required. This is where most adults confuse the role of a psychologist and psychiatrist.

“Therapy is provided by clinical psychologists. But giving medical prescriptions can come only from psychiatrists. There are professionals who violate these rules, and it’s dangerous. Before seeking help for mental health issues, you need to have a basic understanding of what you need and where you need help with. This will determine on the kind of intervention,” explains Dr Poorna Chandrika, director of Institute of Mental Health.

Type of therapy

There are different forms of therapy. Most popular are cognitive behaviour therapy and psychotic therapy, and also other clinical therapies that are decided by the therapist based on individual symptoms.

While understanding your problem gives clarity over the type of therapy you need, finding trained and qualified professionals to address those problem is crucial.

Dr Vandhana, consultant-clinical psychologist, Kanchi Kamakoti Childs Trust Hospital, says that people are becoming more aware of the need to seek therapy and their understanding of mental health issues has improved in recent times.

“However, there are misconceptions about the right approach and the process of therapy,” she points out. “A lot of patients read about mental health and therapy online before coming to see me. There are even sites that encourage medications. These must be avoided completely, as they’re not written by professionals. It is important to get the right person to talk to about mental health and qualified professionals should be approached.”

The diagnosis of someone’s mental health issue decides the need for the number of sessions in therapy. Mental health concerns include depression, anxiety, phobias, schizophrenia, bipolar disorders and several others that can be the result of an unhealed/untreated injury.

“Severity of the mental health issue is the deciding factor for the course of the treatment,” she adds.

The process usually requires 6-8 sessions that are given for basic counselling but even this is subjective. “It can vary — increase/decrease based on the individual’s requirement. Moreover, it’s important to understand that therapy does not yield immediate results and the whole process takes time for it to make a difference,” avers Dr Vandana.

Beyond affordability

The cost of psychiatric medicine and counselling sessions are expensive for a middle-class individual. Even at Rs 1,000/session initially, they’re not affordable if one wants to follow the schedule of at least 6-8 sessions.

“Since the course of treatment can take time to show results, the affordability of mental health treatment is a concern. The government set-up usually provides for all these services free of cost but in the private sector, since the process of identifying the issue and addressing it takes time, the cost goes up,” said Dr Vandana.

There’s definitely a need for more clinical psychology courses to be recognised so that the accessibility and affordability can be improved.

“Additionally, more hospitals should have mental health professionals including psychologists and psychiatrists, and make them affordable. Insurance coverage for mental health treatment can also ease the pockets of individuals,” points out Dr Poorna Chandrika.

MYTHS & MISCONCEPTIONS

A therapist will fix my problem: Nope, that’s not in the job description! What a therapist does is to make you understand the root cause of your problem/issue, ask questions and guide you through the process of coming up with answers yourself. There are exceptions, of course, but those are rare, not the norm.

■ Therapy is like going to the spa, it relaxes you: No, it doesn’t! Going to therapy is like poking at an open wound, you start gently. You peel it layer by layer until you reach the bone. It’s gut-wrenchingly painful but can also be immensely helpful.

■ Pills can solve my problems: While medication must be prescribed only by a qualified professional, and when absolutely necessary, pills can help you cope with debilitating symptoms, which is often a sign to a larger issue.

■ My therapist can be my friend: Professional boundaries have to be respected for the sake of objectivity. You’re paying for the time you spend with a therapist, that’s not friendship. That’s an expert/ consultant you’re hiring to analyse an issue.

■ A couple of sessions will do: Therapy is not a quick fix to a tear/wound. It takes 2-3 sessions, at a bare minimum, to understand the history of the patient. The course of treatment can take a few more sessions. For many, the treatment method can change multiple times.

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