Mental Health Professionals: What Can You Expect? ; When is Mental Help Vital? ; Sessions Can Make Difference

              Mental health professionals: what can you expect?
In the stereotypical therapy session, the pa-tient
plops down on the couch and the doctor
asks him about his childhood.
In reality, the therapist's office may not even
have a couch.
What should you expect when you seek help
from a mental health professional?
The first thing you will probably be asked is
"Why are you here?" That may be followed
with "How did this situation develop?"
Next may come questions about basic demo-graphic
information.
When is
mental
help
vital?
At points the session will be more conversa-tional,
but the patient may talk about things he
would not talk about with friends.
Warren Lowe, a local psychologist and
chairman of the professional affairs committee
of the Louisiana Psychological Association,
said he asks patients about the circumstances
under which the problem occurs and previous
treatment of the problem.
A normal session will be about 50 minutes,
according to local professionals. The number of
times a week that a person goes to therapy will
depend on the individual, the type of therapy
and the therapist.
The actual form a therapist's help takes also
varies. While some professionals may make
explicit suggestions, others may act as a guide
as they strive to help their client solve his own
problems.
In general, Lowe said, the trend is for
therapists to be more directive and more in-volved
in the therapy.
Lowe, for example, may assign a patient
homework. If a person is depressed and
withdrawn, he may be asked to read a specific
piece on depression and keep a daily log of his
activities. Lowe may then go over the log,
emphasizing the activities that gave the patient
pleasure.
A patient may also be given specialized tests
during early sessions to test such things as his
intelligence quotient.
Lowe also believes a patient should ask
questions during the initial session. For exam-ple,
fees and the therapist's cancellation
policies should be discussed.
March 24 1981
By JUDY PACE
Of The Times Staff
You've been depressed for months. You can't
seem to get your work done any more. It's been
weeks since you've had a good night's sleep, and
you've dropped more than 20 pounds.
According to local experts, you should con-sider
professional psychotherapy.
However, suppose your symptoms are not so
severe.
How do you know when to seek help from a
mental health professional? How much will it
cost you? How can you pick the professional
who is right for you?
In an effort to answer these questions, The
Times interviewed a variety of local experts.
They agreed that a person should seek help
when he has trouble functioning in his day-to-day
life. __
Dr. John Brauchi, head of
the d e p a r t m e n t of
psychiatry at Louisiana
State University School of
Medicine in Shrevepdrt,
said depression is the most
frequent symptom that
[ brings a patient in.
Others may include
I weight loss, a slowing down
Brauchi of activities and interests,
an inability to concentrate, job dissatisfaction
or an inability to sleep.
Those interviewed emphasized, though, that
the symptoms which cause a person to seek help
vary. They also stressed that every symptom
does not concern everyone. Just because a
person is unhappy with his job, for example,
does not necessarily mean he needs
psychotherapy.
Anxiety may be a symptom which brings
people to psychotherapy.
Brauchi and Ronald
Nathan, Ph.D., head of the
division of medical
psychology in the depart-ment
of psychiatry, said
that everyone has some
anxiety, which can be
useful in life.
People have a coping
range, they said, which they I
may go outside of on oc- Nathan
casion. However, a person who is always out-side
his coping range is chronically anxious and
could use therapy.
Anxiety, Brauchi said, is an undefinable
sense of impending doom.
The men said a person may wish to seek help
from a mental health professional if he has
chronic self-defeating behavior, is not able to
form close relationships or makes frequent job
changes.
"The patient is frequently the elected
representative of an unhealthy family,"
Brauchi said.
A person may also want to consider therapy
if he feels life is not fulfilling, according to
Nathan.
For example, a person may feel trapped in a
role he or she did not expect, such as the bored
housewife. While some people may be content
to continue their life feeling unfulfilled, others
may want to try to change it.
Psychotherapy can help people try out new
ways of living, according to Nathan.
Physical symptoms may often accompany
other symptoms, Brauchi said. Tension
headaches, for example, are among the most
frequent.
He said that many times potential
psychotherapy patients will see a family doctor
with physical symptoms.
Symptoms may shift around the body, he
said, from complaint of a heart attack to
diarrhea to headaches as the person plays out
his anxiety.
"You can chase it all over the body," he said.
Dr. Erie Harris Jr., who
works with Area'
Psychiatric-Psychological
Associated Services, said
many times problems de-velop
with predictable
changes in life.
For example, young
adults who are getting out
into the world may have
t career and job problems or
problems completing their
^dependence. Middle-aged people may ex-
Yrience problems when they no longer have
|ldren to care for. Older people may have
yible coping with their age.
Harris
Those interviewed agreed that the stigma
attached to mental health care has lessened as
people become more educated about the sub-ject.
However, some people still fear others will
think they are crazy if they seek help and would
rather blame their problems on someone else.
When a person decides to seek professional
help, he is faced with a variety of choices. He
must decide whether he wishes to see a
psychiatrist, a psychologist or a social worker
and who the professional will be.
Those interviewed said most patients come
to them through the recommendation of a
family doctor, friend or minister.
A psychiatrist is a medical doctor who has
specialized in psychiatry. He can prescribe
medicine.
A psychologist has done undergraduate work
and received a doctorate degree from an ac-credited
university. In Louisiana, he must have
a license to practice as a psychologist.
Other mental health professionals include
social workers and psychiatric nurses.
The ethical psychiatrist, psychologist or
social worker will be interested in making sure
that the best qualified person takes care of the
patient, those interviewed said. Therefore, they
will refer the person to the proper professional
for treatment, if they cannot provide it.
Warren Lowe, Ph.D., a local psychologist, is
chairman of the Professional Affairs Commit-tee
of the Louisiana Psychological Association.
Lowe recommended that patients use a
licensed professional, whether it be a
psychiatrist, psychologist or social worker.
Such licensing requires scrutiny by pro-fessional
committees, and patients have an
Lowe
avenue to complain if they are dissatisfied with
the service they received.
As a consumer, Lowe
said, a patient can com-plain,
for example, if he
thinks he was charged un-reasonably.
In many cases a clinic I
will include a variety of
support personnel. A pa-tient
may see a psychiatrist
at first and then go into'
group therapy led by a
social worker, for example.
Harris, whose clinic offers diversified
services, said such series are being offered
more and more now. A professional may see the
family as a group, he said. The parents may
then be directed to a social worker for informa-tion
on parenting, and the child may receive
help with learning difficulties.
The type of treatment a patient receives is a
clinical judgment based on the individual's
needs.
* If a person's condition requires medication, a
psychiatrist is the mental health professional
he needs to see.
Depression, for example, may be treated
with a mild drug. "Depression is like a financial
depression and occurs when people stop invest-ing"
in such things as hobbies, their job, church
or relationships, Brauchi said.
Drugs may be needed to make the person feel
like investing in life again, helping him explore
what caused his problems in the beginning, he
said.
The cost of therapy depends on the type of
A patient may also be interested in the access
he will have to his therapist during non-office
hours.
He may want to know about the therapist's
background: Is he licensed? Where was he
trained? Has he had experience treating pro-blems
similar to his current patient's?
The patient has the right to be informed of
any side effects or limitations of a type of
therapy, Lowe said. He also has a guarantee
that the therapist will not reveal any informa-tion
from the sessions, or even the fact that he is
in psychotherapy, without the patient's consent.
therapy and the professional.
Estimates of the price for a session with a
local psychiatrist range from $40 to $90 an
hour, with the average at about $60. The cost
for a session with a psychologist is approx-imately
the same.
Group therapy is cheaper, and generally
ranges from about $20 to $35 a session.
Patients who cancel appointments may be
subject to charge, depending on the rules of the
person they are seeing. Some professionals, for
example, require 24 hours notice of cancella-tion.
For those who cannot afford therapy at a
private clinic, other help is available. The
Shreveport Mental Health Center at 1310 N.
Hearne and Family Counseling and Children's
Services at 864 Olive offer therapy at a price
based on the patient's income.
At the Mental Health Center, prices range
from $1 to $23.50 for a 45-minute session.
The facility is funded by the state, and its
staff includes psychiatrists, psychologists,
social workers, nurses and occupational
therapists. It has an active caseload of 3,500.
The center is open to anyone, and patients do
not have to be referred there. "If a person is
experiencing a problem in their everyday liv-ing,
they can just pick up the phone," said
administrator Beverly Stuckey.
People who come to the center complete an
application and are sent to the proper pro-fessional.
Family Counseling Services,-a United Way
Agency, provides therapy from master social
workers. The fee is from nothing to $30 an hour.
Sessions
can make
difference
They made fun of her, told her she was stupid,
and made her mad.
They were eager listeners and a built-in set of
friends.
That is how one woman who sought
psychological counseling described the people
she came into contact with during group
therapy.
The woman, who asked jiot to be named,
spent about two years in therapy after her
marriage broke up. She praises the difference
the sessions made in her life.
Before her divorce, she and her husband also
saw a psychiatrist in private sessions.
The doctor was recommended by a family
friend and seemed to be the only alternative at
the time, she said.
When she and her husband split up, the doctor
put each of them into separate groups.
She admits she was dubious at first. "You
think, 'I'll go, and I'll listen, but I'm not going to
get involved.'"
However, it did not take long for that to
change. Soon she was talking to the group
regularly, eager for suggestions.
"I wanted somebody to listen," she said.
"Here you have an audience of people who are
willing to listen and help if they can."
A new perspective
The sessions, she said, also helped put her
own problems into perspective.' "I thought my
problem was bigger than anything in the whole
world," she said. "Then you get to listening to
problems other people have and yours become
kind of minor."
When you say your problem out loud, she
said, you get feedback. The way your group
members see it may be so different from the
way you see it.
Included in the sessions were two social
workers who served as leaders. Although the
leaders rarely gave a direct answer, she said,
they asked questions and helped make mem-bers
think. "They sort of keep you on the right
track and don't let you get off the subject."
The sessions were considerably cheaper than
the private meetings with the psychiatrist.
While she paid $65 for an hour with the doctor
("and an hour is actually only 50 minutes"), she
paid $27.50 for a 1 1/2-hour group session ("more)
time for less money").
Because of limited tiime, group members
were required to register if they wanted to talk
during a session. If they did not register, they
could not air their problems even if they
decided during the session that they wanted to.
Group problems
The problems of the group ranged from the
unusual to the pathetic.
The specific problem that the woman con-fronted
the group with was her feelings of
rejection after her husband left.
"You don't think you're worth much any
more," she said.
Her husband, she learned in the group, had
been her entire base of support. .While she
should have used friends and family for sup-port,
she had leaned entirely on him. When he
left, she had no base of support.
The group soon became a support system for
her, she said, and its members were "sort of
built-in friends."
The members exchanged phone numbers and
were encouraged to call each other during the
week if they needed support. Members also
occasionally got together for social outings, she
said.
When members called her for help, she said,
she would drop everything else because she
knew it was important to them.
One benefit she received from the group was
the incentive to lose weight. At first, she said,
she was so depressed that she' didn't care.
However, as she felt better, it became impor-tant
to lose. Her group members told her she
should lose weight.
A group leader drew up a contract with her in
which she agreed to lose a pound a week or pay
$2. "I never did have to pay them any money,"
she said proudly.
Sinking in
Sometimes when she told the group a pro-blem,
they would laugh at her foolishness. "To
them it was so outlandish that it finally began to
sink in to me," she said.
"You'd get mad sometimes, and you say, 'but,
but, but, but," she said. "They (group members)
just beat my head against the wall — telling me
I was all right by myself."
She quit therapy when the group began to
dissolve, but recommends it for anyone. "Do i t
It can't hurt. It is going to help in some way.
"I know that there is supposed to be a stigma
to it, but it didn't bother me," she said. "I
wanted the help so bad I didn't care."
She said she reached the point where she was
proud of it because she was helping herself.
"The big thing," she said, "is that support-system
business."
— JUDY PACE