The ABC’s of Mental Health

Most people need some type of counseling or mental health support at some time in their life. Common emotional/psychological problems range from stress-related health symptoms, to relationship issues, grief & loss, anxiety, and depression. Many people have problems with substance abuse or other compulsive behaviors (e.g., with food, spending, “workaholism”) that can be defeated only with professional help. Finally, there are chronic mental illnesses such as schizophrenia and bipolar disorder (manic-depression) that often cause serious impairment if left untreated.

So where to begin? It can be difficult to choose from among many types of treatment and mental health professionals of various backgrounds. So here is a summary….

Mainstream treatment options include:

Counseling offers support, help with problem-solving or decision-making, and an opportunity to learn better coping strategies. Counseling is usually focused on a specific problem area, for example, employee assistance, grief and loss, substance abuse, marital/couples issues or health concerns (e.g., reproductive health, managing heart disease).

Psychotherapy lets you take a more in-depth look at emotional/psychological issues, especially if you have longstanding or recurring problems in one or more major life area (e.g., relationships, career). Therapy can help you move beyond unresolved traumas or losses from childhood, understand psychological defenses that are keeping you “stuck”, and change unhealthy patterns of relating with others.

Both counseling and psychotherapy can be conducted individually or in small groups.

Crisis Counseling services are geared toward people in serious distress who need immediate help. The main goals of crisis counseling are to provide support, stabilize the person(s) in crisis, and help deploy appropriate community resources (e.g., psychiatric evaluation, police response, social services). Crisis counseling can be provided over telephone hotlines, or in person through free-standing crisis centers or hospital emergency rooms. Some crisis counseling services are focused on specific issues like suicide prevention or domestic violence/sexual assault.

Self-Help Programs are focused on providing information, support and help coping with defined issues like substance abuse and other compulsive behaviors; chronic illness; and relationship and family problems. A good example is Alcoholics Anonymous (AA), which is centered around twelve emotional and spiritual “steps ofrecovery”. AA has offshoots for friends & family members of alcoholics (Al-Anon) and for children & adolescents from alcoholic families (Ala-Teen).

Psychopharmacological Treatment refers to medication for psychological or psychiatric symptoms, including anxiety or depression. A psychiatrist or sometimes a primary care physician can evaluate the need for medication, particularly if you have problems with sleep or appetite that do not improve after a few weeks; low motivation/ energy or poor concentration that makes it hard to meet your normal responsibilities; extreme sadness or mood swings; explosive anger; or severe anxiety or “panic attacks”. Psychopharmacological treatment is also a crucial component of managing persistent mental illnesses, including thought disorders and some mood disorders.

Hospital-Based Treatment is available for people who need intensive mental health or substance abuse assistance and some degree of medical monitoring. Treatment can be inpatient or outpatient (also referred to as “day treatment”). Hospitalization is sometimes needed for severe depressive or manic symptoms, especially if the person is suicidal, and for psychotic symptoms including hallucinations or delusions. Also, it can be a crucial phase of treatment for drug/alcohol addictions or severe eating disorders. Patients are typically treated with medication, group counseling, and a range of activity therapies (e.g., art therapy, music therapy, movement therapy).

Types of mental health professionals include:

Psychologists have a doctorate (sometimes a master’s degree) in clinical, counseling or school psychology. Psychologists usually offer some combination of counseling, psychotherapy and assessment (psychological, educational, vocational).

Clinical Social Workers have a master’s degree or a doctorate in social work. Social workers usually offer some combination of counseling, psychotherapy, and case management.

Professional Counselors have a master’s degree or a doctorate in counseling, usually affiliated with the field of education. Counselors usually offer some combination of counseling, psychotherapy, assessment (behavioral health, educational, or vocational).

Pastoral Counselors have education and experience in counseling, along with their divinity training. Pastoral counselors usually offer some combination of counseling, spiritual guidance and possibly case management.

Psychiatrists are medical doctors (MD’s) who have specialized training in the treatment of psychological/psychiatric illness and biological conditions of the brain. Psychiatrists can prescribe psychotropic medication and provide some combination of medical/neurological assessment, counseling, psychotherapy, and case management.