Learn About Psychotherapy

Research published over the past five decades has repeatedly demonstrated that psychotherapy is an effective treatment for many life problems, including anxiety, depression, children’s behavior problems, marital difficulties, stress, trauma, problems in living, and developmental or life-stage issues.[1] Psychotherapy is so effective that researchers claim that at the end of psychotherapy, the average treated patient is better off than 80% of untreated patients.[2] The effectiveness of psychotherapy has been demonstrated through carefully controlled small-scale studies and in large-scale surveys.

Statistical reviews of a dozens of individual studies on the effectiveness of psychotherapy demonstrate that therapy is not only beneficial[3] but cost-effective for many patient populations, including children, and those with anxiety, depression, and medical patients with concurrent psychiatric problems.[4] Psychotherapy pays off in reducing absenteeism from school, days lost from work, and decreasing patients’ need for expensive medical treatments or hospitalizations.[5]

Consumer Reports published the best-known large-scale survey on the effectiveness of psychotherapy, based on responses by 2900 of their readers.[6] All had received psychotherapy from mental health professionals and reported that they were pleased with the experience and that their psychotherapy had been effective. The author reported that patients’ satisfaction was unrelated to the type of treatment or the additional use of medications, that longer length of treatment was associated with better outcomes, and that worse outcomes were suffered by patients whose insurance or managed-care plans artificially limited the frequency or length of their treatment.

The decision to see a therapist is very personal, most often made at times you’re stressed or in pain. You may wish to consider psychotherapy or family therapy if you or someone close to you is experiencing: negative thoughts or feelings; depression or mood swings; stress or anxiety; problems with drugs, alcohol, sex or food; excessive anger, frustration, or guilt; constant worries or obsessions; relationship concerns, communication problems, or loneliness; stress due chronic illness; school problems, employment concerns, workplace stress; life changes; issues of sexuality or sexual identity; problems following traumatic events or the after-effects of childhood abuse; domestic violence or other forms of abuse.

Deciding to ask for help is hard. An experienced therapist knows this and can help put you at ease and answer your questions.

Children and adolescents need therapy when their problems or symptoms seem prolonged or serious or when they have problems in several areas of their lives simultaneously.

Children and adolescents are less able and less likely than adults to talk about their problems. They may show their distress in a variety of ways. They may be irritable, have sleep problems, eating problems, personality changes, or physical complaints. They may have problems with their loved ones, have problems in school, or have problems making or keeping friends. If children or adolescents have prolonged problems in one area (family, school, or friends) or if they have problems in two or three areas, consult with an appropriate child therapist. You can find child and adolescent therapists in the Index.

Confidentiality. Effective therapy is built on a foundation of trust. Therapists in this directory believe that maintaining your confidentiality is essential to preserve trust.

Some people are reluctant to enter therapy because they fear that their most personal, private, and confidential feelings will no longer be safe. They may have heard that therapists have to report such confidences to insurance companies so they can receive payment. Others may have heard stories about unscrupulous employers who have learned private information about their employees when employer-provided insurance has paid for psychotherapy. And others may have heard about the medical insurance database, which stores patients’ diagnoses and confidential disclosures, sharing them with insurance companies and researchers.[7]

You can guarantee yourself confidentiality by choosing to enter treatment with a member of Psychotherapy Saint Louis. You can trust that your therapist will protect your privacy, no matter what you need to discuss.[8] The therapists whose listings are in this Directory prize confidentiality and see it as essential for effective psychotherapy.

Choice. When you need help, you want to choose the therapist you will work with. And you want to choose a therapist who will use the most appropriate treatment for you and your problem, based on your needs and your interests.

Some people are reluctant to consider psychotherapy because they are unwilling to settle for a therapist selected for them by their insurance company. Others know that some insurers require therapists to use “quick fix” methods of therapy that address only the most superficial aspects of a patient’s problem. If fast methods are not sufficient, the insurer may not allow the therapist to provide enough therapy to resolve the real source of their patients’ distress.

Because therapists in Psychotherapy Saint Louis work only for you, they do not need permission from insurers to give you the care you need. You and your therapist together select the appropriate treatment for your situation. You remain in therapy as long as you believe it is helpful.

Yes, you can, if you select a therapist in Psychotherapy Saint Louis. All our therapists are dedicated to preserving confidential psychotherapy. They will disclose nothing about you without your written permission. In contrast, managed-care therapists do not bind themselves with this promise. To permit you to enter therapy, some managed-care companies require their therapists to release confidential information to anonymous reviewers about the most personal aspects of their patients’ lives. Therapists listed here will maintain your privacy.

Potential patients and caring professionals who refer patients to psychotherapy need a way to find and select therapists. This directory provides extensive, interdisciplinary, inclusive, and descriptive information about therapists practicing in St. Louis . Use the Index to find a therapist with the specialization you need and then read the therapists’ descriptions. You will find information on therapists’ practices, where their offices are located, where and when they trained, the kinds of patients they like to work with, and the kinds of therapy they provide (individual, group, couple, or family therapy). The index will help you find a therapist with the skills you need.

Therapist listed in this directory will explain the advantages of paying for therapy yourself and the disadvantages of using your insurance coverage or managed-care benefits. Most patients remain in therapy for fewer than 20 sessions, so the cost for therapy can be quite manageable, especially since many of the therapists will adjust fees to make them affordable. Check out the chart that compares paying by managed-care benefit, insurance benefits, and self-pay through PSYCHOTHERAPY SAINT LOUIS.

Think about what you hope to gain from therapy. Then, select the kind of therapy you think will be appropriate for your problem. Review the categories on our Search page, which will help you identify a small of therapists who treat your problem. Look over their individual listings. Call one or more of them and talk briefly on the phone about your questions and concerns. You can also have your friends, clergy, physicians, attorneys or others whose opinions you respect, recommend therapists for you.

Visit one or more therapists. Some therapists charge for initial consultations, and some do not. Ask when you call. An interview helps you choose a therapist you’re comfortable with.

The most important consideration about the length of your therapy is how well you meet your personal goals. To build a relationship of trust and understanding with a therapist can take time. This is probably one of the reasons why the Consumer Reports survey found that, while most people found relief in both brief and long therapy, those who stayed in therapy for more than six months reported the most improvement.[9]Most therapy doesn’t very that long, though. People typically end therapy after an average of only twelve sessions.[10] Another study reported that two-thirds of patients experienced progress in 20 sessions or fewer. [11]

You and your therapist decide the length of your treatment. This is one of the main advantages of using your own funds to pay for your therapy and why therapist in Psychotherapy Saint Louis encourage you to do so. If you wish to use your insurance or managed-care benefits, inquire whether your insurer or managed-care company will limit the length of your therapy or constrict the type of services offered to you. Many insurance and managed-care companies restrict the length of treatment to reduce their costs (and increase their shareholders’ profits).

As an aware consumer, you should ask your therapist how long he or she expects treatment to last, whether you are on the right track, and how you will know when it is time to end treatment. You and your therapist together are in the best position to decide when to end your therapy.

Make sure the therapist you choose works your age group. Check to see if the therapist you are considering offers the kind of therapy you need—individual, couple, family or group therapy. There are many effective types of therapy. Ask the therapist how he or she would help you work on your problems, then see if the response makes sense to you.

You should feel comfortable with and respected by your therapist. Trust, openness and honesty are crucial for therapy. In your first interviews—or soon after—try to notice if you feel comfortable with the therapist. If you do not feel comfortable, discuss your feelings with your therapist. If your discomfort continues, consider interviewing other therapists.

Therapists set their own fees. Most patients discuss fees with a therapist before the first appointment. Some therapists in Psychotherapy Saint Louis have “sliding” fee scales that take into account your ability to pay. Others may reduce the fee if you say you located them through this site and you require no insurance paperwork. You can find these therapists in the Search under “Fees, Reduced or Discounted,” (listed under "Additional Services" at the bottom of the search criteria).

Psychotherapists licensed by the State of Missouri have completed a professional training program, have been supervised for a period of time, and have passed a formal examination in their specific profession. Therapists from all professional backgrounds may employ a variety of techniques and theoretical approaches.

Licensed Clinical Social Workers (LCSW ) must complete a two-year master’s degree in social work (M.S.W.) followed by two years of supervised clinical training, and they must pass a state licensing examination. Clinical social workers address personal, relationship, and family problems through individual, group, marital, and family therapy. Some social workers go on to earn the Ph.D. degree.

Licensed Marriage and Family Therapists (LMFT ) must complete at least a two-year master’s degree, though some earn doctorates. They also undergo two years of supervised practice and pass a state marriage-and-family-therapist examination. LMFTs work with individuals, couples, and families to resolve the relationship problems that often bring pain and confusion to people’s lives.

Licensed Professional Counselors (LPC ) must complete at least a two-year master’s degree followed by two years of supervised work and pass a state professional counselor’s examination. LPCs are psychotherapists whose training usually includes an emphasis on vocational and educational assessment and support, although their expertise can vary widely. Many offer individual, couple, family, and group psychotherapy.

Licensed Psychologists must complete a four-year doctoral degree (Ph.D., Psy.D., or Ed.D.). Some have a master’s degree in psychology (M.A.). They serve a pre-doctoral internship and then are supervised for one year after completing their course work. They must pass a state licensing examination. Psychologists are psychotherapists who may specialize in individual, family, group, or marital therapy. Some offer psychological testing for vocational, educational, or personality problems.

Psychiatrists (M.D.) complete four years of medical school, a year of medical internship, and three years of psychiatric residency. Child psychiatrists must train an additional two years. All must take a national examination to be certified in psychiatry and neurology. Psychiatrists are trained especially to understand the biological aspects of emotional problems and mental illnesses, and many specialize in psychotherapy. Most psychiatrists listed on this site offer medication in addition to psychotherapy.

Beyond being licensed, therapists may complete training in various specialties and may be awarded special recognition by their profession. When appropriate, therapists have listed these specialties in the directory. Such a professional specialty acknowledges training in a particular method of therapy, preparation to work with a particular group of people, or thorough study of a particular clinical problem. The most prominent specialties include:

A special recognition awarded by a professional organization is a sign that a therapist has completed significant training, has become experienced, and has shown dedicated professional service. Some of the better-known recognitions are:

The American Association for Marriage and Family Therapy recognizes some therapists as Approved Supervisors when they have enough advanced training and experience to supervise marriage and family therapists. AAMFT Members also have advanced training.

The American Family Therapy Academy recognizes some therapists as Clinical and Research Members when they have five years of experience in teaching and researching family therapy.

The American Board of Professional Psychology (ABPP) recognizes Diplomates in various psychological specialties, including Clinical, Counseling, School, and Family Psychology.

The National Association of Social Workers recognizes Diplomates in Clinical Social Work (DCSW).

The American Group Psychotherapy Association (AGPA) recognizes Certified Group Psychotherapists (CGP) has special training in the practice of group psychotherapy in addition to basic professional training. Professionals with this certification meet nationally accepted criteria in training, supervision, and clinical experience. These usually require two to four years of training beyond their professional degrees.

Many therapists in Psychotherapy Saint Louis have achieved these recognitions. Look for them when you search for a therapist.

Medication can be useful in relieving specific symptoms such as panic, confusion, obsessions, tics, anger, sadness, or depression. Some people use medication alone to cure their symptoms, but many studies indicate that, when needed, a combination of medication and therapy produces better results than either alone. Some people avoid medication because of concern about side effects; others find that medication alone is not enough. With so many medications becoming available, you and your therapist will want to consider whether medication would improve your treatment.

Be smart in making decisions about medication. If your therapist is not trained to prescribe medication, ask for the name of a medical doctor who can or check the Search section of this site to find a psychiatrist who can help you decide.. You also can ask your primary care physician. Obtain as much information as possible about your options before you decide.

Occasionally a patient in therapy does not improve. Some seem to get worse.
Even when therapy goes well, there are difficult times. You may question whether or not your therapist is providing the right treatment. At other times, you may become angry or feel hurt because of something your therapist says or does.

These situations can be difficult for a patient to understand and evaluate.
When you have problems or concerns in therapy, it is important to discuss them with your therapist. Remember that therapists are professionals, and part of their job is to answer your questions about your treatment.

If the answers your therapist gives do not satisfy you, get a second opinion. That’s your right. To get a second opinion, call another therapist and ask for a consultation. You do not have to tell your therapist you are seeking a second opinion. However, if you do decide to continue with your therapist, you should discuss your concerns and your need for a second opinion.

^{^1]} Matt, Georg E., Navarro, A. M. (1997). What meta-analyses have and have not taught us about psychotherapy effects: A review and future directions. Clinical Psychology Review, 17, 1-32. Back

^{^[2]} Lambert, M. J., & Bergin, A. E. (1994). The effectiveness of psychotherapy. In A. Bergin & S. L. Garfield (Eds.), Handbook of psychotherapy and behavior change, 4th ed. New York : Wiley. Pp. 141-150. Back

^{^[3]} Matt & Navarro. (1997). Back

^{^[4]} Lazar, S., & Gabbard, G. O. (1997). The cost-effectiveness of psychotherapy. Psychotherapy Practice & Research, 6, 307-314. Back

^{^[5]} Dossman, R., et al. (1997). The long-term benefits of intensive psychotherapy: A view from Germany . In S. Lazar (Ed.), Psychoanalytic Inquiry supplement: Intensive dynamic psychotherapy: Making the case in an era of managed care. Pp. 74-86. Back

^{^[6]} Mental health: Does therapy help? Consumer Reports. November 1995, pp. 734-739. Back

^{^[7]} Allen, A . Exposed: Computer technology, managed health care and genetic science are all undermining the American tradition of medical privacy … . Washington Post, Feb. 8, 1998 , p. W-10. Back

^{^[8]} Therapists in Psychotherapy Saint Louis adhere to Missouri laws limiting confidentiality in situations in which certain crimes have been committed or may be committed. Back

^{^[9]} Mental Health: Does Therapy Help? Consumer Reports, November 1995, 752. A summary of the report appears in the Appendix. Back

^{^[10]} Garfield, S. L. (1993). Research on client variables in psychotherapy. In Bergin, A. E., & Garfield, S. L. Handbook of Psychotherapy and Behavior Change: An Empirical Analysis. New York : Wiley. Back

^{^[11]} Doherty, W.J., & Simmons, D.S. (1996). Clinical practice of marriage and family therapists: A national survey of therapists and their clients. Journal of Marital and Family Therapy, 22, 9-25. Back

Answers To Frequently Asked Questions

Before Entering Therapy . . .

When Meeting a Therapist . . .

During Therapy . . .