Is improved mental health as part of your goals for next year???
If so, you are not alone
Let’s start by acknowledging that just as we all have physical health, we also have mental health. Sometimes our mental health may just function in the background, with no problems. Other times it flares up and we need to address what’s going on. Just as some people may have diabetes, hypertension, other medical issues, some may have depression, anxiety, eating disorders or PTSD as psychiatric concerns.
In this blog, I am going to discuss various mental health treatment options and how to access them. I am writing about these in a purely American way. I will discuss insurance, privacy and confidentiality laws and various professions. Some of the specifics will be different across the globe, but the bottom line remains the same: mental health is as important as physical health and you deserve to get the treatment you need.
Have we reached the point where the stigma surrounding mental health is finally gone?
The short answer is no. The longer answer is: it's complicated, and the complexity is visible in the differences between generations.
When I conduct telehealth sessions as a therapist, I've had college students introduce me to their roommates by title—no hesitation, no shame. This simple, open acknowledgment shows how far we’ve come; seeking treatment is no longer the guarded secret it once was. However, this openness is often a generational story. While Millennials view mental health as a critical part of overall wellness and Gen Z sees seeking treatment as a sign of strength and self-awareness, their Baby Boomer counterparts often adhere to the “pick yourself up by the bootstraps” mentality.
The stigma is shrinking, but it hasn’t vanished. So, what exactly is this elusive thing we call mental health, and how do we navigate treatment in a world full of acronyms?
Mental health is the foundation of our psychological, emotional, and social functioning. To put it simply, it is how you think, feel, and act. It is an intrinsic part of overall wellness. I have written previously about mental health here and here.
Since we agree that mental health is vital and that seeking treatment is a sign of strength, the next logical question is: How do you actually go about getting treatment? The mental health field is full of similar-sounding titles (psychiatrist, psychologist, psychotherapist) and an overwhelming number of acronyms (CBT, DBT, EMDR, IOP, etc). Let's break down the two most common pathways to care: the therapist and the psychiatrist.
The Therapist: The Talk and Skill Builder
The word “therapist” is a common, umbrella term used to describe a licensed professional who works with individuals, families, or groups using talk therapy (psychotherapy) to achieve some type of improved functioning—how a person thinks, feels, or acts.
Role and Focus: The therapist's primary goal is to help you build self-awareness, develop coping skills, process emotions and trauma, and change unhealthy behavioral patterns. Sessions typically last between 45 to 60 minutes and often occur weekly, especially at the start of treatment.
What They Can't Do: In the vast majority of cases across the United States, therapists cannot prescribe medication.
Common Modalities: Therapists are trained in evidence-based techniques, which is where those acronyms come in. Some of the common therapies are:
CBT (Cognitive Behavioral Therapy): Focuses on the relationship between thoughts, feelings, and behaviors.
DBT (Dialectical Behavior Therapy): Helps with emotional regulation and managing intense feelings.
EMDR (Eye Movement Desensitization and Reprocessing): A therapy designed to help process traumatic memories.
The Psychiatrist: The Medical Specialist
A psychiatrist is a medical doctor who focuses on the biological, chemical, and neurological aspects of mental health.
Role and Focus: A psychiatrist’s primary responsibility is diagnosis, medication management, and medical assessment. They complete four years of medical school (earning an MD or DO), followed by a four-year residency specializing in psychiatry. This extensive medical training allows them to rule out physical causes for mental health symptoms (like a thyroid issue causing anxiety).
The Key Difference: As a medical doctor, a psychiatrist is licensed to prescribe and manage psychotropic medications (e.g., antidepressants, mood stabilizers, anti-anxiety drugs).
Appointments: Sessions are often shorter (15–30 minutes) and less frequent than therapy, focusing on how you are responding to medication, managing side effects, and adjusting dosages.
Other Prescribers: Growing in popularity are Psychiatric or Mental Health Advanced Practice Nurses (APN/NP), who can also prescribe and manage medication, often working collaboratively with a physician. In the United States our General Practitioners (family doctors) often prescribe psychiatric medications, they account for nearly ⅔ of psychotropic medication prescriptions.
The Integrated Approach
For most people, the most effective form of treatment is a combined approach: seeing a therapist weekly for psychotherapy and developing coping skills, and seeing a psychiatrist or APN monthly or quarterly for medication management, if needed.
The good news is, no matter who you see first, either provider can—and often will—give you a referral if they feel you would benefit from the other service.
Finding Your Therapist: Where to Start
The process of finding a therapist can feel overwhelming, but a systematic approach can simplify the journey. Think of this process as dating, not marrying—you are interviewing professionals to find the best fit for your unique needs.
Your search should begin with two key questions: What do you need help with? and What are your logistical requirements?
Determine Your Needs: Search for therapists who specialize in your specific concerns. Directories like Psychology Today or your insurance company's provider list allow you to filter by issues like anxiety, trauma (look for EMDR or Trauma-Informed), couples counseling (LMFT), or a specific age group.
Check Logistics: In the U.S. Your insurance coverage is critical. Start by calling your provider to ask about your mental health benefits: Is there a deductible? What is the co-pay? You can also look for therapists who offer a sliding scale fee based on income if cost is a concern. Finally, decide if you need in-person sessions or prefer telehealth.
The Initial Call: Once you have a shortlist, reach out! Many therapists offer a free 10-15 minute phone consultation. This brief call is your chance to get a "vibe check." Ask them about their experience with your specific issue, what their general approach is, and confirm their fee structure. If you don't feel a sense of comfort or trust during this call, it is perfectly okay to move on to the next name on your list.
Your First Appointment: Setting the Foundation
Congratulations—scheduling that first session is the biggest step! The first appointment is generally referred to as an Intake Session and it is different from a typical therapy session. The primary goal is not to solve your problems immediately, but to build rapport and collect information.
Paperwork and Confidentiality: You will likely spend the first few minutes filling out formal intake paperwork, including medical history, privacy agreements (HIPAA), and consent forms. Your therapist will then thoroughly review confidentiality with you, explaining that what you discuss is private, except for rare exceptions (e.g., immediate threat of harm to self or others, or mandated reporting of child/elder abuse).
The Deep Dive: Your therapist will guide the conversation, asking open-ended questions to gain a comprehensive understanding of your life. Expect to cover:
The Presenting Problem: “What brings you to therapy right now?”
History: A brief overview of your family, work, relationships, and previous mental health experience.
Goals: “What do you hope to accomplish in therapy?”
Expect to be Nervous (and That's Okay): Sharing deeply personal information with a near-stranger is difficult. Therapists are trained to create a non-judgmental space and will respect your pace. You don't have to share everything on day one. At the end of the session, the therapist may offer a preliminary diagnosis and suggest a treatment plan. Ultimately, the session is about ensuring you feel safe, heard, and that this professional is the right partner for your healing journey.
Taking the Step: The Power of Action
The most challenging part of any journey is almost always the first step. If you've reached the end of this post and feel even a flicker of curiosity about seeking support, you've already demonstrated the strength and self-awareness that Generation Z celebrates.
The stigma surrounding mental health may not be entirely gone, but the barriers to access are lower than ever, and the benefits are profound. Whether you choose to work with a therapist to develop better coping mechanisms, a psychiatrist to explore medication options, or both, you are investing in the most important resource you have: yourself.
Mental health treatment is not about fixing a broken person; it’s about refining an existing one. It's about giving yourself the tools to navigate the inevitable challenges of life with greater resilience, clarity, and peace. Don't wait for a crisis to start seeking support. I am licensed in NJ, PA, MA and NM in the US, if you are in any of those states feel free to reach out to me for a free consultation to see if I can be the right fit for you.
