“I need help.” These are words that we do not often hear nowadays, even though many people are constantly suffering and would require someone’s assistance. Self-esteem problems, anxiety, constant sadness, the experience of traumatic events that we cannot overcome…
We are talking about people who need psychological help , but who often do not go to it for different reasons or who are not sure whether their problem requires professional help or not.
In this article we will talk about when we need this kind of help and how and where to get it.
Psychological help: how do I know if I need it?
The question of when we need the help of a professional psychologist may seem simple to answer, but the truth is that many people find it very difficult to decide to consult and even consider that their discomfort is not enough to seek professional help.
The truth is that in clinical practice psychologists attend to all kinds of people, with different types of problems . People of any age and condition may consult a psychologist, although within psychology there are different profiles of professionals who are more specialised in certain sectors, such as child and adolescent psychology or psychogeriatrics.
There are many problems that are treated or in which a psychologist can intervene. It is common for people with mood problems, anxiety, emotional and/or self-esteem problems, people with cognitive disorders, obsessive problems (such as OCD) or psychotic problems (such as schizophrenia), post-traumatic stress disorder or those with adaptive problems or difficulties in coping with certain situations to seek professional help.
Sexual dysfunctions and couple problems, lack of communication or the presence of family problems are aspects that can also lead a person to consultation. Other possible affectations can be learning problems, in the achievement of one’s identity, or a high level of work stress. Family counselling or psychoeducation or coping with an illness can also be carried out by a psychologist.
But the above are only examples. In fact, any person who presents some problem that generates a deep psychological suffering (whether we are talking about an identified disorder or not) or difficulties to adapt to the environment around him can seek professional help. It is possible that in some cases we are facing an adaptive process or one derived from a situation that we do not know how to solve or for which we do not feel that we have the resources to solve.
A psychologist is not going to fix, for example, an economic problem or a dismissal, but can help to regain a sense of control and combat beliefs of futility or disadaptive elements that are established in the person’s psyche and that are derived from it.
But you have to keep in mind that a psychologist is not a magician. Many people come to the office hoping for a quick and miraculous remedy . And in most cases, this will not be the case. Moreover, any treatment or intervention carried out will require an effort on the part of the patient/client/user, with the psychologist serving as a guide or promoter that leads them to overcome their problems.
Why so much doubt?
Much of the blame for this is due to the persistence of strong prejudices about the work of psychologists or going to one. Traditionally, and even today, the fact of going to a psychologist has been seen as indicative of a serious mental health problem (until not so long ago we were called “shrinks”), something that is in turn seen as stigmatizing .
Many people are embarrassed by this, while others may be afraid of discovering the presence of serious problems. Others feel a deep sense of reluctance to open up and explain their problems to someone they don’t know, even if that person is a qualified professional. Also, many feel that their condition is not serious or profound enough to require professional help even if they have been suffering for years.
And this can be almost dramatic, since in many cases the postponement of seeking professional help can contribute to lengthening and even chronifying problems that could be solved or reduce the level of affectation they generate much more quickly and efficiently if earlier intervention had been initiated.
Fortunately, with the passage of time, the level of stigmatization that comes with going to a psychologist has been greatly reduced, and even in terms of suffering from some kind of psychological problem (for example, anxiety or depression problems are very common in most of the population). There is a growing awareness of the need for professional help from someone trained in the functioning of the human psyche. In fact, it is technically estimated that one in four people would need some kind of psychological help at some point in their lives.
Psychological help: public or private?
Before going into the discussion of how to seek and find psychological help from a professional in this branch of science, it should be noted that we can find professionals who practice in the public health sector and others who practice in the private sector (there are also those who practice in both).
Both options have advantages and disadvantages. On the one hand, private practice involves an outlay that, depending on the professional, his or her experience, theoretical framework or specialization in a particular subject, may be greater or lesser. Likewise, the large number of private professionals makes it difficult to choose one in particular. On the other hand, it is possible to follow up each case more thoroughly, frequently and effectively, the sessions are longer and generally productive and there are no waiting lists.
With regard to public health, although we are dealing with a mental health service that does not require direct payment by the patient, the limitations of the health system and the little presence of psychologists within this system means that there is usually a certain delay in obtaining a visit, which is often monthly, and that the time taken for each visit is quite limited (meaning that there is less time to deal with the problem in question).
Both systems have high quality professionals who have received intense and exhaustive training over the years, and their situation in the public or private sector is not a determining factor in this regard. In both cases they have the same functions and responsibilities at the legal level, and in all cases they must be registered with the official college of psychologists (otherwise they could not practice in the clinical setting) and be either Psychologists Specialising in Clinical Psychology and/or have a Master’s degree in General Health Psychology.
A different kind of help is offered by other sectors, such as coaching. While they can help to address and cope with some problems of everyday life and promote the implementation of change and strengthening of potential, it should be borne in mind that many coaches are not psychologists and their knowledge and skills can be very limited, not being qualified for the treatment of mental or health problems and disorders.
How do you get to a psychologist?
The process of seeking and finding psychological help from a professional is relatively simple, although it depends to a great extent on whether one is seeking professional help from the public administration or from a private professional.
In the case of seeking psychological help through the private channel, the main difficulty will be to choose a professional from the large number of consultations and psychology institutes that exist. In this sense, to guide us we can make use of different directories of professionals , being that of the Colegio Oficial de Psicólogos one of those that will allow us to find the collegiate professionals.
In order to choose correctly, it would be useful to know the line or theoretical framework used preferably by the professional (although nowadays a great majority is eclectic with regard to the use of the different techniques) in order to choose the one we consider most appropriate, as well as the type of problem or problems it deals with in its clinical practice. It may also be useful to know the prestige of the professional himself or herself (although this does not indicate that it will be useful to us).
Finally, we can also be guided by the opinions of the users regarding the different professionals, although it must be taken into account that each patient may have certain preferences and that there are different branches and ways of acting within psychology. What is good for one patient does not necessarily have to be what is good for another, even if they have the same type of problem, and the feeling and the therapeutic relationship established between patient and professional can vary enormously.
Another aspect to take into account is that if the therapeutic relationship does not flow or after a reasonable time the treatment applied does not bear any fruit (let’s remember that a psychological therapy requires a certain amount of time and the accomplishment of tasks by the user in order to be effective, and its benefits are not always grasped at first), we can change the professional.
Once the professional has been chosen, it will be a matter of arranging a visit with the psychologist in question via telephone or e-mail. At that time we will ask (if not provided directly by us) for a series of data in order to have some information, such as a brief explanation of the general situation, contact details and possibly some demographics. In any case, the first visits are focused on knowing the problem and the situation of the patient, client or user and the evaluation of this, to later enter into an analysis of objectives and a possible treatment plan.
Practice in the public sphere
Making an appointment with a psychologist in the public domain requires first of all that the subject goes to the family doctor, who depending on the situation may refer the subject to psychiatry , and from there to a psychologist. However, unless some persistent and serious problem is detected, in many cases this referral is not made unless the patient in question requires it (partly due to the over-saturation of the service), and this is something to be taken into account.
Thus, the patient usually passes first through the CAP (Primary Care Center), from where he or she may be referred to different services depending on the problem detected. In the case of mental disorders, the subject is referred to a Mental Health Centre (CSMA in the case of adults or CSMIJ in the child and adolescent population). A large number of cases only receive treatment in these devices, although in emergencies or acute phases of some disorders a stay in other devices may be required.
In the case of an urgent case, such as a psychotic break or a subject in a manic state in an acute phase, he can be referred to the Psychiatric Emergency Department (where we can find detoxification units or UHD, dual pathology, eating problems, gambling addiction, intellectual disability and mental disorder or UHEDI). In the event of a case of addiction to any substance, the referral would be made to a Centre for Attention and Monitoring of Drug Dependencies or CAS.
The subject will be in an Acute Unit for the first three or four weeks in order to stabilize him. After the stabilization of the patient or in case a temporary internment is needed until the patient is completely stable, the subject may be sent to a Sub-Acute Unit for a period of about three months. If necessary, the subject may be sent to a Mid-Stay Unit for about half a year, or to a MILLE Unit in the case of a long stay.
In addition, different temporary residential facilities can be used, such as day hospitals , therapeutic communities or community rehabilitation services. There are also permanent ones, such as supervised flats and residential homes. In conclusion, there are multiple services to which a person can turn if necessary, and there are alternatives for treating various needs.