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Mental health and wellness: Finding the right therapist

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(Editor’s note: this is the first in a series of mental health and wellness columns written by therapists and clinicians from Restorative Health, a mental health clinic located in Bangor.)

An individual came to see me for therapy several weeks ago. They described a long history of anxiety in the form of generalized worry, difficulty with sleep and irritability with nearly everyone in their life- family, friends, co-workers. They finally reached out for help after their spouse and co-workers began to express concern that they “just did not seem happy anymore.” They shared that, although they had been working with a therapist for the past year, it was unclear if it had been helpful. 

In fact, this person had difficulty articulating exactly what they had been working on in therapy at all, saying “We talk. I give them an update on my problems week-to-week, and they make suggestions and provide support to me along the way.”

I have heard similar comments from my clients before and have often worried about the impact of these therapy experiences on their long-term efforts to stay engaged and continue working towards their personal recovery goals - surely after a year of treatment without known benefit it must be difficult to feel as if improvement is possible. I also worry about these experiences in therapy to the extent that they truly misrepresent what therapy is, and how it should work.

The bottom line is that therapy participants are generally better off than those who chose not to attend. However, for the vast majority of therapists in practice nationally, very few rely on an evidence-based practice - one that has been demonstrated to be effective within multiple clinical trials.

What's more, far fewer therapists routinely measure and regularly monitor their client's treatment response using standardized scales to help guide their interventions and to continually engage their clients about what's working and what is not to hasten their treatment response. Instead, many therapists rely on instinct, life experience and intuition to guide their practice and evaluation of their client's treatment response - a practice which has been demonstrated to be often unhelpful and inaccurate. 

Instead, upon first sharing with a therapist about their condition for which they seek help, an individual should expect to receive specific feedback from the therapist about the range of therapies available to treat that condition and their demonstrated effectiveness relative to the individual’s primary concerns. The individual should expect to learn what the treatment will look like, approximately how long it will last and what the primary indications might be to inform whether it is working or not. Additionally, they should expect to learn about the particular therapist and their personal outcomes - how and where did they receive training in their particular practice models and how well do their clients generally respond to treatment and over what period of time.

Restorative Health differentiates itself from traditional therapy by providing both evidence-based treatment, and by continually monitoring client response to treatment. All of our providers, regardless of their training and years of experience, regularly participate in training in Cognitive Behavioral Therapy (CBT) and receive ongoing case supervision to advance their psychotherapy skills. Each provider at Restorative Health is uniquely trained to administer, interpret and discuss with his or her clients the results of our routine clinical outcome monitoring using standardized scales. Such a practice enables us to quickly identify whether our practice with each individual is yielding results, or if we need to modify our work to improve, and very quickly meet their needs. 

(Brent Scobie, PhD, LCSW, is the Senior Director of Clinician Services and Analytics at Acadia Hospital. He also provides clinical oversight for Restorative Health.)

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