Therapy

Dr. Hannah Roberts · May 23, 2024 ·

Graduating from Therapy – What to Expect

Learning to Thrive: A How-To Guide for Therapy

by Gavin Hannegan, Cal Poly, San Luis Obispo undergraduate intern, supervised by Dr. Hannah Roberts

Hello Thrivers! Welcome to the final installment of a three-part series called, “Learning to Thrive: A How-To Guide for Therapy.” This series will help you understand what to expect from the beginning and end of your therapy journey. Over the past few months, we’ve explored how therapy can be an effective self-care tool no matter what your needs are. Now, let’s put those discussions into context as we explore graduating from therapy.

Wait, graduating from therapy? Wouldn’t that be counterintuitive coming from therapists? After all, we even have a blog post dedicated to the evidence-based benefits of long-term therapy. But long-term therapy doesn’t mean that you have to see your therapist for the rest of your life. Graduating from therapy is a lot like graduating from college. It’s an achievement that not only captures how hard you’ve been working, but it also signifies that you’re ready to apply your new skills out in your day-to-day life. For today’s post, we will be answering the following questions about graduation in order to best support you in this process:

How Do I Know When it’s Time to Graduate?

Consider if you have met the goals that you and your therapist have developed since your first session. Maybe you’ve been able to properly process a traumatic event you experienced, or perhaps you’ve been able to consistently address new stressors in your life using healthier strategies. You may even feel like you can continue working towards your goals without the direct guidance of a therapist.

If you’re thinking about graduation, give yourself plenty of time to discuss with your therapist. Oftentimes, your therapist might be the one to initiate this conversation and propose the idea of graduation (Olivera et al., 2021). Like you would with any other therapy work, collaborate with your therapist to plan out what graduation from therapy will look like for you. This mutual agreement will both strengthen the therapeutic bond and improve the likelihood of a successful transition out of therapy (Olivera et al., 2021). These conversations may continue throughout a couple of sessions to ensure that both you and your therapist are comfortable and prepared for graduation.

What Will My Final Therapy Session Look Like?

The focus of this session is to create a sense of closure with your therapeutic relationship. Your therapist will give you the space to reflect on what you have achieved through therapy, be open about your feelings surrounding graduation from therapy, and to explore how you will maintain your mental health gains following therapy termination (Norcross et al., 2017). You can also talk with your therapist about your expectations and their boundaries regarding communication post-treatment. Due to ethical guidelines, this type of communication should be kept to a minimum. But your therapist may be okay with you reaching out if you ever need a brief check-in, you’re ready for another chapter, or if you would like a referral for you or someone else. Additionally, feel free to update your therapist on your progress post graduation; it’s a great feeling for therapists to know that their clients are doing well. And we’re always thinking of you! This session can be a bittersweet moment for you and your therapist, so feel what you need to feel. Although it may be sad to leave your therapist, try to walk away from this session with a sense of pride, because you deserve it.

How Can I Navigate Life Without Therapy?

Evidence-based therapy practices are designed for long-term success. Many of the therapy models that we offer here at Thrive have been found to support clients after their graduation from therapy. Here are some highlights from recent studies:

A meta-analysis of 69 clinical trials found that cognitive-behavioral therapy (CBT) consistently reduced symptoms of anxiety disorders up to a year after treatment (van Dis et al., 2019).
Through interviews, clients of dialectical behavior therapy (DBT) revealed that they have been able to navigate conflicts and build social connections more effectively in the years following graduation (Gillespie et al., 2022).
Compared to standard treatment from a healthcare provider, mindfulness-based cognitive therapy (MBCT) is significantly more successful in reducing the likelihood of relapse for depression symptoms (McCartney et al., 2020).
Another meta-analysis featuring clinical data from over 34,000 clients with depression reported that varying different therapies, including CBT and interpersonal therapy, all produced healthier outcomes within a year of graduation (Cuijpers et al., 2021).

Therapy provides you with the tools to navigate life, but you’ve always been in charge of using these tools. If you’ve been practicing these strategies in your everyday life already, then the transition out of therapy may not feel as jarring as you would think. Remember that your last few sessions will help you gain the confidence to make this transition. You and your therapist wouldn’t have discussed graduation if you both didn’t feel it was the right choice to make.

Is It Okay to Eventually Go Back to Therapy?

Yes, the door is always open! While you may not need a weekly session anymore, you can always schedule a check-in with your therapist when you need it. These sessions would be especially helpful for putting your therapy strategies into a new context, such as an unexpected crisis. You may also have a new development on a previous area of concern that you may want to discuss with your therapist. Keep in mind that at this phase in your therapy journey, your sessions will be more about the maintenance and fine-tuning of your mental health. The growth you experience may seem less pronounced compared to the first six weeks you started therapy, but you will continue to see improvements as you take care of yourself. (Wojnarowski et al., 2019). Your graduation might be the end of this particular therapy chapter, but continue to prioritize your own needs. Help is available whenever you need it.

For those of you who are graduating from therapy, congratulations on this accomplishment! Therapy can be intensive work, and your graduation from therapy is a testament to your perseverance and determination to show up for yourself. You may continue to face challenges in your everyday life, but your experience in therapy will leave you equipped to overcome those challenges. We hope this series played even just a small role in your self-care journey. Best of luck as you enter this new chapter, and we can’t wait to see you THRIVE!

Have more questions or feel ready to start therapy in California today? Schedule a session with one of our therapists! You can schedule online here!

We hope you enjoyed this blog post! Have more topics you’d like us to blog about? Contact us and we’ll be sure to include your topic in a future post.

References

Cuijpers, P., Quero, S., Noma, H., Ciharova, M., Miguel, C., Karyotaki, E., Cipriani, A., Cristea, I. A., & Furukawa, T. A. (2021). Psychotherapies for depression: a network meta-analysis covering efficacy, acceptability and long-term outcomes of all main treatment types. World Psychiatry, 20(2), 283-293. https://doi.org/10.1002/wps.20860

Gillespie, C., Murphy, M., Kells, M., & Flynn, D. (2022). Individuals who report having benefitted from dialectical behaviour therapy (DBT): a qualitative exploration of process and experiences at long-term follow-up. Borderline Personality Disorder and Emotion Dysregulation, 9(8), 1-14. https://doi.org/10.1186/s40479-022-00179-9

McCartney, M., Nevitt, S., Lloyd, A., Hill, R., White, R., & Duarte, R. (2020). Mindfulness-based cognitive therapy for prevention and time to depressive relapse: Systematic review and network meta-analysis. Acta Psychiatrica Scandinavica, 143(1), 6-21. https://doi.org/10.1111/acps.13242

Norcross, J. C., Zimmerman, B. E., Greenberg, R. P., & Swift, J. K. (2017). Do all therapists do that when saying goodbye? A study of commonalities in termination behaviors. Psychotherapy, 54(1), 66-75. http://dx.doi.org/10.1037/pst0000097

Olivera, J., Challú, L., Gómez Penedo, J. M., & Roussos, A. (2017). Client-therapist agreement in the termination process and its association with therapeutic relationship. Psychotherapy, 54(1), 88-101. http://dx.doi.org/10.1037/pst0000099

van Dis, E. A. M., van Veen, S. C., Hagenaars, M. A., Batelaan, N. M., Bockting, C. L. H., van den Heuvel, R. M., Cuijpers, P., & Engelhard, I. M. (2020). Long-term outcomes of cognitive behavioral therapy for anxiety-related disorders: A systematic review and meta-analysis. JAMA Psychiatry, 77(3), 265-273. http://dx.doi.org/10.1001/jamapsychiatry.2019.3986

Wojnarowski, C., Firth, N., Finegan, M., & Delgadillo, J. (2019). Predictors of depression relapse and recurrence after cognitive behavioural therapy: A systematic review and meta-analysis. Behavioural and Cognitive Psychotherapy, 47(5), 514-529. https://doi.org/10.1017/S1352465819000080

Dr. Hannah Roberts · May 16, 2024 ·

Your First Therapy Session – What to Expect

Learning to Thrive: A How-To Guide for Therapy

by Gavin Hannegan, Cal Poly, San Luis Obispo undergraduate intern, supervised by Dr. Hannah Roberts

Hello Thrivers! Welcome to the second installment of a three-part series called, “Learning to Thrive: A How-To Guide for Therapy.” This series will help you understand what to expect from the beginning and end of your therapy journey. Over the past few months, we’ve explored how therapy can be an effective self-care tool no matter what your needs are. Now, let’s put those discussions into context as we explore your first therapy session.

Your initial meeting with your therapist will help you feel more prepared for your subsequent therapy sessions. You’ll gain experience with the ~50 minute timeframe, begin building the therapeutic relationship, and start adjusting to your chosen setting. This can be exciting, but may feel a little intimidating too. You might not know what to say or you may even feel pressured to present yourself a certain way. Know that it is okay to not feel fully comfortable. On the flip side, don’t expect to be fully healed the moment you leave this first session. Remember, this is only the beginning of your journey. You have so much time to grow!

Overall, your first therapy session is:

A Chance for Your Therapist to Get to Know You

There’s no better place to talk about yourself than in therapy. Of course, your therapist wants to understand why you’re seeking out therapy. But more importantly, your therapist wants to establish a connection with you. Therapist-client bonding serves a few different purposes:

It demonstrates the therapist’s investment in the client and that they care about what the client has to say.
It helps build trust between both the therapist and the client.
It allows the therapist to be more attentive to the needs of that client, and the client to respond more positively to therapy (Vandenberghe et al., 2018).

Over time, the more open you are with your therapist, the better you and your therapist can tailor your self-care strategies to fit your individual needs. But at this stage of therapy, share what you feel comfortable sharing. You may not feel ready to fully disclose everything about an area of concern. And with only 50 minutes in this first session, you simply may not have enough time. Think of this session as the “getting to know you” stage of the relationship. The goal is to make sure that both you and your therapist would be comfortable working together.

An Opportunity to Learn More About Your Therapist

The field of therapy has moved past the idea that therapists are “unknowable,” or that there should be rigid boundaries between the therapist and the client. While the focus of the session should not be on the therapist, you are more than welcome to ask your therapist questions about themselves. This can make your therapist feel more relatable and approachable. For example, therapists that disclose their mental health status, to a moderate extent, are perceived more favorably by their clients compared to therapists who do not practice self-disclosure (McCormic et al., 2019). Believe it or not, your therapist is human, too, and they may have personal experience with the topics you bring up in your first therapy session, in addition to their clinical experience. If you’re curious about your therapist, and you believe the information will help you feel more comfortable, then ask!

A Safe Space to Express Your Emotions

Being open with your emotions is a skill. Some of you may have grown up in an environment where you felt like you had to hide your true emotions, or otherwise didn’t get the necessary practice to hone this skill. This may be new territory, but your first therapy session will help you navigate it. When discussing your area of concern, pay attention to the emotions that come up for you. Such sensations can range from a feeling of tension and restraint to feeling like you’ve released a floodgate of tears. It is okay for your emotions to feel messy. You and your therapist will work together to identify your emotions and understand where they are coming from. Once you can name these emotions, you can tame them. No matter which emotions arise, know that your feelings are valid. Learning to accept your emotions and thoughts can improve your psychological well-being. By asserting more control over your negative emotions specifically, you can better adapt to and overcome daily stressors (Ford et al., 2018). You’ll be provided with the tools to channel your emotions in healthy, productive ways. Having these vulnerable conversations may be the toughest part of your first therapy session, but they will also be the most rewarding.

A Place to Establish Your Goals for Therapy

Moving forward, what do you hope to achieve through therapy? You and your therapist can develop a personalized action plan to make your next sessions feel intentional and productive. Setting goals encourages you to stay committed to the therapeutic relationship; those who do not set goals are more at risk of ending the therapeutic relationship prematurely (Cairns et al., 2019). Goals make your progress in therapy tangible. They illustrate how far you’ve come, and how much farther you want to go. A lot of the work that goes into reaching these goals will be done on your own outside of therapy, but your first therapy session will prepare you for that work. When working with your therapist to develop goals, remember the acronym SMART: Specific, Measurable, Achievable, Realistic, and Timed (Cairns et al., 2019). Examples of effective SMART goals include:

“I will power down my phone at 9pm before I go to bed at 10pm each night.”
“This Saturday, I will sit down with my roommate after they get home from work and have an open dialogue about our responsibilities in the apartment.”
“When I feel stressed, I will take a minute to practice the box breathing technique.”

The types of goals you set will depend on your individual needs. And sometimes, there may be new topics you want to discuss with your therapist, so some goals may need to be delayed in favor of more pressing ones. There is no timeline for personal growth or healing. Work towards your self-care at your own pace. You have a whole therapy journey ahead of you.

Next week, we will discuss how to bring your therapeutic relationship to a close, and how to adjust to your day-to-day life after therapy. Enjoy your first therapy session!

Have more questions or feel ready to start therapy in California today? Schedule a session with one of our therapists! You can schedule online here!

We hope you enjoyed this blog post! Have more topics you’d like us to blog about? Contact us and we’ll be sure to include your topic in a future post.

References

Cairns, A. J., Kavanagh, D. J., Dark, F., & McPhail, S. M. (2019). Goal setting improves retention in youth mental health: a cross-sectional analysis. Child and Adolescent Psychiatry and Mental Health, 13(31), 1-8. https://doi.org/10.1186/s13034-019-0288-x

Ford, B. Q., Lam, P., John, O. P., & Mauss, I. B. (2018). The psychological health benefits of accepting negative emotions and thoughts: Laboratory, diary, and longitudinal evidence. Journal of Personality and Social Psychology, 115(6), 1075-1092. http://dx.doi.org/10.1037/pspp0000157

McCormic, R. W., Pomerantz, A. M., Ro, E., & Segrist, D. J. (2019). The “me too” decision: An analog study of therapist self-disclosure of psychological problems. Journal of Clinical Psychology, 75(4), 794-800. https://doi.org/10.1002/jclp.22736

Vandenberghe, L., Coppede, A. M., & Bittencourt, M. V. (2018). Building and handling therapeutic closeness in the therapist-client relationship in behavioral and cognitive psychotherapy. Journal of Contemporary Psychotherapy, 48, 215-223. https://doi.org/10.1007/s10879-018-9388-9

Dr. Hannah Roberts · May 9, 2024 ·

Starting Therapy – How to Prepare

Learning to Thrive: A How-To Guide for Therapy

by Gavin Hannegan, Cal Poly, San Luis Obispo undergraduate intern, supervised by Dr. Hannah Roberts

Hello Thrivers! Welcome to the first installment of a three-part series called, “Learning to Thrive: A How-To Guide for Therapy.” This series will help you understand what to expect as you are starting therapy and continue through the end of your therapy journey. Over the past few months, we’ve explored how therapy can be an effective self-care tool no matter what your needs are. Now, let’s put those discussions into context.

Even if you feel ready, starting therapy can still feel daunting, especially for the first time. If you’re asking yourself, “Where do I even start?”, this guide is for you! Our goal is to alleviate any uncertainties you may have about the initial contact with your chosen therapist. Here are a few recommendations to help make this process feel comfortable and accessible.

Set Aside a Weekly Time for Therapy

It’s helpful if you have an idea of when you would be willing and able to meet with a therapist. Therapy sessions tend to last about 50 minutes, but you may need to factor in additional amounts of time for commuting to and from the therapist’s office, for example. Additionally, to be fully present, give yourself a few minutes before and after the session to center yourself, identify your goals for the session, and reflect on what was discussed. Your sessions should be a consistent part of your schedule, but it shouldn’t become a burden. Unfortunately, a perceived lack of time tends to be one of the largest barriers for mental health treatment among college students, especially those from ethnic or racial minority backgrounds (Miranda et al., 2015). The good news is that the format of therapy can be flexible to meet your needs. You can meet with your therapist virtually, meet with an on-campus professional, or schedule a nature therapy appointment to combine therapy with movement outdoors. Weekend sessions are also an option if you have a full workload during the week. An agreed time between you and your therapist is one of the first steps in starting therapy and crafting the therapeutic relationship.

Select a Therapist That You Will Feel Comfortable Working With

Therapy is a space that allows you to be vulnerable and open about yourself, so it is important that you find someone who is capable of holding space for you. Your therapist does not have to come from the same background as you, but they should have the experience necessary to make you feel affirmed, heard, and supported. One way to gauge if a therapist is right for you is to read their bios. Click the “Meet Us” section to learn more about the team behind Thrive. Psychology Today is a great resource for finding therapists in SLO county, virtually in California, and all across the country. These bios will contain the therapist’s specializations (eating disorders, LGBTQ+ care, etc.), the format of their sessions (in-person or virtual), the cost of each session and how to pay for it, and their contact information. Feel free to reach out to a therapist if you have specific questions about their style and practices. And don’t be afraid to advocate for yourself as you’re starting therapy. Therapy clients see the greatest improvements in their mental health when both the therapist and the client believe in the strength of their relationship (Zilcha-Mano et al., 2017). Choose a therapist that you would be comfortable working with in order to build this strong relationship.

Consider How You Might Pay for Your Sessions

A common challenge in starting therapy is concerns about the cost (Miranda et al., 2015). In a study of over 12,000 adults with a mental illness, over 70% cited financial concerns for their lack of treatment, particularly among those with no health insurance (Walker et al., 2015). In SLO, the cost of a session usually ranges from $150-$250, which is what you can expect with your Thrive therapist as well. While money can be a sensitive subject, remember that therapy can accommodate your needs. Attending therapy sessions from home can reduce transportation costs. When reading the bios of different therapists, identify a price range that would fit well within your budget. Psychology Today lists the different payment methods that therapists accept, such as credit cards, Venmo, and cash. Each bio also lists which insurance each therapist can take. Some therapists may offer a sliding scale depending on your income. Remember, if you have a PPO insurance, you may be able to get some reimbursement for your sessions. And finally, colleges and universities may offer free or reduced-cost therapy sessions with on-campus treatment centers – Cal Poly’s Graduate Students offer low-cost services for all (you do NOT need to be a student) at the SLO Counseling Service at Cal Poly. There are a variety of options to help you afford your therapy sessions. Build your therapy into your budget so it doesn’t feel overwhelming.

Remind Yourself That You’re Deserving of This Care

The stigma against mental health is rampant and pervasive. When we start to internalize these messages, we become less likely to seek help for ourselves (Schnyder et al., 2017). Instead of listening to problematic messaging in society, surround yourself with uplifting voices. Think about the goals you hope to achieve through therapy and let that motivate you. Practice some daily affirmations such as, “I am worthy,” “I feel inspired,” or “I want to grow.” Share your concerns with a friend who would be happy to support you in this journey. Be open about these insecurities with your therapist so that you two can identify and work towards a solution. It may take time to build your self-worth, but that’s part of what therapy is for!

Feeling ready for starting therapy? Next week, we will identify what this initial session may look like, and discuss strategies to help you adjust to this new environment. We’re so excited to see where therapy takes you!

Have more questions or feel ready to start therapy in California today? Schedule a session with one of our therapists! You can schedule online here!

We hope you enjoyed this blog post! Have more topics you’d like us to blog about? Contact us and we’ll be sure to include your topic in a future post.

References

Miranda, R., Soffer, A., Polanco-Roman, L., Wheeler, A., & Moore, A. (2015). Mental health treatment barriers among racial/ethnic minority versus white young adults 6 months after intake at a college counseling center. Journal of American College Health, 63(5), 291-298. https://doi.org/10.1080/07448481.2015.1015024

Schnyder, N., Panczak, R., Groth, N., & Schultze-Lutter, F. (2017). Association between mental health-related stigma and active help-seeking: systematic review and meta-analysis. The British Journal of Psychiatry, 210(4), 261-268. https://doi.org/10.1192/bjp.bp.116.189464

Walker, E. R., Cummings, J. R., Hockenberry, J. M., & Druss, B. G. (2015). Insurance status, use of mental health care in the United States. Psychiatric Services, 66(6), 578-584. https://doi.org/10.1176/appi.ps.201400248

Zilcha-Mano, S., Snyder, J., & Silberschatz, G. (2017). The effect of congruence in patient and therapist alliance on patient’s symptomatic levels. Psychotherapy Research, 27(3), 371-380. http://dx.doi.org/10.1080/10503307.2015.1126682

Dr. Hannah Roberts · April 4, 2024 ·

Accessing Therapy Beyond Crisis Situations

“When we are no longer able to change a situation,

we are challenged to change ourselves.”

~Viktor E. Frankl

by Gavin Hannegan, Cal Poly, San Luis Obispo undergraduate intern, supervised by Dr. Hannah Roberts

There’s a misconception that therapy should be complete once you start “feeling better.” It’s important to recognize your progress, but there shouldn’t be a deadline to feel your best. Mental health is complex, and oftentimes, your progress doesn’t follow a linear fashion. One week, you might feel stable and secure, and then the next week, you might feel like you fell a few steps back. Don’t worry, these ups and downs are perfectly normal. But what if you’ve been “feeling better” for months, or even years? Or, what if you’ve never had a mental health crisis? Therapy can still be a valuable resource! No matter your background or previous experiences, you are deserving of this kind of care.

Here are 3 reasons for considering therapy beyond the context of a crisis:

#1: The Brain Doesn’t Function Properly While Under Distress

Chronic stress can make your body feel like it is in a never-ending fight-or-flight state. This is because of how chronic stress delays two important parts of the brain: the prefrontal cortex and the neurotransmitter GABA. The prefrontal cortex is responsible for processes such as cognitive planning and self-regulation, while GABA produces a calming effect meant to counteract stress. Because of these delays, traumas or other ongoing adversities can impair daily functioning. For example, those who experience such stressors have significant declines in working memory, a component of short-term memory that allows you to actively process information. As we age, our working memory skills decrease naturally, but chronic stress accelerates this process (Gandy et al., 2024). COVID-19 has contributed to global increases in chronic stress, which has subsequently produced similar accelerated aging effects in adolescents (Gotlib et al., 2022). Our bodies are not equipped to handle such extreme amounts of stress in small amounts of time, which can increase the risk of cognitive and health-related deficits.

Therapy can help us navigate these stressors by providing coping strategies. However, deficits in working memory impair the learning of these strategies, and delays in the prefrontal cortex and the firing of GABA impair the proper use of these strategies. This is not to say that therapy wouldn’t be helpful to someone actively experiencing a crisis. Rather, you don’t need a crisis to justify therapy. In fact, you might be more receptive to these strategies if they are learned before a crisis emerges.

#2: Therapy Can Be a Protective Measure Against Future Mental Health Crises

It’s never too early to consider therapy. We may not be able to predict when we will encounter another crisis, but we can take action to better prepare ourselves for one. This doesn’t mean that you need to be in therapy for the rest of your life. But attending therapy even when you feel stable can help you maintain that stability over time. One way that therapy operates as a maintenance tool is by teaching skills such as mindfulness, which can help reduce symptoms of anxiety and depression (Eilert et al., 2021). Your therapist can work with you to develop mindfulness strategies that fit best for you. These can include daily affirmations, breathing exercises, or meditations. Additionally, compared to brief forms of therapy (~6 months), long-term therapy, which we often prefer at Thrive SLO (~3 years), is slightly more effective in reducing depressive symptoms and improving daily functioning (Knekt et al., 2016). For some individuals, short-term therapy may not be enough time to implement maintenance strategies and measure their effects, especially for those who are only focused on overcoming a chronic stressor. There isn’t necessarily an ideal length of therapy; it depends on the goals that you set with your therapist. You might have multiple short-term goals (e.g., wanting to be social at an upcoming party) or one overarching goal (e.g., adjusting to daily life after an unexpected loss). Each step you take towards reaching these goals can have a strong positive impact on your well-being, and the lessons you learn can be applied to new goals or concerns.

#3: Long-term Therapy Gives You More Time to Build an Alliance With Your Therapist

Another valuable aspect of therapy is that you have someone to talk to who knows you well. Someone who is unbiased, who recognizes your potential, and who encourages your personal growth. In one meta-analysis that reviewed over 30,000 therapy clients, the relationships those clients had with their therapists were consistently associated with positive outcomes such as symptom reduction (Flückiger et al., 2018). Your therapist can be a consistent form of support. Even having one such person in your life can make a difference.

As with many other kinds of relationships, though, it can take some time for you and your therapist to form a close bond. You may be hesitant to be vulnerable to a new person in your life, while your therapist has to adapt to your level of comfort with certain topics or situations. If you’re experiencing a crisis, then your typical responses to these topics may be exaggerated or distorted. You could be more on edge, less willing to disclose personal information, or you could be more likely to think irrationally. As a result, there could be misinterpretations between the two of you that can threaten the therapeutic alliance. By spending more time with your therapist, they will have more opportunities to learn about who you are outside the context of a crisis situation. Remember that crises are temporary, and the skills you develop with your therapist can help protect you not just against the crisis you’re currently facing, but also against many other future challenges. There is no concern too small for therapy.

Have more questions or feel like you need supportive therapy? Schedule a session with one of our therapists today! You can schedule online here!

We hope you enjoyed this blog post! Have more topics you’d like us to blog about? Contact us and we’ll be sure to include your topic in a future post!

References

Eilert, N., Wogan, R., Adegoke, A., Earley, C., Duffy, D., Enrique, A., Palacios, J., Timulak, L., & Richards, D. (2023). The relationship between posttherapeutic cognitive behavior therapy skills usage and follow-up outcomes of internet-delivered cognitive behavior therapy. Journal of Clinical Psychology, 79(1), 55-67. https://doi.org/10.1002/jclp.23403

Flückiger, C., Del Re, A. C., Wampold, B. E., & Horvath, A. O. (2018). The alliance in adult psychotherapy: A meta-analytic synthesis. Psychotherapy, 55(4), 316-340. https://doi.org/10.1037/pst0000172

Gandy, H. M., Holis, F., Hernandez, C. M., & McQuail, J. (2024). Aging or chronic stress impairs working memory and modules GABA and glutamate gene expression in prelimbic cortex. Frontiers in Aging Neuroscience, 15. https://doi.org/10.3389/fnagi.2023.1306496

Gotlib, I. H., Miller, J. G., Borchers, L. R., Coury, S. M., Costello, L. A., Garcia, J. M., & Ho, T. C. (2023). Effects of the COVID-19 pandemic on mental health and brain maturation in adolescents: Implications for analyzing longitudinal data. Biological Psychiatry Global Open Science, 3(4), 912-918. https://doi.org/10.1016/j.bpsgos.2022.11.002

Knekt, P., Virtala, E., Härkänen, T., Vaarama, M., Lehtonen, J., & Lindfors, O. (2016). The outcome of short- and long-term psychotherapy 10 years after start of treatment. Psychological Medicine, 46(6), 1175-1188. https://doi.org/10.1017/S0033291715002718

Dr. Hannah Roberts · March 28, 2024 ·

Why Therapy Is Important for College Students

“Anything that’s human is mentionable, and anything that is mentionable can be more manageable.

When we can talk about our feelings, they become less overwhelming, less upsetting, and less scary.”

~Fred Rogers

by Gavin Hannegan, Cal Poly, San Luis Obispo undergraduate intern, supervised by Dr. Hannah Roberts

College life is exhilarating! You’re able to explore your passions and fine-tune what you want your career to look like. It’s a chance for new connections, new experiences, and newfound freedom. Sometimes, all of these new opportunities can feel overwhelming. They may create struggles or exacerbate those that were already present. Juggling everything that college life has to offer can be challenging, but you can always ask for help when you need it! Therapy can be a great resource to help you navigate this chapter of your life. For those who might be unfamiliar with therapy for college students, we wanted to address a few common concerns about therapy to help you feel more comfortable.

Why Would I Need Therapy?

The responsibilities of a college student can feel demanding. On top of academic obligations, you also may have to adjust to living away from home and paying for your own needs. Each of these factors have been linked to increases in depression, anxiety, and stress among college students. Certain types of college students are more likely to experience these increases, such as juniors who are not provided with as much school-based support as first-years or seniors (Beiter et al., 2015). Current students also had to transition from high school to college during the COVID-19 pandemic, a time period that substantially worsened students’ mental health concerns (Lee et al., 2021). Having such high levels of stress or anxiety can impair your ability to fulfill your duties as a college student. One study found that students with ongoing mental health problems saw a decrease in their GPA compared to those without these problems (Bruffaerts et al., 2018). When left untreated, mental health concerns can amplify the already stressful roles that college students have to fulfill. Therapy can provide you with tools to manage these responsibilities, while also offering self-care strategies to address the stress in life. For those of you who feel like they don’t need therapy yet, consider that therapy can also be a way to help you prepare against future stressful events.

Does therapy really work?

Yes, but it depends on the type of therapy you’re participating in and the strength of your relationship with your therapist. When thinking about scheduling an appointment with a new therapist, it is important to make sure that their practices are evidence-based. Examples of evidence-based therapy for college students at Thrive San Luis Obispo include:

Interpersonal Therapy
Dialectical Behavior Therapy (DBT)
Gestalt Therapy
Cognitive Behavioral Therapy (CBT)
Mindfulness-Based Interventions
Behavioral Activation

Therapies that are supported through research tend to be more reliable than other types of clinical treatment. When participating in these treatments, many college students experience at least moderate reductions in symptoms of trauma, depression, or anxiety (Huang et al., 2018; McIndoo et al., 2016). Each of the Thrive SLO Therapists gives you a sense of the types of treatment they use on their profile in the Meet Us section. You can also email or talk to a therapist directly if you’re still unsure.

Successful therapy also requires active participation from both you and the therapist. This means that a therapist won’t necessarily tell you what to do, but will rather work with you to develop strategies that best fit your individual needs and level of comfort. Forming this relationship may take some time, and your ideal relationship may not be with the first therapist you meet with. Once this relationship is established, your therapist can help you feel satisfied with your treatment (McIndoo et al., 2016). Instead of asking, “What’s wrong with me?”, therapy often helps you answer the question of “How can I become my best self?”

I’m Nervous About Starting Therapy

That’s okay! You are not alone in your feelings. If you have some reservations about seeing a therapist, it could be helpful to reflect on where these feelings are coming from. Globally, college students underutilize forms of mental health treatment, with one study reporting that nearly 75% of college students would not use these resources even if they were experiencing clinical symptoms of depression or anxiety. Some of the most common reasons for not wanting to go to therapy include the desire to fix problems on one’s own and feeling embarrassed about therapy (Ebert et al., 2019). The stigma surrounding therapy for college students can feel intimidating, but know that you are still deserving of this care. You can address these feelings in the following ways:

Take a screening test to more accurately identify the next steps towards treatment.
Feel free to keep your relationship with therapy private for as long as you need.
Be honest with your therapist about your fears regarding therapy.

Allow yourself to feel what you need to feel at first. Know that your therapist is here to help you, and here at Thrive SLO, we specialize in working with college students. All of our therapists they have worked with hundreds of other college students who have experienced similar concerns. These nerves are healthy. Even considering therapy shows that you care about your well-being. Therapy doesn’t define your college experience; it helps you enjoy it.

Have more questions or feel like you need supportive therapy as a college or university student? Schedule a session with one of our therapists today! You can schedule online here!

We hope you enjoyed this blog post! Have more topics you’d like us to blog about? Contact us and we’ll be sure to include your topic in a future post!

References

Beiter, R., Nash, R., McCrady, M., Rhoades, D., Linscomb, M., Clarahan, M., & Sammut, S. (2015). The prevalence and correlates of depression, anxiety, and stress in a sample of college students. Journal of Affective Disorders, 173, 90-96. http://dx.doi.org/10.1016/j.jad.2014.10.054

Bruffaerts, R., Mortier, P., Kiekens, G., Auerback, R. P., Cuijpers, P., Demyttenaere, K., Green, J. G., Nock, M. K., & Kessler, R. C. (2018). Mental health problems in college freshmen: Prevalence and academic functioning. Journal of Affective Disorders, 225, 97-103. http://dx.doi.org/10.1016/j.jad.2017.07.044

Ebert, D. D., Mortier, P., Kaehlke, F., Bruffaerts, R., Baumeister, H., Auerback, R. P., Alonso, J., Vilagut, G., Martínez, K. U., Lochner, C., Cuijpers, P., Kuechler, A. M., Green, J., Hasking, P., Lapsley, C., Sampson, N. A., & Kessler, R. C. (2019). Barriers of mental health treatment utilization among first-year college students: First cross-national results from the WHO World Mental Health International College Student Initiative. International Journal of Methods in Psychiatric Research, 28(2), 1-14. https://doi.org/10.1002/mpr.1782

Huang, J., Nigatu, Y. T., Smail-Crevier, R., Zhang, X., & Wang, J. (2018). Interventions for common mental health problems among university and college students: A systematic review and meta-analysis of randomized controlled trials. Journal of Psychiatric Research, 107, 1-10. https://doi.org/10.1016/j.jpsychires.2018.09.018

Lee, J., Jeong, H. J., & Kim, S. (2021). Stress, anxiety, and depression among undergraduate students during the COVID-19 pandemic and their use of mental health services. Innovative Higher Education, 46, 519-538. https://doi.org/10.1007/s10755-021-09552-y

McIndoo, C. C., File, A. A., Preddy, T., Clark, C. G., Hopko, D. R. (2016). Mindfulness-based therapy and behavioral activation: A randomized controlled trial with depressed college students. Behaviour Research and Therapy, 77, 118-128. http://dx.doi.org/10.1016/j.brat.2015.12.012