May 25, 2010

Dr. Katherine Nordal on How Therapy Helps Treat Mental Health Disorders

Questions for psychologist Katherine C. Nordal, PhD, about the benefits of therapy in treating mental health disorders.

Reporters/editors/producers Note: The following feature was produced by the American Psychological Association. Feel free to use it in its entirety or in part; we only request that you credit APA as the source. We also have a photograph of Dr. Nordal available to reprint.

May is Mental Health Awareness Month. Approximately one in four American adults has a diagnosable mental disorder in any given year and about 6 percent of American adults suffer from serious mental illness, a ccording to the National Institute of Mental Health . Many Americans do not receive treatment. We spoke with Dr. Katherine Nordal, APA’s executive director for professional practice, about the benefits of therapy in treating mental health disorders. This is the third in a four-part series in recognition of Mental Health Awareness Month. The fourth and final piece covers mental health and insurance.

Katherine C. Nordal, PhD, is a licensed psychologist experienced in treating adults, children and adolescents and has clinical expertise in the treatment of stress-related disorders. As executive director for the APA’s Practice Directorate, Dr. Nordal manages a wide range of APA activities, including legislative advocacy, legal initiatives, and nationwide public education campaigns, including the Mind/Body Health Campaign. Dr. Nordal is a recipient of the APA’s Karl F. Heiser Presidential Award for advocacy on behalf of psychology. She was an APA/AAAS Congressional Science Fellow (1990-91) who served as a legislative assistant in the U.S. House of Representatives and with the House Select Committee on Hunger. Her clinical interests included: learning, behavioral and emotional disorders in children and adolescents; neuropsychological assessment; brain injury in children and adults; and civil forensic psychology.

What can a patient expect at his or her first therapy appointment? How will therapy help a patient in everyday life?

Therapy is a collaborative process involving you and your psychologist, who can help you figure out the best approach to handling your problems. It is important that you have confidence in your therapist and believe in his or her approach. It may take some time to fully understand your psychotherapist’s recommendations so do not hesitate to ask questions.

The first step is to identify the problem. For example, you may feel angry or frustrated but can’t easily pinpoint the cause. A psychologist will help to determine the best way to address your issues. Treatment will be based on current scientific research, the psychologist’s theoretical orientation, and your culture, values, and preferences.

Your psychologist may recommend a more hands-on approach to treatment such as cognitive behavioral therapy or behavior modification. These treatment methods often involve homework or specific tasks designed to help you develop more effective coping skills. In other approaches such as psychodynamic, humanistic or psychoanalytic therapy, you may talk about your early experiences to provide a better understanding of the root causes of problems that are affecting you now.

How long does it take for therapy to help?

Most people find some benefit from therapy after just a few sessions and many people feel some relief in the first session. For example, anxiety is relieved because therapy brings with it some hope and a better understanding of how things may change. The therapist may offer explanation or insight in that very first session that the client has been unable to understand on his or her own. However, for some people it takes longer to experience any benefits. So, it’s important to give some time to the therapy process.

Specific problems can often be resolved in a relatively brief number of sessions – even as few as two or three. But even if the problem isn’t resolved immediately, many people feel confident within a few sessions that changes have been made and they are making progress.

In some cases, the course of therapy will be longer. For example, people with very severe trauma histories can take a long time to feel the trust necessary to move forward with the painful work of dealing with their trauma and the problems it has caused them.

Or, for some others, benefits may continue to accrue after the initial problem is solved because they continue to experience new insights, better functioning and improved well being from continued therapy.

And finally, for people with serious mental illness, therapy can provide the regular support needed to maintain a satisfactory level of day-to-day functioning.

In most health settings, patients return to their health care professional at multiple times during their lifetime. Mental health is no different. It is okay to go back to your therapist at different points in your life for a booster session or additional course of treatment to help address other problems that have arisen. You don’t have to wait until you are in crisis.

Is there a place for prescription drugs alongside therapy?

If the individual is continuing to function relatively well, can attend work or school and have relationships with family and friends, therapy alone can be very effective. However, there is a role for medication in treating mental health disorders. Medication can sometimes be necessary for a patient in crisis to get to the point where he or she is able to engage in therapy. It can also help those with serious mental health disorders – but in most cases medications are necessary for only a circumscribed period of time and should not be relied upon indefinitely.

But what is important to remember is that medications do not help you develop the strategies necessary for dealing with life’s problems. Once medications are discontinued, the problems often still remain – or may return. Therapy will teach you new strategies and problem-solving skills that will help you better address future problems that arise in your life.

The American Psychological Association, in Washington, DC, is the largest scientific and professional organization representing psychology in the United States and is the world's largest association of psychologists. APA's membership includes more than 152,000 researchers, educators, clinicians, consultants and students. Through its divisions in 54 subfields of psychology and affiliations with 60 state, territorial and Canadian provincial associations, APA works to advance psychology as a science, as a profession and as a means of promoting human welfare.