Psychologists and Therapists are often misunderstood to be the same profession, but they aren’t one and the same. Both types of mental health professionals, however, do have a vast knowledge of mental processes. As a general rule, they may work closely together to conduct sessions with their clients and work to alleviate the individuals’ mental health status. In this article, we try to help you understand the difference between the two and explain how each can help with your mental health needs.
Psychologists – not to be confused with Psychiatrists – are mental health professionals who are adept at the study of the mind, and are professionally trained in one or more subfields of psychology. In terms of their clinical orientation, psychologists can have different specialisations. To list a couple of examples, some specialisations may include the treatment of patients with affective disorders, addictions, trauma, or personality disorders.
Psychologists are skilled at clinical interviews and comprehensive psychological testing and assessments, with common ones such as a Patient Health Questionnaire-9 (PHQ-9), or others including a Wechsler Abbreviated Scale of Intelligence (WASI). Clinical psychologists, while unable to provide neuropharmacological support, are able to make a diagnosis if a patient is suspected to have a mental health condition, before moving on to the treatment process. Generally speaking, psychologists tend to approach treatment by exploring the larger theoretical bases of human thought and behaviour. Through this, they work alongside the patient to sieve through difficult life events, long term anxiety or traumatic experiences, in order to trace back to a possible cause of dysfunction. The most common type of treatment used by psychologists is psychotherapy, or talk therapy. The treatment process certainly isn’t one-size-fits-all, for all individuals and their life experiences are different and unique in their own ways. Psychologists ensure that the course of treatment is tailored to each patient’s needs and goals, and help them work through their concerns in a holistic manner. Psychologists can often work in tandem with psychiatrists, in order to provide the optimal treatment for a patient.
In contrast, therapists tend to work from a broader perspective. As social relationships are a significant contributor to one’s mental wellbeing, it is important that they are balanced and are not debilitating towards one’s mental health status. Thus, therapy often helps an individual to gain insights into his interpersonal connections, in addition to self-actualisation. Therapists can also have varying specialisations. For instance, a marriage and family therapist can help couples or families resolve interpersonal hardships, a child therapist can help a child overcome developmental disturbance, and a Cognitive Behavioural Therapist can aid one in switching away from destructive life habits. Regardless of their specialisations, therapists are, at their core, there to provide mental health support, focusing mainly on improving an individual’s well-being and their ability to cope with day-to-day stressors.
Therapy can be exceptionally beneficial for persons who require skill sets involving emotion and problem-solving strategies, such that they are better able to cope with difficult times in a healthy manner without having their emotions rule over them. Therapists are in some sense, a guiding light for patients. By providing guidance and support, therapists can nudge one towards clarifying their emotions and helping them make better life decisions (not making the decisions on their behalf!)
Therapists, like psychologists, are unable to prescribe medications. A therapist’s goal is to help patients make decisions and clarify their feelings in order to solve problems. Therapists provide support and guidance while helping patients make effective decisions within the overall structure of support.
Just like how your body can react to physical illnesses, issues with mental health (especially if they are persistent) can be debilitating too. Now that you have a better understanding of the differences between psychologists and therapists, how you do choose the right clinician for your mental health issues? A great first step would be to browse our list of professionals at Promises Healthcare and make an appointment with one whose speciality best suits your needs.
Fear resulting from psychological trauma can be extremely deep-seated. The distress, feelings of helplessness and constant flashback of traumatic events can turn one’s world upside down, causing major problems with daily activities and quality of life. It may be easy for someone to say, “Well, why can’t you just get over it?” But in reality, we need to recognise that it is much easier said than done. In order to help people move past their traumatic experiences, researchers and psychologists have worked tirelessly, creating various therapeutic methods and tweaking them to achieve the optimal recovery outcome. In regards to the treatment of post-traumatic stress disorder (PTSD), you may be familiar with an approach known as Dialectical Behavioural Therapy. In this article, we’ll be introducing you to an alternative psychotherapy technique, also known as Eye Movement Desensitisation and Reprocessing (EMDR).
Developed by Francine Shapiro in 1987, EMDR therapy is an empirically validated treatment for trauma and other negative life experiences. While it is also increasingly applied for the treatment of other mental health conditions such as depression, anxiety or panic attacks, researchers have not found EMDR to be as effective as with trauma-related conditions. As its name suggests, EMDR isn’t all about talk therapy or medications. In a different vein from cognitive behavioural therapy, EMDR doesn’t focus on altering a client’s thought patterns or behaviours. Instead, it relies on one’s own rapid, rhythmic eye movements, allowing the brain to process memories and resume its natural healing process.
What is the Basis of EMDR Therapy?
EMDR is fundamentally based on the Adaptive Information Processing (AIP) Model. A key tenet of this model is that the symptoms of PTSD are manifested due to memories that are dysfunctionally stored or not fully processed. Memories of disturbing experiences often string along negative emotions, thoughts, beliefs and even physical sensations that were associated with them at the time of occurrence. This can bring about a multitude of unpleasant symptoms that can be exceptionally detrimental to one’s mental health.
When one is exposed to stress or trauma, the body’s automatic response would be to activate its Sympathetic Nervous System (SNS). As an adaptive system, it controls our natural fight, flight or freeze instincts, which is critical in ensuring our survival. When the SNS is activated, the individual will undergo physical alterations such as increased heart and breathing rates, decreased blood flow to the digestive system and constricted blood vessels. In addition, hormone levels including those of adrenaline and cortisol will increase dramatically, causing hypervigilance. However, for someone who is under constant stress from traumatic flashbacks, the over-stimulation of the SNS will be greatly damaging to this person’s physical health. As such, EMDR therapy aims to process memories such that the experience is remembered, but the fight, flight or freeze response is eased.
At this juncture, you may be wondering how clinician-directed eye movements could possibly alleviate trauma-induced stress. EMDR therapy involves guiding the client towards reliving triggering experiences in short phases while the clinician directs his eye movements. During the process, the client will be tasked to focus on trauma-related imagery and the relevant sensations. The clinician will then simultaneously move their finger across the client’s field of view, with each phase lasting approximately 20 to 30 seconds. This will then be repeated a couple of times. At some point, other forms of rhythmic left-right stimulation (for example, listening to tones that go back and forth between the left and right sides of your head) will also be incorporated into the therapeutic process. As distressing as it sounds, the process in fact allows for the vividness and emotional triggers of the memory to be reduced over time. When the client’s attention is diverted as they recall the traumatic event, this makes the exposure to negative thoughts and memories less upsetting, hence limiting a strong psychological response. After attending several EMDR therapy sessions (depending on the individual), the impact of the traumatic event is believed to be significantly reduced.
How is EMDR Structured?
Generally speaking, EMDR takes on an eight-phase approach.
Stage 1: History Taking and Treatment Planning
For a start, the clinician will work hand-in-hand with the client to identify the traumatic experiences which require attention. Should the client have a problematic childhood, the initial stage of EMDR may focus on resolving childhood traumas before moving on to resolve adult onset stressors. Identifying targets for EMDR treatment is also crucial – this means looking further into the client’s past memories, their current emotional triggers, as well as what they hope to achieve by the end of the treatment phase.
Stage 2: Preparation
In this phase, the clinician introduces the client to a few emotion-coping strategies to ensure that the client is well able to manage their emotional distress whenever a trigger is brought up. It is important that the client is able to deal with overwhelming emotions even between EMDR sessions in daily life. The clinician may also familiarise the client with the eye movements or bilateral stimulations.
Stage 3: Assessment
The clinician will then identify and assess the specific traumatic memories that need to be tackled. This also involves analysing the associated emotions and sensations triggered by the memories.
Stages 4 to 7: Treatment Process
These intermediate stages focus on the process of desensitisation, installation, a body scan, and seeking closure. The client is asked to concentrate on the trauma-related imagery and memory while engaged in the directed eye movements or other bilateral stimulation. After each set of stimulation, the client will be asked to clear their mind and report what they feel, think, and the sensations they experience. Depending on the individual, the clinician may have the client refocus on the same memory, or move on to another. This process is repeated until the client reports no distress.
Installation is where the clinician works with the client to increase the strength of positive cognition. This means focusing on the preferred positive beliefs, rather than negative ones. For example, an individual dealing with trauma arising from childhood domestic abuse may start off with a negative belief of “I am weak and powerless”. Installation aims to change that belief into one of “I am now in control.” Of course, EMDR does not force one to believe in something that is inappropriate or unsuitable for the situation. In the example brought up, allowing the client to realise that positive belief could mean encouraging them to take on self-defence training, or other skills that can provide them with a greater sense of security and control.
A body scan is used in order to check for any residual somatic response that is linked to event-related tension or stress. Should any undesirable bodily sensations be present, the clinician will then target them specifically in subsequent sets.
Stage 8: Evaluation
The next EMDR session begins with this phase. This stage is mainly for the re-evaluation of the client’s plight. More importantly, this step is to ensure that the necessary progress is made and to review the client’s psychological state. Further review will be carried out, and the relevant changes will be made to provide the optimal treatment effect.
Although EMDR may be a relatively new technique as compared to other forms of therapy, it is nonetheless an extensively researched method proven to alleviate the stress symptoms of trauma survivors and other individuals who have had distressing life experiences. If you think that EMDR therapy is right for you, do seek help from a mental health professional.
As a couple therapist, the question I sometimes get is, ”Is my problem serious enough to warrant a therapist?”
I like to address this question in this article.
There are 3 key reasons why you’d want to see a couples therapist/relationship coach
When you have issues in the relationship that you’ve tried to solve but you’re unable to.
When you want to do a health check for your relationship
When you’d like to enhance your relationship
Prevention is better than cure and this applies to relationship as well. If you’re in a committed relationship and not married yet, nothing should stop you from finding ways to strengthen your romantic competence.
The majority of couples that I see now in my clinic are those with troubled marriage or also known as ‘relationship recovery’. Increasingly, I have more couples who decided to seek help and they are in under category 2 and 3. It’s highly encouraging for me to see this trend as younger couples are less affected by the stigma of seeking help.
In enhancing your relationship, what you can expect is the identification of possible conflict areas, assessment of your communication and conflict management skills, emotional regulation skills as well as the strength of your relationship. The former framework of therapy is based on looking at the problems and trying to fix them. What was missing is how to focus on what is good in the relationship and magnify and fortify those strength? This is equally important and it’s also more positive.
For ‘relationship recovery process’, the types of cases that I see include infidelity, being stuck in conflicts, poor emotional regulation which leads to avoidance of conflict and rebuilding trust and commitment.
There is a certain transition in life where relationship coaching or therapy is highly recommended. This is as follows:
Pre-marital: Before you make the lifelong commitment, you want to be ensured that your chances at staying married is as high as possible. You want to know what the non-negotiables are and learn skills that make the process of integrating your life smoother.
Transitioning to parenthood: While bringing a baby into a family is a happy occasion, it brings about a lot of stresses to the marriage. 2/3 or 67% of couples who transition to parenthood suffer a decline in their satisfaction of marriage. Help and support is available foryou to learn how you can mediate this and continue to keep the spark in the marriage alive.
Couples who have suffered child lost or have unsuccessful attempts at assisted reproduction.
Couples who are planning to adopt: You will want to know what are the expectations that you have of each other and what sort of rituals of connection you can establish so that you don’t lose sight of your own relationship.
When you have a child with special needs either physical, intellectual or mental: This additional stress could make or break the marriage and often times, couples place so much focus on the child that he/she ends up neglecting the partner. What you want to cultivate is the mindset “we against the world” rather than “I am alone in this marriage”.
Empty nest: There is an increase in marital break-ups at this stage because they have waited for their young children to grow up. The many years of emotional disconnection and busyness of life in caring for the children may have caused neglect to the marriage but it is possible to breathe a new lease of life to the marriage so that you can enjoy your golden years meaningfully.
Ultimately, relationship is hard work. You will need to consistently invest in it just like how you would a plant. You will need to Create an environment that’s conducive for the relationship to thrive; learn the skills that can help you connect better with your significant other and be intentional in what you want in the relationship.
So you are going to see a psychologist for the first time – now what should we expect? The thought of having to step into a psychologist’s room for the first time can be nerve-racking, and understandably so. Oftentimes, individuals may be apprehensive and would wonder if talking to a complete stranger is really going to help, or if opening up your innermost thoughts to a stranger was too much of a risk to take. However, rest be assured that these mental health professionals are well-versed in psychotherapy methods to help you manage your issues as best as possible, and will work closely with you at a comfortable pace. Just like in the treatment of physical illnesses by physicians, patient privacy and confidentiality are also primary obligations for psychologists. In this article, we hope to give you a clearer idea of what you can expect from your visit to a psychologist, especially if it is your first session.
First things first, it is important to understand that psychotherapy isn’t merely a one-off session. While the duration of treatment may vary from one person to another, the American Psychological Association (APA) reports that “recent research indicates that on average 15 to 20 sessions are required for 50 percent of patients to recover as indicated by self-reported symptom measures.” The type and duration of treatment also heavily depend on the nature and severity of each client’s conditions, and it would simply be unfair to make an overgeneralised statement. Regardless, it would be beneficial to go in with an open mind, and to have an honest conversation with your psychologist. It really helps to trust that the process works, while acknowledging that it takes time.
Meeting the psychologist
At the beginning, the first few sessions would aim to help one identify the most pertinent issue that needs to be dealt with. The psychologist will talk through with you gathering some information on your life history, your family’s mental health history, the problems you are dealing with, and analyse those details – no matter how insignificant they may seem at first – that could have possibly led to emotional distress or coping difficulties. For the psychologist, being able to get a good grasp of the situation and seeing the big picture is vital for formulating the treatment plan and treatment process, as it will help to determine the type of psychotherapy that is best suited for you. The psychologist is trained to listen and analyse your conditions in order to help you with your recovery. As such, it is equally important that you don’t hold yourself back from being fully honest with your psychologist. To a large extent, the patient’s participation in the therapy is an important determinant of the success of the outcome.
Goal-setting
While we fully understand that it can be unnerving, these mental health professionals are trained to help you work through the challenges you face, and the therapy room is very much a safe, non-judgemental space. Goal-setting is one of the key aspects of psychotherapy, and it is exceptionally important to set goals from the start that you can use to track your progress. You may start by identifying personally meaningful broad motives, hopes and dreams – having a clear direction in mind will better steer future sessions towards alleviating symptoms of distress and tackling the root cause of one’s concerns. Don’t worry if you feel the need to change your goals or take a different approach halfway through the treatment process. Psychotherapy is a dynamic process after all, and increased self-discovery along the way can certainly give you a better sense of what needs to be changed.
Different approaches to psychotherapy
There are several approaches to psychotherapy that can be implemented in the following sessions. Not strictly limited to one or the other, psychologists may make use of psychoanalysis and psychodynamic therapies, cognitive-behavioural, interpersonal, and other types of talk therapy. They can help you focus on changing problematic behaviours, feelings, and thoughts to build on healthy habits, or teach you emotion-coping strategies to cope with your symptoms. Forms of treatment like cognitive-behavioural therapy also aim to help individuals recognise negative thought and behaviour patterns, thereby working towards a positive change. Each session is essentially a problem-solving session. By allowing yourself to talk to your psychologist about your most difficult moments, your feelings and the change you want to observe, the psychologist is then able to make use of his/her expertise to assist you. Many mental health professionals don’t limit their treatment to any one approach. Instead, they blend elements from different approaches and tailor their treatment according to each patient’s needs.
‘Homework’
To make the most of the treatment process, “homework” may sometimes be assigned as between-session tasks to clients as part of your treatment. A variety of homework assignments exist – sometimes in the form of practising new skills, habits, and other coping mechanisms, or someone who is dealing with complicated emotions could be asked to record your negative thoughts in nightly journal entries. When you return for your next session, the psychologist would then check in on your progress, and address any issues that may have arisen while you were completing your tasks. For some clients the benefits of therapy can be achieved in a few sessions, while for other clients they might need more to improve. Empirical evidence supports the benefits of homework in promoting positive symptom change and increasing patient functioning, that is, the quality of a client’s participation in therapy through active application of what they learn will lead to improvements in their conditions.
Was the psychologist right for you?
Often during the conversation with the psychotherapist, or after the session, you may feel a sense of relief, elation, or anxiety and exhaustion. However you feel, it is important to take note of those feelings. Did the psychologist put you at ease? Did he/she listen to you carefully and demonstrate compassion? Did he/she develop a plan to guide you with your goals and show expertise and confidence in working with issues that you have? For the treatment to be effective, you need to be able to ‘click’ with the psychologist, that is you are able to build trust and a strong connection with your psychologist.
To end off, the first session with a psychologist is understandably a bit intimidating and overwhelming, but the first step in the journey to recovery is a critical step to regain your mental wellbeing.
Depression! It’s a common term for many things. “I feel depressed!”, “This is so depressing.” The medical definition of depression, however, takes a more definitive approach than just the typical expression of exasperation. If you display five or more of the above symptoms over a period of two weeks or if the symptoms cause clinically significant distress or impairment to normal functioning, there is a chance that you may be diagnosed with depression.
Is it that serious?
A study was done by IMH in partnership with MOH and NTU to find out about Singapore’s mental health. In Singapore, one in 16 people may have depression at some point in their lives. That is just one of the most common mental disorders in Singapore! The percentage of lifetime prevalence of depression has seen a steady increase from 12% in 2010 to 13.9% in 2016. What’s scary is that 3 out of 4 (78.4%) people with mental disorders are not seeking help!
To find out more about depression you can read our recent article: What Is Depression & How to seek help? So, what is CBT, and how does that help with depression? Glad you asked! Cognitive Behavioral Therapy, otherwise known as CBT, is considered the “gold standard” treatment for depression. It is a combination of cognitive and behavioral therapy that targets our limiting or unhelpful thoughts and behaviors which most of the time can be untrue to reality.
Normally the therapy takes 8-12 sessions where the patient and therapist work together to identify problem thoughts and behaviors. With that as a reference, the therapist will equip the patient with tools and techniques to change the way they think, feel or behave in the situation. The basis of this model is the assumption that a person’s thoughts, feelings, and behaviors are deeply connected. Thus, by actively taking part in changing the way we think or behave (which is honestly easier than changing our emotions), we can affect how we perceive certain situations that might have given us a hard time. Also, “homework” between these therapy sessions is useful to help practice the skills acquired during therapy.
That sounds complex and great but the big question is, does this work well for depression?
Well, over the last few decades there have been a plethora of studies to assess just how efficient CBT is. These studies have shown that CBT is not only effective but also produces solid results as a treatment not only for depression but also other mental illnesses! One study that has shown just how effective CBT would be is a study done by Hollon et al (2005). The study found that patients who underwent and withdrew from CBT were less likely to relapse than those who underwent and withdrew from medications. In another six studies, CBT combined with medications added a 61 lower relapse/ recurrence rate (Vittengl et al, 2009, in Otto, 2013).
To conclude, CBT is efficient and definitely better than not doing anything about our mental health. If you do want to seek help or learn more about CBT therapy, feel free to contact us.
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